Mental Health

Sleep Strategies for the Anxious Child

A good night’s sleep is critical for your child’s well-being. It affects physical growth, cognitive development, emotional regulation, and much more.

While  we know how important sleep is, getting our kids to bed can be a struggle, especially if they’re prone to separation anxiety at bedtime.

Here, we explain how to establish healthy childhood sleep habits and help kids sleep despite the challenges that arise. Because it’s not just your child who needs sleep — you do, too.  So, if you’re struggling to get a solid night’s sleep, it’s worth taking the time and energy to establish good sleep routines for everyone. 

How to Help Kids Sleep

  1. Set up a restful sleep environment.

    Your child’s sleep environment should promote restful sleep. This means the room should be dark, quiet, and at a comfortable temperature. Depending on your child’s sensitivities, you may need to add blackout shades, a night light, and/or a sound machine.

    This step is particularly important for kids with sensory processing disorders. Consider her specific needs: Are her pajamas and sheets comfortable? Does she need less noise or light in order to fall asleep? Would she benefit from a weighted blanket?

    Invite your child to problem-solve with you to make bedtime comfortable for both of you.

  2. Avoid screen time before bedtime.

    It’s best to avoid screens close to bedtime, because blue light can disrupt sleep patterns. Establishing this habit early on will also help your child maintain healthy sleep patterns as she grows.

  3. Develop consistent bedtime rituals.

    A calming bedtime routine helps infants and toddlers understand that it’s time to wind down. While the routine doesn’t need to be long, it should be consistent, occurring around the same time every night. The fewer unknowns there are, the better; predictability will help soothe your child’s separation anxiety at bedtime.

    A sample bedtime routine might look like this: bathtime, pajamas, bedtime story or song, Shema, and lights out.

Many children — especially those with special needs or autism  — can benefit from visual schedules. A visual bedtime schedule with pictures of each step can help cultivate a sense of safety and predictability, lessening sleep anxiety in children. You can even make it into a game by creating a chart and allowing your child to check off each step completed in the bedtime routine.

Addressing Common Sleep Challenges

Despite your best efforts, sleep challenges may still arise. Here’s how to address some common issues and help kids sleep. 

  • Frequent night wakings

    When your baby is still little, she may need regular feedings throughout the night. (Consult with your pediatrician to determine an appropriate feeding schedule.) During this stage, minimize stimulation during nighttime feedings: keep lights off, noise low, and diaper changes quick.

    As your baby grows older, she might outgrow the need for middle-of-the-night feedings but still cry out for comfort. There are many approaches to this challenge, and there’s no one-size-fits-all solution.

    Some parents embrace the exhaustion and soothe every tear, while others opt for some form of sleep training to help kids sleep through the night. It’s important to know that there are many solutions available, so find one that aligns with your parenting values and give it a try.

  • Inability to fall asleep

    Children often have difficulty falling asleep, and there are countless reasons why this happens. However, if your baby or toddler consistently stays awake past bedtime, you may want to reexamine her sleep and nap schedule. You may need to wake her up earlier, put her to sleep later, or adjust nap times.

  • Bedwetting

    Bedwetting is a common issue among children. It’s not typically caused by laziness or disobedience but by other factors, including genetics, hormones, excessive fluid intake, or stress.

    You can help manage bedwetting by limiting fluids before bedtime, establishing regular bathroom trips, and using waterproof mattress covers. It’s also important to address any emotional stress or significant life changes your child may be going through, as these factors can contribute to bedwetting episodes. Bedwetting is especially common amongst anxious children, as it can return during periods of heightened anxiety or stress. Reassure your child that bedwetting is common and not something to be ashamed of.

    If bedwetting persists beyond the age of 6 or 7, or if your child is distressed by it, consult your pediatrician. They can rule out any underlying medical conditions and provide guidance on effective management strategies.

  • Sleep Anxiety in Children

    For children prone to anxiety, falling asleep can be especially challenging. Common issues that may come up are separation anxiety at bedtime, fear of the dark, and racing thoughts.

    Consider using these tools to help kids sleep: consistent bedtime routines, a nightlight, and stuffed animals with a calming recording of a parent’s voice. If your child continues to struggle with severe separation anxiety at bedtime, explore it with a mental health professional.

  • Nightmares

    Nightmares are vivid and frightening dreams that happen during REM sleep (the deepest phase of sleep), often triggered by stress, anxiety, or exposure to scary stories. If your child has a nightmare, comfort and reassure him. They might find it helpful to tell you about their scary dream so you can alleviate their fears. Following a nightmare, your child will likely need support, like a nightlight or someone to sit with them, in order to fall back asleep.

  • Night terrors

    Night terrors might seem similar to nightmares, but they’re far more intense. Unlike nightmares, which occur during REM sleep, night terrors happen during non-REM sleep. During a night terror, your child may appear partially awake but remain unaware of their surroundings. Typically, children will have no recollection of the event in the morning. Children experiencing night terrors may scream, thrash around, and remain unresponsive to their parent’s attempts to comfort them.

    As a parent, you might feel helpless during these episodes, especially if your child doesn’t acknowledge or respond to your presence. However, you can do a few things to help manage night terrors.

    It’s important not to fully wake your child, as this can cause further confusion and distress. Instead, ensure her safety by keeping her away from any hazards and staying with her until she calms down and falls back asleep.

    While most children outgrow night terrors on their own, discussing recurring episodes with your pediatrician is a good idea. Common triggers for night terrors include stress, sleep apnea, reflux, or changes in medication.

If you’ve tried the tips above, and your child is still struggling, reach out to your pediatrician. They’ll likely have insights or referrals to help alleviate separation anxiety at bedtime. 

Just remember — no one knows your child quite like you. If something’s working for you and your child, stick with it. And if something doesn’t feel right to you,  keep looking for other solutions. 

Auditory Sensitivity

My child is sensitive to loud noises
(e.g., sirens, vacuum cleaner).

My child seeks out specific sounds or types of music and appears calmer when listening to them.

Tactile Sensitivity

My child is irritated by certain fabrics or tags in clothing.

My child seems indifferent to sensations that are usually painful or to extreme temperatures.

Visual Sensitivity

My child is sensitive to bright or flashing lights.

My child tends to avoid eye contact.

Taste/Smell Sensitivity

My child constantly prefers bland foods and rejects foods with strong flavors or spices.

My child seeks out strong or unusual smells, such as sniffing food or objects.

Proprioceptive Sensitivity

My child prefers tight hugs or being wrapped in a blanket.

My child is unaware of body position in space (e.g., often bumps into things).

Social Sensitivity

My child becomes anxious or distressed in crowded spaces.

My child is hesitant or resistant to climbing or balancing activities (e.g., jungle gyms, see-saws).

Movement Sensitivity

My child dislikes fast or spinning movements

Vestibular Sensitivity

My child becomes anxious or distressed in crowded spaces.

My child is hesitant or resistant to climbing or balancing activities (e.g., jungle gyms, see-saws).

Please answer all questions before submitting.

Your Child’s Score is

  • 0-15

    Low Sensory Sensitivity

  • 16-30

    Moderate Sensory Sensitivity

  • 31-45

    High Sensory Sensitivity

  • 46-60

    Very High Sensory Sensitivity

0-15: Low Sensory Sensitivity

  • Interpretation: Your child exhibits low levels of sensory sensitivity, usually falling within the typical developmental range.
  • Recommendation: Generally not  a cause for concern. If you have specific worries or notice a sudden change in behavior, consult a healthcare professional for a comprehensive evaluation.
  • 0-15

    Low Sensory Sensitivity

  • 16-30

    Moderate Sensory Sensitivity

  • 31-45

    High Sensory Sensitivity

  • 46-60

    Very High Sensory Sensitivity

16-30: Moderate Sensory Sensitivity

  • Interpretation: Your child displays moderate sensory sensitivity, which may warrant intervention.
  • Recommendation: Consider sensory-friendly activities, sensory sensitive toys, or sensory sensitive clothing like noise-canceling headphones and weighted blankets to improve comfort. If symptoms persist, consult health care professionals.
  • 0-15

    Low Sensory Sensitivity

  • 16-30

    Moderate Sensory Sensitivity

  • 31-45

    High Sensory Sensitivity

  • 46-60

    Very High Sensory Sensitivity

31-45: High Sensory Sensitivity

  • Interpretation: Your child has higher than average sensory sensitivity that may interfere with daily functioning.
  • Recommendation: Seek a detailed evaluation by health care professionals for sensory integration therapy options and potential environmental modifications.
  • 0-15

    Low Sensory Sensitivity

  • 16-30

    Moderate Sensory Sensitivity

  • 31-45

    High Sensory Sensitivity

  • 46-60

    Very High Sensory Sensitivity

46-60: Very High Sensory Sensitivity

  • Interpretation: Your child demonstrates high levels of sensory sensitivity that could significantly interfere with daily life.
  • Recommendation: If your child displays this level of sensory sensitivity, it’s highly recommended that you consult with a health care professional for a multi-disciplinary assessment. You will probably be directed towards early intervention programs and specialized support.

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