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By Dhanashree Padhye

MA (Psychology)

06 October 2022
Medically reviewed by
Dhanashree Padhye
MA (Psychology)
Sleep Anxiety in Children
Table of Contents

What is Sleep Anxiety?

Sleep Anxiety is a kind of fear or worries about going to sleep. You may be concerned about not being able to fall asleep. It’s like stage fright, but for sleeping. And for some people, sleep anxiety can become so severe that it starts to get in the way of daily life. 

In Somniphobia, people experience extreme fear or anxiety around sleep. People with somniphobia will think that something terrible will happen to them while sleeping or that they should stay awake and alert.

Typical thinking Pattern of Sleep Anxiety Includes thoughts like:

  • I’ll be awake for hours before I can fall asleep
  •  I’ll wake up a lot during the night
  • I’ll be tossing and turning all night long
  • I’ll only be able to get a few hours of sleep
  • Is there something wrong with me? 
  • I’ll be so tired tomorrow that I won’t be able to function
  • I’m a terrible sleeper

Like many other types of Anxiety, sleep anxiety also has physical symptoms. For example, when you’re feeling anxious, you might experience:

· Fast heartbeat
· Physical restlessness
· Muscle tension
· shallow breathing
· Upset stomach

Sleep disturbance has been frequently observed in individuals with anxiety and similar Anxiety disorders (Babson & Feldner, 2010 et al.), and the link between sleep and anxiety was found in adults and children (Johnson, Roth, & Breslau, 2006; et al.)

For some children, sleep problems will result from poor habits and hygiene; for others, the sleep disturbance may represent an initiator or preliminary expression of a more serious emotional disorder (Ivanenko, Crabtree, & Gozal, 2004).

Typical thinking Pattern of Sleep Anxiety

What Causes Sleep Anxiety?

 When we have Anxiety, it will trigger our bodies to release hormones that may make us react quickly to escape harm. Children or adults with chronic anxiety may feel stressed or worried often. They may experience fear or anxiety in everyday situations like going to school or falling asleep every night.

There are various causes of Anxiety in children which may harm their sleep:

  1. Unresolved sleep issues for a long time
  2. Over-thinking and over-worrying about small things 
  3. Nightmares 
  4. Fear of dark places, fear of dangerous animals
  5. Disturbed family background 

Older school-aged children who are overachievers in school struggle with sleep more than average children as they have high expectations from themselves. They constantly worry about how lack of sleep will hurt their work.

Children with autism and ADHD will have more anxieties than their peers. ADHD children have difficulties calming their racing minds from the stresses and worries about their day.

Stress and Anxiety cause our bodies to discharge certain hormones; Children with chronic Anxiety might constantly feel pressure and worry. Significantly high levels of hormones before sleep will make it hard to relax, which causes difficulty falling asleep. It is possible that, even after falling asleep, you may wake up in the middle of the night due to Anxiety and disturbing thoughts.

When there is a condition where there is not enough thyroid hormone in our bloodstream, our metabolism will slow down, and that will then stimulate the combination of Anxiety and insomnia.

Research suggests that Anxiety may affect rapid eye movement (REM) sleep. In REM sleep, children tend to have vivid dreams. Children with Anxiety may get nightmares due to these dreams causing them to wake up at night.

Symptoms of Sleep Anxiety

Symptoms Of sleep anxiety

  • Children with sleep Anxiety will face trouble while falling asleep
  • They may not be able to concentrate
  • They will experience restlessness and nervousness
  • Gastrointestinal issues may arise 
  • Frequent night terrors and nightmares
  • Difficulty staying awake during the day
  • Snoring
  • Unexplained decrease in daytime performance
  • Unusual events during sleep, such as sleepwalking
  • teeth grinding
  • Bedwetting
  • Restless sleep
  • Difficulty waking up in the morning

Can We Diagnose Sleep Anxiety?

The answer is yes!! 

To get diagnosed with Sleep Anxiety, a healthcare provider will perform a physical exam; he then reviews your medical history and classifies your symptoms accordingly.

They will ask you these questions:

  • Usually, do you eat or drink anything before bed?
  • Does your Anxiety appear before going to bed?
  • How much time is required for you to fall asleep?
  • Do you wake up at night? How often?
  • Do you perform any activities before going to bed? What are those activities?

Treatment for Sleep Anxiety

Cognitive behaviour therapy (CBT):

Cognitive behavioural therapy or CBT-I can be used if a child has constant sleeping troubles. CBT-I will teach a child about managing his Anxiety. It will also support their parents. Dr. Nash said CBT-I has shown to be more effective than medication in treating sleep Anxiety. A sleep therapist will recommend some CBT-I techniques depending on the child's needs.

  • Stimulus control therapy: Helps remove factors that condition your mind to prevent sleep. 
  • Sleep restriction:  This treatment will reduce sleep deprivation (the time you spend in bed ). Once your sleep has improved, your time in bed is gradually increased.
  • Sleep hygiene. It is necessary to change essential lifestyle habits, which may affect our sleep-wake cycle. Sleep hygiene can be very effective in children as it will help them maintain routine activities while reducing their anxieties.
  • Sleep environment improvement. When you create a comfortable sleep environment, such as keeping your bedroom quiet, dark, and calm, not having T.V or other electronic devices in the room (laptop, tablets), and not having a clock in the room, it becomes easier to fall asleep.
  • Relaxation training. Relaxation will help calm our minds and body. Different relaxation techniques include meditation, imagery, progressive muscle relaxation, healing, etc.

Medication:

Sleeping pills, such as Ambien and Sonata, and other medications, are prescribed to deal with sleep problems. Antihistamine Atarax, the antidepressant Desyrel, and the high blood pressure medicine Catapres are also prescribed sometimes.

  • Antidepressants: Trazodone (Desyrel) is an antidepressant for sleep Anxiety.
  • Benzodiazepines: Some drugs stay for a more extended period in the system and can help treat insomnia symptoms. They are sleeping pills--temazepam, Restoril), triazolam (Halcion), and others.
  • Doxepin (Silenor) is an approved drug for people who experience trouble sleeping.

Eszopiclone (Lunesta), Lemborexant (Dayvigo), Ramelteon (Rozerem), Suvorexant (Belsomra), Zaleplon (Sonata), and Zolpidem (Ambien, Edluar, Intermezzo) are some of the medications which can be used to treat Sleep Anxiety in children.

Healthy Sleep Habits:

Make sufficient sleep a family priority.

Understand that making sleep your priority will set an example in front of your kids. Staying up all night and doing work will not send the right message.

Keep to a regular daily routine.

Having the same waking time, meal times, nap times, and play times will help the child feel safe and comfortable. For younger children, you can start using early bedtimes such as brushing, reading books, and going to bed.

Create a sleep-friendly home environment

Dim the lights before bedtime and keep the room temperature appropriate for your children. Don't keep too many toys in the bed. Only one or two things, like a blanket or a favourite bear, the doll can help ease separation anxiety. 

Sleep problems can be recognized.

Sleep problems like night terrors, waking up at night, and difficulty falling asleep snoring, can be recognized by parents.

Avoid overscheduling.

Even if it is necessary to have a healthy sleep routine, don't overschedule it. For example, Don't make your child indulge in additional activities like sports games, appointments, or lessons apart from homework. It can become challenging for children to get regular sleep, and it may put a lot of pressure on them.

Conclusion:

     Sleep Anxiety is common among children as various factors like school, homework, other activities, and social environment affect their thinking mind. It can happen that parents will set a specific timetable for daily activities, meal times, and bedtimes. Still, the children may be unable to follow these routine activities at a particular time. 

At that time, a parent’s responsibility is to understand that their children are trying hard to achieve them, but they cannot. Rather than punishing them, parents should act as role models for their children by helping them understand the importance of daily routine.

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