It is common for children to have periods when they sleep poorly, but for some children, many nights of little sleep add up and could mean they’re struggling with a sleep problem.

While the number of sleep hours a child gets matters, even more important is how well-rested a child seems when they wake up in the morning. Also take into consideration how long this goes on for.

If your child has enough energy to go about their daily activities, they are probably getting enough sleep. The following signs suggest your child might need to get a better night’s sleep and clock more zzz’s:

• Feeling tired in the mornings or after lunch
• Having less energy than usual
• Feeling more irritable than usual
• Having difficulty concentrating or remembering
• Falling asleep in school or needing to nap during daytime

The following aims to assist you in identifying sleep goals, deciding if it’s a problem, and when to seek more advice from a health professional.

Steps to identifying sleep challenges in children and youth:

1. First, review their sleep habits and fine-tune

Think about your main concerns - Is it a problem with falling asleep? An issue of struggles at bedtime? Keeping consistent routines?

Choose what is the most important to start with for your family’s goals. Find the low hanging fruit, something small you can start with, and see if it helps or not. For example, if a young child is having difficulty falling asleep at night, perhaps you start with looking at their daytime nap routine before tackling the tougher evening challenges.

Many sleep problems are linked to bedtime habits and daytime behaviour that you can work with your child to change. Read more tips on making small changes to sleep habits, from building better sleep schedules and bedtime routines to sleep environments.

Keep working at it every day, but be patient. Building new family habits takes time. It can take weeks of building up a sleep schedule with your child before it becomes easier.

2. Keep a sleep diary

Track your child’s sleep routine and patterns using a sleep diary. Try this for at least 10 days including two weekends, as weekend schedules tend to vary more. 

See if you can see a pattern to your child’s sleeping habits on the “good” vs “bad” sleep nights. This can help you identify an area that you can start to address.

You can also take the sleep diary to show your child’s doctor or health care professional to talk about sleep. They will welcome this extra information! They can help pinpoint sleep challenges and offer suggestions. They may also ask your child (with your help) to fill out a sleep diary and bring it back on the next visit.

Try one of these sleep diaries.

You can monitor and write down things like:

• time they go to bed, fell asleep, and woke up
• how much sleep they are getting per night
• if they wake up at night, how long they’re awake and what they do
• their physical activities and daily routines
• what they eat before bed and if any drinks had caffeine
• their mood and feelings
• how much energy they feel during the day
• was there need for downtime or even a nap, and did they take any naps
• medications they may be taking, and timing
• any concerns you have about them when they’re asleep, for example: snoring, restlessness (tossing and turning), jerking movements of legs, night terrors or sleepwalking

3. Talk to a health care professional if sleep isn’t improving

After trying to identify areas that you can change in your child’s sleep habits, it may be that you don’t find anything to change, or despite efforts, your child is still struggling with sleep.

This is a good time to seek more advice from a health professional, especially if your child is not getting enough sleep and they seem overtired and sleepy a lot during the day. You don’t need to have a major issue to seek help, having an expert weigh in on why your child is struggling can help everyone relax and sleep better! Reach out for support.

Visit your doctor or speak to a team of health professionals (e.g. pediatrician, behavioural consultants, occupational therapists).

Given the close relationship between sleep and mental and physical health, here are some common sleep problems to pay attention to: 

• consistent trouble falling or staying asleep (sleep insomnia) 
• complaints of sleepiness during the day
• persistent, vivid nightmares
• difficulty breathing (waking up with a dry mouth, sore throat, observed breathing challenges)
• restless legs, feet, toes (feelings like itching, aching, or “growing pains”)

Some sleep-related problems in children with mental health conditions are due to their medications, a sleep disorder, or another underlying (and sometimes undiagnosed) medical condition.

In these cases, good sleep habits alone may not resolve the issue, and a review of medication timing, dosage, or need for additional treatment may be required.

For more information on sleep disorders, visit the Sleep On It website.