All children, especially those who suffer from anxiety, need regular amounts of quality sleep in order to function normally. Lack of sleep in children can produce irritability, increase anxiety, result in poor grades in school and lead to depression. Children and teens need more sleep than most of them get for proper growth and development. According to Psychology Today, adolescents require 9 hours or more of sleep each night, children 10 to 12 hours depending on their ages with naps recommended for the youngest children to add sleep in a 24 hour period. Children who don’t get enough rest are often cranky and complain of conditions like headaches and stomach aches. Studies show that children who slept less than 9 hours per day were 3 to 5 times more likely to develop behavior problems, attention problems and other psychological illnesses. Children who already suffer from anxiety will see their symptoms increase without the proper amount of sleep. Parents who have children with anxiety need to take a proactive approach to making sure their kids are getting the right amount of quality sleep. Establishing routines and developing other good habits can help.
Establishing and maintaining a bedtime routine is one of the most important things you can do for any child, but especially one with anxiety. According to the Anxiety Disorders Association of America sleep deprivation can exacerbate anxiety symptoms, but sleep disorders may also actually be the cause of anxiety. Psychologist Marie Hartwell-Walker, Ed.D. says, “Establishing and maintaining a bedtime routine is worth the struggle. There is so much good learning that can go on during the hour before lights out that it really shouldn’t be missed.” Bedtime routines help relieve worry in the child with anxiety because they know exactly what to expect each evening. Of course there will always be days when the bedtime routine gets interrupted, but keeping a consistent schedule for the majority of the week is the goal. Try these bedtime rituals to help your child go to sleep more easily:
- Turn off all electronic devices one hour before bedtime. Over stimulation from computers, phones and even television can inhibit sleep.
- Give your child a warm bath at night before bed. Once the electronic devices are off, he or she will enjoy playing or relaxing in the tub for 15 minutes or so.
- Get into pajamas after the bath and then brush teeth, comb hair and use the restroom. Do not offer multiple choices in toothbrushes, toothpaste or mouthwash. Having to make choices while relaxing for bed can increase anxiety.
- Choose a book to read as a bedtime story. Limit the choice between books by offering only two or three suggestions. Read only one story or at the most two depending on the length of the book. Keep story time to around 15 minutes.
- Have your child get comfortable on his or her bed or in a favorite chair with you to read the story. Then spend a few minutes talking about the day or saying bedtime prayers if that is a part of your household.
- Give hugs and kisses and turn out the light. Use a nightlight if your child is afraid of the darkness and make sure he or she has a favorite toy to sleep with.
After a few nights of your new routine, your child will begin to settle down and get ready for sleep more easily than before. If your child resists at first, just keep trying and be consistent.
Exercise and Activity
Physical activity is important for your child’s overall health and wellbeing, but it is also a very important part of getting quality sleep. A child who is sedentary most of the day will not fall asleep as easily as one who is physically active. Planning times for exercise and other physical activity will not only relieve anxiety in your child and help him or her relax, it will also make him ready for sleep when the time comes. Just make sure any activity ends well before your bedtime routine and you will begin to see your child more willing to go to sleep. Consider these activities for some great after-school exercise:
- Join an after-school sports team. Make sure that it is a sport your child enjoys, is something he is interested in and that it does not add more anxiety by being too time consuming.
- Go for a walk or bike ride after homework and before dinner.
- Invite friends over to play in the backyard after dinner.
- Go to the park and enjoy the playground.
- Take a dance class but be sure the schedule and requirements are not too overwhelming.
The goal of physical activity for children with anxiety is to improve their overall health and help them to sleep better. Adding too many activities may increase anxiety due to increased pressure to perform in both school and sports. Make sure all activity is done at least two hours before your bedtime routine so your child has plenty of time to relax.
Guided Meditation and Visualization
A great way to promote relaxation and help prepare your child for sleep is through guided meditation and visualization. Guided meditation and visualization uses mental images from nature to help a person calm down and relax. Guided visualization also uses music to sooth the senses and promote feelings of peacefulness. Practicing guided meditation and visualization with your child will help him or her learn to channel anxiety in positive ways. Doing some guided meditation and visualization as part of your bedtime routine promotes relaxation, calms the senses, promotes quality sleep and reduces nighttime wakefulness.
Promoting Sleep with Dietary Changes
Certain foods can inhibit sleep while others can promote it. Understanding the relationship between sleep problems and food can help you make better pre-bedtime choices for your children. Children who suffer from anxiety may have heightened sensitivity to certain foods which makes planning meals throughout the day even more important. The National Sleep Foundation calls making food choices to promote better sleep a part of an individual’s sleep hygiene. Like other areas of personal hygiene, good sleep hygiene can improve one’s ability to fall asleep and stay asleep throughout the night. The National Sleep Foundation offers the following dietary recommendations:
- Do not eat right before bed. Large meals can be especially problematic as feeling full can be uncomfortable.
- Limit caffeine in beverages as well as food. If your child is having trouble sleeping eliminating all caffeine is a good idea.
- Limit sugary snacks and beverages throughout the day but especially at bedtime. Too much sugar can cause excess energy.
To help promote sleep have your child try a cup of warm milk with a sprinkle of nutmeg before bed. Nutmeg contains a compound called myristicin that encourages the production of serotonin in the brain and helps with relaxation. If you have a child who struggles with bed wetting, try the drink with dinner so there’s no liquid consumed right before bed.
Electronics and Sleep
With so much technology available, children often spend more hours than we realize with electronics. The American Academy of Pediatrics recommends that children under the age of two watch no television at all, and those over the age of two should limit time in front of the TV to one to two hours a day of high quality programming. Prior to the age of two, the brain is developing rapidly, and time spent in front of the television or computer replaces creative play, exploring and interacting with others which is vital to healthy growth and development in children.
Children with anxiety and sleep issues need less time interacting with electronic devices and more time in true relaxation prior to going to bed. Many recent studies, including those at Osaka University in Japan and the Lighting Research Center at Rensselaer Polytechnic Institute in New York, show that video games and other electronics cause the sleep hormone melatonin to drop and can produce the “fight or flight” syndrome in children. This puts the mind and body in a state of stress and can elevate both blood pressure and pulse. Along with this, Dr. Victoria L. Dunckley, M.D. says in Psychology Today that there are two other ways electronics affect your child’s ability to sleep:
- Unnatural brightness of the screen. Melatonin is released by darkness and inhibited by light. When the eyes experience intense brightness, they channel that bright light directly to the brain, shutting down the sleep switch. Sleep/wake cycles, or circadian rhythms, are also disrupted. Studies show that deregulated circadian rhythms causes mood, concentration and hormonal dysfunction
- Electromagnetic radiation (EMR), a by-product of electronics. Monitors, anything wireless, and internet use compound the level of EMR, making handheld video games particularly toxic. Like bright light, EMR disrupts melatonin release. (It also exacerbates the fight-or-flight state)
Turning off all electronics at least one hour before bedtime will help encourage your child’s natural sleep-inducing mechanisms to work properly. Consider limiting use of electronics throughout the day as well to decrease stress in children with anxiety.
Sleep and Environment
Along with establishing a bed-time routine, creating an environment that is conducive to sleep is also important. Children who suffer from anxiety need organized spaces without being over-stimulated. Too many posters and other decorations can become a distraction. Bright colors can cause excitement rather than relaxation. Too many toys and stuffed animals at an arm’s reach from the bed may create too much temptation to play while trying to go to sleep. Use these tips to create an environment that is calming to help your child go to sleep and stay asleep:
- Choose room colors that are soothing like greens and blues.
- Wash and dry bed linens and blankets in lavender-scented laundry detergent or dryer sheets. Lavender increases relaxation.
- Keep clutter to a minimum, and make sure toys are put away before bedtime.
- Use white noise like a fan or white noise machine to block out noise from other parts of the house.
- Use a night light if your child is anxious about the dark, but make sure it is not too bright.
- Use your child’s bed for sleep and napping only and not a place for time out. This helps him or her associate going to bed as a pleasant thing rather than as a punishment.
Doing these few simple things can help create a soothing environment for your child and encourage better-quality sleep.
A Time to Relax
Getting more sleep for your child may mean he or she needs to go to bed earlier. It is also important to look at your family schedule and find ways to make more time for sleep by eliminating some activities. Busy schedules can make getting to bed on time almost impossible. Helping your child get to sleep, especially if he or she has anxiety, can be a challenge. Making bedtime a time to look forward to is the best way to encourage quality sleep. Reading stories, talking quietly about the day, singing quiet songs together or any other soothing activity your child enjoys can help. Talking to other parents about what they do at bedtime is also a great way to get new ideas. Getting advice from parents who have experience or are trying to accomplish the same goal helps you know you are not alone.
Children who suffer from anxiety may struggle more with falling asleep and staying asleep than other children and talking to your pediatrician or therapist is a great place to begin looking for answers. Your child’s pediatrician can look for and diagnose any medical condition that may be contributing to the sleep issue. Therapists can help you and your child understand why falling asleep is an issue and give you tools to use that may help. Both children and adults can benefit from getting enough quality sleep. Living a balanced life of work, play and rest promotes better health and an overall sense of well-being in your child. We all need quality sleep to refresh our minds and repair out bodies. Helping your child by modeling good sleep behaviors will benefit everyone in the family and create a more peaceful and relaxed environment in your home.