|Sleep problems at this age usually involve having a late sleep phase. School age children will sometimes stay up very late on the weekends and then sleep in the next day, sometimes until noon. This carries over into the school week and can causes difficulty falling asleep at a proper time on school nights. One way to prevent this is to encourage a routine of falling asleep and waking up at about the same time each day.
As treatment of a late sleep phase, it is sometimes necessary to allow your child to stay up until the time that she commonly falls asleep and insisting on a regular morning wake up time to get ready for school. After a few weeks, you can gradually (10-15 minutes a week) make the time that she goes to sleep a little earlier, so that you can move her to a more regular sleep cycle.
Like adults, children have dreams when they are in REM sleep. This occurs 4-5 times each night, and while most dreams aren't remembered, some are frightening enough to wake the child and make them summon their parents. Nightmares usually begin when a child is about three years old, they are most common between the ages of three and eight (when their fantasy life is more active) and they are most likely to occur later in the night. Unlike night terrors, your child will be wide awake and responsive after the nightmare and she may be able to recall the details of the nightmare the next morning.
While an occasional nightmare is normal, an increase in the number of nightmares can be a response to stress or your child being anxious about something. Other triggers can be a change in her normal routine, like moving, starting a new school, or a death in the family. Or the nightmares may be a response to a violent or scary movie, television show or story.
When your child has an occasional nightmare, you should reassure her that it was just a dream and isn't real. Give her lots of hugs and be supportive. You may need to search her room with her to reassure her that their aren't any monsters or whatever the nightmare was about. It is probably best to wait until the next morning to really talk about the details of the dream, at which time she should be calmer. And try to figure out if there was a specific event or stressor that may have triggered the nightmares. Did she see a television show or movie or read a story in which this may have occurred? Have you recently moved or had another big change in your home situation? Is she on any new medications that may be affecting her sleep?
Tips to decrease nightmares include:
- Decreasing stress in her life.
- Avoid television at least an hour before bedtime.
- Avoid telling her scary bedtime stories.
- Let her sleep with a night light.
- Talk about the nightmare the next day. Suggest that she draw a picture of the dream to help her talk about it.
While an occasional nightmare is normal, you should seek professional help if the nightmares are also associated with changes in her daytime personality or behavior. If she is under a lot of stress or seems very anxious and the nightmares are increasing, then she may need professional counseling. Otherwise, with a lot of reassurance, she should outgrow them.
Night terrors are more frightening for parents, but can also be normal. They usually occur a few hours after your child has gone to sleep, at which time you may wake up to your child's crying or screaming. When you go to him, he will NOT be alert and won't recognize you, even though he may seem like he is awake. He will usually seem like he is terrified and may have a rapid heart beat and rapid breathing. Night terrors occur as your child moves through different stages of sleep and they represent a partial awakening. Since your child isn't really awake, there is nothing that you can do to reassure him. You should see that he is safe and do not try to wake him up. He will usually settle himself down after a few minutes.
Sleepwalking is similar to night terrors, in that they represent a partial awakening. They also occur a few hours after your child goes to sleep. Although your child may be walking around the house, he is not awake and isn't aware of what he is doing. It is not necessary to wake a child up that is sleepwalking. Instead, you should just make sure that he can't hurt himself and maybe return him to bed. If sleepwalking occurs often and you are worried about your child's safety, you can try and wake him up yourself, before the time that he typically wakes up. This treatment can disrupt the cycle and decrease his sleepwalking.
Some children grind or clench their teeth while sleeping. This is called bruxism and is usually not a concern, unless it is leading to damage of his teeth. Children with bruxism should be evaluated by a pediatric dentist, who may recommend a plastic mouth guard to prevent damage.
Also see the article Bedtime Problems for more information and help getting your child to sleep through the night.