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‘My 12-year-old gets stressed and worried at bedtime and can’t sleep’

Ask the Expert: ‘It is very upsetting to see him like this, it almost feels like he has returned to being a toddler’

Question

My 12-year-old is finding it hard to sleep at night. This mainly started in the last six months and has got much worse over the summer. He seems to get stressed and worried at bedtime, and can toss and turn and find it hard to sleep. Sometimes we think he has fallen asleep and then he comes out crying, almost in a panic that he can’t sleep. It can take a long while to calm him down.

He says he does not know why he can’t sleep and that he can lie awake for hours. We tried to teach him some breathing exercises (my wife does yoga) but they have not helped him and he gets frustrated that he can’t do them — he ends up nearly being more wound up. It is very upsetting to see him like this, it almost feels like he has returned to being a toddler. He was a terrible sleeper as a baby and young child, and my wife and I were up nights with him. He is a little bit of worrier, which could be a factor.

He has found the summer hard and we have struggled to find things he enjoys doing to keep him entertained. He is a bit old for some camps and has become a bit unconfident making new friends. He can become stressed when we try to introduce him to new things. But the main thing at the moment is his sleep — he is clearly missing sleep and is tired during the day, yet he can’t drift off at bedtime.

Answer

There could be a number of factors that explain the emergence of your son’s sleep problems. The surge of hormones, and body changes associated with puberty can lead to changes in sleeping patterns. Also, adolescents can become more self conscious and deeper thinkers, which can lead to increased anxiety and rumination that can interrupt sleep at night. Like many preteens, it also sounds like your son is finding the ‘out of school’ summer routine challenging. Less structured and less active days can be stressful and lead to bedtime routines being disrupted meaning that children are going to bed much later, and/or sleeping during the day and less at night.

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Understanding the sleep cycle

Good sleep is usually about association and habit, both of which can easily be interrupted. When sleep is working well, your mind associates lying down in your bed as a cue to sleep and you usually have a couple of relaxing habits that help you drift off (such as a how you lie on your pillow or recalling happy events or relaxing breathing etc). If your son is spending hours stressed trying to sleep, then he will no longer associating his bed with sleep and lying down could become a cue for worry or stressful thoughts. The goal is to help your son rebuild his positive association with sleeping in his bed and to create new sleep habits that help him.

Establish a routine

Even though it is the summer, establish a routine with your son for the evening that is relaxed with a fixed bedtime. Don’t be tempted to make bedtime later, so your son is ‘very tired’ as this is usually counterproductive often making it harder to sleep. Identify with your son relaxing things he can do before bed such as reading in his room or listening to music.

It can helpful to have a routine of chatting about the day with your son and to encourage him to talk about worries and stresses — but this is usually best earlier in the day (eg after dinner) and not immediately before sleep. In addition, try to make sure he has a routine of exercise and physical activity during the day as this will help with sleep. Even making sure you do a daily family walk will help and this can be a great time to chat also.

Identify sleep associations

Explore with your son habits and rituals that help him sleep. Ask him ‘on a good day, when you fall asleep immediately what helps you? Identify good sleep positions he can adopt, and how he helps his mind and body relax. What works is usually individual and techniques such as visualising a happy place, recalling happy memories, counting breathes and systematically relaxing the different parts of his body can all help (and there are great videos on YouTube for each of them). Remember if you are teaching your son a new technique this is usually best done during the day. For example, your wife could teach him some yoga techniques in the morning and once he learns them he can apply them at night to help him sleep.

Interrupting a poor sleep pattern

If your son is finding it hard to sleep, it is important that he gets up and interrupts this before he gets too stressed. Below are the suggested steps

  1. When feeling a little tired, lie down in bed and use the relaxing rituals identified above to help sleep.
  2. If after a period of time, your son is not asleep and he starts feeling stressed or worried about this, he should interrupt this and get up for a few minutes.
  3. Once up he should do something to relax and change how he feels — I recommend many of the children I work with to do two minutes of exercise (eg press ups or sit ups) but reading at a desk or writing thoughts down in a note book can help too.
  4. After a few minutes and once your son feels a little tired again, he should lie back down in his bed and restart step 1.

As your son is learning these steps you can help as a parent by encouraging him to call or come out to you for step 3 if he needs support to relax. At that point it is important to be very calm and patient yourself, and gently encourage him back to sleep. Over time, he will not need you and can use the techniques himself.

Though poor sleep is stressful for children and parents alike, with patience and gentle persistence, progress can be made to ensure a restful night’s sleep for all.

Send in your question by filling up the form below, or by e-mailing health@irishtimes.com (with “John Sharry” in the subject line)

John Sharry is Clinical Director of the Parents Plus Charity and an adjunct professor at the UCD School of Psychology. See www.solutiontalk.ie