What are persistent sleep problems?

Persistent sleep problems affect your child’s ability to sleep or settle over a long period.

Not all sleep problems are persistent. A sudden change in your child’s sleep might be a short-term sleep problem, rather than a persistent one. You can sort out many short-term sleep problems by encouraging good sleep habits.

Behaviour-based persistent sleep problems

Some persistent sleep problems are related to behaviour. These problems can happen at bedtime or during the night.

Behaviour-based persistent sleep problems include your child:

• calling out and getting out of bed
• not wanting to sleep in her own bed
• having trouble getting to sleep because she needs you to help her settle
• waking up often during the night
• feeling very anxious
• sleeping at irregular times – for example, going to sleep much later on some nights.

These persistent sleep problems can sometimes be treated with behaviour strategies to reduce the behaviour that’s causing the problem. For example, if your child gets out of bed at night as a way of keeping you around, it can help to minimise the amount of talking and eye contact you give him each time you gently return him to bed.

Your health professional will work with you and your child to find a behaviour strategy to help your child sleep better.

Medical conditions and persistent sleep problems

Some persistent sleep problems might need some kind of medical treatment. They include:

• sleep apnoea
• insomnia
• restless leg syndrome – when a child (or grown-up) feels really uncomfortable in the legs and can’t stop moving them
• nightmares and night terrors
• narcolepsy – when a child (or grown-up) can’t control overwhelming feelings of tiredness during the day (this is a lifelong neurological problem)
• delayed sleep phase – when a child’s circadian rhythm is later than the bedtime and wake time needed for school, work or other daily routines.

For example, if your child has sleep apnoea that is caused by enlarged adenoids, she might need an operation to take out her adenoids. This should improve her breathing during sleep.

How persistent sleep problems affect children and their families

Persistent sleep problems usually mean not enough sleep – and not enough good sleep – for children and their families.

On top of that, if your child has a persistent sleep problem, he might have daytime problems like:

• behaviour problems – for example, being sleepy or overactive
• poor memory
• trouble with concentrating or understanding instructions
• more tiredness during the day
• the need for more naps
• inability to wake up for school or work
• mental health issues like childhood depression, teenage depression, childhood anxiety or teenage anxiety.

You, your partner and your other children might also have some of these daytime symptoms.

Caring for a child with a persistent sleep problem disrupts the family routine and can increase your stress and anxiety. Try to look after yourself and ask for help from family and friends. Parenting helplines might also be helpful.

Getting help for persistent sleep problems

Persistent sleep problems can affect your child and your whole family, so it’s important to seek help. Persistent sleep problems usually need professional treatment.

The first step is talking with your GP about getting an assessment of your child’s sleep. You might be referred to a paediatrician, psychologist or other health professional who’s experienced in identifying and treating persistent sleep problems in children.

Sometimes your child’s doctor might prescribe a sleep medicine to treat your child’s persistent sleep problem.

Children often grow out of sleep issues like body-rocking, head-rolling and head-banging, nightmares and night terrors. If these issues aren’t upsetting your family or your child, you don’t usually need to seek help.

Persistent sleep problems at different ages

Children of all ages can have persistent sleep problems, but different problems are more common at different ages. Below are some examples of persistent sleep problems at different ages.

In preschoolers (3-5 years), common persistent sleep problems include:

• night-time fears
• the need for something or someone to go to sleep with – for example, a bottle of milk in bed or a parent
• resisting bedtime – for example, calling out and getting out of bed
• nightmares
• sleep apnoea
• night terrors
• sleepwalking.

In school-age children (5-8 years), common persistent sleep problems include:

• poor sleep habits – for example, caused by having a screen-based device in the bedroom
• sleepwalking
• night terrors
• teeth-grinding
• sleep apnoea
• anxiety – either general anxiety or anxiety about not getting enough sleep.

In pre-teens (9-11 years), common persistent sleep problems include:

• poor sleep habits – for example, caused by having a screen-based device in the bedroom
• anxiety – including being anxious about getting enough sleep
• sleep apnoea
• insomnia
• delayed sleep phase.

In teenagers (12-18 years), common persistent sleep problems include:

• poor sleep habits – for example, caused by having a screen-based device in the bedroom
• insomnia
• delayed sleep phase
• restless leg syndrome.

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