Sleep Anxiety in Children: Expert Guide
Have you ever found yourself struggling to get off to sleep, only to realise that you have been churning around worried thoughts in your head for the last 30 minutes?
Sleep anxiety in children can be just like this too.
Night time anxiety can also become a vicious cycle. Sleep is needed to help alleviate anxiety.
The nervous system needs sleep to recover from the day.
But if anxiety is present at bedtime, this much-needed sleep can be disrupted.
In this article we’ll look at the symptoms and causes of sleep anxiety in children and teenagers.
Then we’ll look at how to resolve it.
Causes of Sleep Anxiety in Children
Night time anxiety can be a response to a stressful event but it is also common generally in children who are sensitive. It may be exacerbated by events such as:
- Starting something new (such as a new school year)
- Friendship problems
- Family illness or bereavement
Sometimes long-term night time anxiety can be worsened by a child’s fear that something might happen or change during the period they are asleep.
Child Sleep Anxiety Symptoms
Sleep anxiety in children can look like one or more of the following:
1. Expressing many worries or fears just before bedtime
2. Angry outbursts or arguing
3. Crying
4. Defiant behaviour or language
6. Procrastination (avoiding going to bed)
7. Gripping on and not letting go of you
8. Ignoring you and your instructions for getting ready for bed (avoidance)
This behaviour is telling you something, so be sure to be curious.
Often, the anxiety your child is feeling is because they will be separating (albeit temporarily) from their ‘safe base’ ….you.
Kids’ Sleep Anxiety: Fear in Different Forms
Some of your child’s night time anxiety may feel irrational and overblown.
But it’s important to remember that your child’s fears are all real for them.
Look at some of the common root causes of child sleep anxiety below. Which ones apply to your child?
Separation Anxiety
An anxious child is grappling with the messages its anxious brain is sending them.
“If I go to sleep, Mummy might not be there when I wake up”, or “I’m frightened of being alone”.
They may struggle to settle in their own room and want to come in with you.
Separation anxiety may not be obvious.
For example, if a child experiences a traumatic life event such as or illness of a loved one, they may feel the need to suppress this pain and worry and instead focus their worry on something else such as a monster.
This is a sign that they need soothing and holding. More on that later.
Fear of the Dark
Darkness can be scary for children as they can’t see around them.
Children often have vivid imaginations and this “blank slate” can lead them to imagine many scary or dangerous things. They can feel vulnerable and this will often cause them to be hypervigilant.
Anxious kids who are scared of the dark will be on full alert leading to the fight or flight response.
This doesn’t help with relaxing into sleep. In fact, it’s the opposite of what is needed for sleep.
A Fear of Monsters
Its proper term is Teraphobia. It’s an irrational fear which is common in pre-school children.
We know there aren’t any monsters, but if you ask your child to draw a picture of the monster, this might provide some clues to a trigger.
It may be simply that they’ve seen a monster on TV and they imagine it in their world.
Night Terrors
Lots of sensitive children with vivid imaginations have night terrors that they grow out of in time. Night terrors and nightmares are different from bad dreams, and happen at different stages of sleep.
A night terror often makes your child talk in their sleep or thrash around and they usually don’t remember having it.
Sometimes, if a child is running a fever, night terrors will be more likely to occur, so make sure to check on this.
Generalised Anxiety and Worry at Bedtime
Children with sleep anxiety tend to be worriers.
Multiple worries might be swirling around their minds during this quiet and reflective time. It can feel overwhelming and very scary.
Your child might not be able to state that they feel anxious. They may simply seem unsettled or agitated.
Solutions to Sleep Anxiety in Children
With anxiety, might come difficult behaviour.
It’s important to recognise that your child is not trying to be difficult or naughty.
They are experiencing something that is making them feel unsafe or scared.
1. Emotional Safety and Security
The first step is to establish what is causing the anxiety or worry.
Perhaps you can identify it from the list above?
Finding out the cause will help with the next step of relieving it. Talk to your child in a calm and empathic way.
Try using drawings or getting them to write things down. Our children’s sleep tracker will also help you.
Does your child feel safe in their bed?
A child needs a safe place to sleep, so if bedtime anxiety is present, start with finding out how they feel about their sleep space and go from there.
If they don’t feel safe, what are the barriers to feeling safe? Are there small things you could tweak that would change how your child feels about their bed?
Shift the focus from separation to connection.
What will happen next time you see them (read a morning story, make breakfast together).
Give something of yours to them and vice versa. This is known as a transitional object and helps your child understand that you will be together again soon. For example, a soft toy, pillow or item of your clothing.
Validate their feelings. Acknowledge that they feel worried or scared, but they are actually safe.
Set gentle but clear boundaries and expectations. Bedtime is for sleeping and rest.
2. Worry Box or Worry Journal
A worry box or worry journal are simple but effective tools that can help children overcome nighttime anxiety. They help children to identify, process, and manage their worries.
This helps them get a better night’s sleep in terms of both quantity and quality.
A worry box is a physical container where children can write down their worries on slips of paper and “put them away” for the night. You could use a shoe box with a lid. Cut a little slit in the lid where your child can post little slips of paper.
Worry boxes help children externalize their worries and gives them a sense of control over their thoughts, making it easier to fall asleep.
A worry journal is similar to a worry box but instead of physically putting the worries away, the child writes them down or draws them in a journal before bed. This can serve as a form of self-reflection and encourages children to think about the solutions to their worries.
Writing in a journal can also provide a sense of closure, as the child can see their worries on paper and spot that they have taken steps to address them.
It’s important to emphasize that the worry box or worry journal is not a solution to your child’s worries, but a tool to help them process or problem-solve their thoughts and feelings. Encourage your child to use the worry box or journal every night and to talk their worries through.
3. Gradual Withdrawal For Sleep Anxiety in Children
Perhaps at the moment you are staying in the room until your child falls asleep?
Gradual withdrawal is a technique that can be very helpful for children who are anxious about going to sleep.
It’s a gentle, gradual process of reducing the amount of time spent in the child’s bedroom. It allows them to gradually develop a sense of independence and control.
The goal of gradual withdrawal is to help children become more confident and secure in their ability to fall asleep and stay asleep on their own.
- If you currently stay in the room with your child until they fall asleep, start by sitting in a chair by the bed, then moving the chair closer to the door each night until eventually you are out of the room.
- After this, you may need to sit outside the room for a period each night, moving further away over time.
- Eventually, you want to get to the point where you can get on with your evening as normal but it’s agreed that you will check in with your child regularly. This may be every 15 minutes to start with, but the time can gradually increase.
It stops your child from feeling they have to regularly get up and come downstairs to find you. Therefore, they are likely to settle more quickly.
Gradual withdrawal can take time and patience, but the results can be well worth the effort.
4. The Importance of a Bedtime Routine
As a counsellor, I often hear how much the lack of a bedtime routine (or disrupted routines) adds to general anxiety, stress and worry.
We know that getting enough sleep is vital for physical and mental health, so developing good sleep habits is crucial.
Your child’s needs may differ from others’, so it’s important to work out what they need, rather than following a formula because someone told you to.
Talk to your child about the importance of a bedtime routine and plan this together.
Here’s what I recommend when establishing a bedtime routine to avoid or reduce sleep anxiety in your child.
Set a regular time for bed
Routines help us feel safe.
You may need to consider fitting in after school activities, eating a meal, homework and down-time.
Place the same importance on the activity of sleep as you do on other activities.
Bedtime stories
A great way to connect and have calming, quiet time with younger kids is to read bedtime stories together or listen to an audio book.
Have a look at these 20 reassuring stories about night time fears for young children.
Here are some more recommended books for night time anxiety in children:
A Bedtime Yarn written by Nicola Winstanley and illustrated by Olivia Chin Mueller, Tundra Books
Goodnight, You written and illustrated by Geneviève Côté, Kids Can Press.
Splat the Cat Dreams Big written by Rob Scotton and Annie Auerbach and illustrated by Loryn Brantz, HarperCollins
Reduce Screen Time
Avoid using screens and other devices for at least 1 hour before bedtime.
The blue light from our mobile phone and other devices can affect our ability to get off to sleep.
Read more about the importance of sleep for especially for older kids in our article about sleep problems in teenagers and pre-teens.
Use Relaxation Techniques
Winding down before bed will help the transition to sleep.
It gives cues to the body and brain that it’s time to sleep. This leads the brain to release the sleep hormone, melatonin.
Try some yoga or meditation with your child, or listen to calm music or a calming app.
I recommend a book called Still Quiet Place by Dr Amy Saltzman for younger children. There is also a website with great resources including mindfulness practise videos.
Try Deep Breathing Together
Deep breathing can be a great stress and anxiety buster for night time anxiety in children and something the whole family can practice.
Breathing exercises may also improve the body’s production of melatonin, an important sleep hormone.
I’ve listed some great apps at the end of the article.
Dim the Lights
Pre-dim the lights in your child’s bedroom so the space is calming and soothing as they enter.
Ensure that the colours in their bedroom are calming, and ensure any music or noises are soft and quiet.
These will all give “sleep cues” to your child’s brain, helping it to make the connection between the bedroom and sleep.
If you want to deepen your understanding about anxiety so you feel clear on exactly which steps will help for your child, consider our mini-course, Knowledge is Power!
Night Time Anxiety in Children: Coping With Setbacks
Sleep disturbances can happen and many will be temporary.
However, if they become frequent and appear to be building it’s time to try and nip it in the bud.
Child Anxiety at Bedtime: Practical Tips For Managing Setbacks
1. Take small steps. Don’t try to make a big change all at once, small steps will help to build confidence and a feeling a safety for your child.
2. If your child wakes up in the middle of the night, you should:
- Try to avoid putting on lights.
- Use a lowered and calm voice.
- Offer soothing and reassurance.
- Set boundaries from the start. For example: ‘Let’s hug for a couple of minutes, then I’ll tuck you in again and go back to my own bed.’
3. Talk about dreams. The brain dreams in pictures. Harvard researchers have found that the content of a dream can be changed by talking about a ‘feared’ dream just before bedtime. You can talk about what happened the next night.
4. Be patient. Of course this is easier said than done, especially if you are also tired and getting disturbed sleep. If you are calm and reassuring when your child is anxious, they will tune into that and build their own confidence from yours.
If your child wants you to stay with them while they fall asleep, help build their confidence by usinging a gradual withdrawal programme (see above).
Gradual withdrawal is suitable for children of all ages.
TAKE THE QUIZ!
Bedtime Reward Systems: Pros and Cons
Do reward systems lead to long-term changes in behaviour and help develop the ability to manage night time anxiety in children?
They must be used very carefully.
For example, a child may try to stay in their own bed because they desperately want to earn the reward, but they may feel highly anxious. This is not genuine progress and will only lead to further setbacks.
Having said this, carefully individualised reward systems can be a great incentive for children to work towards a sleep goal.
| Pros of Bedtime Reward Systems | Cons of Bedtime Reward Systems |
| Encourages positive behaviour (e.g. going up to bed at the set time, making sure school bags and PE kit are ready the night before). | Unachieved goals can lead a child to feel like they have failed. |
| Discourages challenging behaviour such as shouting, defiance and procrastinating. | Added pressure can sometimes lead to further sleep anxiety. |
| Can help your child to stay positive and motivated to achieve bedtime goals. | Children can feel demotivated if they don’t earn a reward. |
| Tracks progress. | Emotional problems may feel magnified by the need for a reward chart |
| Reward charts often reap fast results, but these may be temporary. | |
| Rewards are extrinsic motivation rather than intrinsic motivation. The reward is driven by the promise of a sticker or other treats rather than learning behave a certain way because it’s best for them. |
Specific Tools For Children’s Night Time Anxiety
Here are some simple ideas that can help children when they are having a hard time getting to or staying asleep.
o Security Object. Let your child have a security object such as a stuffed animal or blanket. It can help to substitute the lack of tactile connection once the parent has left the room in order for them to sleep.
o Night light. The general rule is the darker a child’s bedroom is the better. This is because light is stimulating to the brain and tells the body that it is daytime. However, night lights can be helpful relaxation tools if your child is afraid of the dark, and they come in calming colours and designs.
o Calming jars. Calming jars, sensory bottles or glitter globes can be home made. They’re a simple way to help children settle and soothe their minds.
o Meditation apps. These are great for calming the whole system and getting the body into a relaxed state ready for sleep. See the section below for some app ideas.
o Worry monsters. Get your child to write or draw their worries on a piece of paper and place in the mouth of the worry monster. The monster looks after the worries so that your child can put them out of their minds while they sleep. You can look at the worries at a designated time in the day and talk about them together.
Bedtime Anxiety in Ten Year Olds Plus
We tend to think that night time anxiety in children is only a problem for little ones.
If our older child is anxious at bedtime, we might assume this is unusual or there’s something seriously wrong.
In fact, eight, nine and ten year olds (and beyond) are developing an understanding about real world issues and mortality that younger children didn’t have. Therefore they are more likely to experienced excessive worries, especially at bedtime.
It’s common for ten year olds to experience night time anxiety.
So should we respond differently to bedtime anxiety in ten year olds, eleven year olds and twelve year olds, compared to younger kids?
Well, yes and no.
You do need to make them feel safe, in the same way you did when they were tiny. But you can adapt this and make it age appropriate.
Let’s take a look at a case study.
Bedtime Anxiety in Ten Year Old Casey
Casey, a bright 10-year-old, loved her days but dreaded night time. Every night, she worried that something bad might happen to her or her family. She had vivid images of someone coming into their home and harming them all.
These thoughts made it hard for her to sleep, and she often woke up scared or wanted to be close to her parents. She would end up in their bed and her sleep patterns were generally disturbed.
To help her overcome her night time anxiety, Casey’s parents tried some specific strategies:
1. Winding Down: They set up a calm hour before bedtime. This included having a warm shower and listening to an audiobook. It helped Casey relax and get ready for sleep.
2. Calm Music: They played gentle music at bedtime. The soft tunes made Casey feel calm and safe, drowning out other sounds that might scare her.
3. Deep Breathing: If Casey felt really scared, her parents taught her to take slow, deep breaths. This helped her calm down and feel better, especially if she woke up scared in the middle of the night.
4. Soothing and Reassurance: Whenever Casey was frightened, her parents would speak softly to her, telling her they were there and everything was okay. They would sometimes pat her back or stroke her hair to soothe her.
5. Nurturing Yet Firm Boundaries: Even though they wanted to comfort Casey, her parents also felt it was important for her to sleep in her own bed to get a better night’s sleep.
If Casey came to them at night, they would say, “Let’s have a quick hug, and then I’ll help you get back to your bed.”
This way, Casey felt loved and comforted but also learned to sleep on her own.
With these steps and a lot of patience, Casey started to feel safer at night. She began to sleep more soundly and the nights became easier for the whole family.
Apps to Help Older Children With Sleep and Relaxation
Further Help For Sleep Anxiety in Children
Night time anxiety in children can quickly build into a vicious cycle of sleep problems.
Your child may have not only the initial worry, but subsequently worry about not getting to sleep.
If left unchecked, sleep deprivation can lead to both physical and mental ill health.
If you are struggling to tackle this alone, the good news is that there is professional help available.
Firstly, see your doctor or healthcare provider for recommendations or a referral to a Sleep Therapist, Counsellor or Psychologist.
CBT (cognitive behavioural therapy) focuses on unhelpful behaviours and thinking patterns.
Together, the therapist and child identify these patterns and work out ways to gently challenge and change them aiming towards a good night’s sleep.
Take a look at Dr Lucy Russell’s ‘Sleep for Success’ online parent course.
Night Time Anxiety in Children: Summary
As a parent you want your child to have calm and restorative sleep.
You also need some down time and you deserve to have a relaxing evening.
Remember the small steps and wins and build on good sleep routines and foundations.
Your child will gradually build up the knowledge that they are safe, secure and loved.
Related Articles
Evening Routines for Positive Teen Mental Health
What to Do When Your Child is Having Anxiety About Death
Separation Anxiety in Teenagers: 8 Clear Steps for Parents
How to Deal With Anxious Attachment
Hayley Vaughan-Smith is a Person-Centred Counsellor accredited by the National Counselling & Psychotherapy Society. She is the founder and counsellor at The Ridge Practice in Buckinghamshire, and counsellor at Everlief Child Psychology.
Hayley has a special interest in bereavement counselling and worked as a bereavement volunteer with Cruse Bereavement Care for four years.
Hayley is mum to 3 grown up girls, and gardening and walking in nature is her own personal therapy. Hayley believes being in nature, whatever the weather, is incredibly beneficial for mental health well-being.
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