Q: I was wondering if you could offer any advice with regard to our seven-year-old son and his sleep pattern. Over a month ago he learned of a break-in to a classmate’s house at night. He has since developed a fear of being left alone in his room and insists that we stay with him at night until he goes asleep with lights left on on the landing .
This invariably leads to him coming in to us in the middle of the night and refusing to sleep in his own bed. What normally happens is that we end up moving in to his bed and everyone gets a poor night’s sleep. Any suggestions you have would be most welcome.
A: Triggered by fears related to his classmate’s break-in, it sounds like your son is experiencing separation anxiety, particularly at night when he ready for sleep. In bed alone at night can be a particularly hard time for anxious children as they can ruminate about worries and daily stresses.
Such anxiety can make it harder for them to sleep, which in turn can cause them to worry more and it can become a vicious cycle. Indeed, children who find it hard to sleep can worry about the fact that they are not sleeping, which only adds to the problem.
As a result, it is understandable for children to seek out their parents when they are worried and usually their presence helps them relax and get back to sleep.
Of course, parents should respond warmly to these requests in the short term. However, the problem is that, if it becomes a habit, the child can lose the ability to fall asleep by themselves and become dependent on their parents to help them to drop off.
As in your case, this means that when your son goes through a period of light sleep or wakes up at night (a very normal occurrence), rather than going back to sleep quickly, he will immediately seek you out and go into your bed to get back to sleep. As you have discovered, this can invariably lead to bed hopping and a poor night’s sleep for everyone.
Managing anxiety/ encouraging good sleeping patterns
So, how can you break this pattern and how can you do it in a way that encourages your son to manage his anxiety? Generally, it is not best to tackle this during the night waking when everyone is tired and likely to be fractious (as getting frustrated with your child is likely to make him feel rejected and even more anxious).
Instead, the key is to change the bedtime routine. You want to gradually help your son re-learn how to relax himself and to get to sleep by himself. Below are some steps:
Establish a relaxing bedtime routine
Set up a bedtime routine that starts early and includes a wind-down period. For example, this might include:
1. Playtime
2. Supper time
3. A night-time chat
4. Teeth-washing/ pyjamas
5. Story time
Included in this routine should be a “worry” or “talking” time when you give your son space and time to express his worries and to chat about what is on his mind. During this time, be a good listener, and encourage your son to express his thoughts and feelings.
At the end, you can be reassuring about what he is worried about ( “all is fine” or “you are safe in this house ”, and so on ) and then concentrate on relaxation and winding down.
Help him fall asleep by himself
Break the pattern of staying with him as he falls asleep. Do this gradually at his pace. For example, you might say that rather than lying on his bed, you will sit in a chair in his room and when he is successful at this, the next night you then sit outside on the landing .
Don’t talk at these times (as talking time is over and could distract him from sleeping) and instead do something relaxing or productive for yourself ( such as reading).
Alternatively, you can break the pattern by returning to check on him periodically. Leave him alone to fall asleep, but agree that you will return to him in five minutes but only if he is lying quietly in his bed trying to sleep. As he gets used to the fact that you will return, you can extend the time you leave him for.
The key to making this method work is to make sure you return to him before he gets agitated or gets out of bed to look for you. He quickly becomes reassured by the fact that you will return and that you are close by and this helps him sleep.
Coach your son in relaxation strategies
Coach your son in relaxation strategies that he can use to help himself. You can teach him how to relax by being attentive or mindful of his breathing or by systematically going though each part of his body, taking time to first tense and then relax the muscles.
Alternatively, you can help think of a happy event that happened in the day or to imagine in detail a safe place he likes to go to. Often it is best to do these relaxation strategies together and to make them part of the bedtime routine.
As a therapist, one of things I like most about working with anxious children is that they usually are very co-operative and frequently they have great imaginations. Unfortunately, their imaginations are employed against themselves to visuali se negative and worrying events.
The goal is to help them turn this round and to use their imagination to visuali se positive outcomes, happy events, and the things they are grateful for in their lives.
Finally, if the problem does not improve over time, do seek the support of a mental health professional in your local primary care centre.
Dr. John Sharry, Irish Times Newspaper, February 2014. John writes in The Irish Times Health+Family every Tuesday.