What Causes Insomnia in Children?

By Brandon Peters, MD

Children are often the perfect sleepers, but when they are not, what causes insomnia in children? Insomnia is the inability to fall or stay asleep or sleep that is not restorative. The causes of insomnia in children may overlap with adults, but there are also some unique conditions that may predispose your child to difficulty sleeping.

How Behavioral Problems Result in Insomnia

Perhaps the most common and frustrating of the causes of insomnia are difficulties related to your child’s behavior. Babies and toddlers may enjoy being comforted as they transition to sleep, but if they awaken and you are not there, this can be a source of great distress. This may result in frequent tearful tantrums in the middle of the night. This sleep-onset behavioral insomnia is remedied by letting your child fall asleep alone.

Another potential problem is toddlers and young children who refuse to go to bed. They will insist on a litany of needs prior to going to sleep: a drink of water, a trip to the bathroom, another bedtime story, a few more minutes with the light on, and the list goes on. This limit-setting insomnia is overcome by setting appropriate boundaries and asserting parental authority.

Moreover, children need to have a set of healthy sleep habits and a bedtime routine that will ensure a smooth transition to sleep. This includes appropriate sleep hygiene, which eliminates disruptions to sleep and makes the period of time just prior to falling asleep a time of relaxation. In addition, many distractions should be eliminated from the bedroom to ensure an appropriate sleep environment.

The Role of Medical Problems

There are a number of medical problems -- including neurologic and psychiatric conditions -- that may lead to insomnia in children. In general, these are rare disorders and other signs would exist beyond insomnia. Some of the possibilities include:

• Depression

• Post-traumatic stress disorder (PTSD)

• Attention deficit hyperactivity disorder (ADHD)

• Autism

• Asperger syndrome

In addition, some children (especially teenagers) may have circadian rhythm disorders such as delayed sleep phase syndrome that result in insomnia. These conditions lead to difficulties falling asleep at night and a desire to oversleep in the morning. This occurs because the desired sleep phase is shifted later than is standard. This may interfere with school performance and some school districts are actually shifting the start times to allow teens to sleep in. The use of phototherapy and melatonin may also help to shift these troublesome sleep patterns.

Other Causes of Insomnia in Children

Aside from the causes described above, there are a few other possible situations that may result in insomnia in children. Some children may experience insomnia as the result of medication use, especially the use of stimulants in ADHD. Finally, precocious children (those who are intellectually gifted) often have insomnia.

If your child is having difficulty falling asleep, and simple changes to address behavioral causes are ineffective, you may want to speak to your pediatrician about exploring other possibilities to improve your child’s sleep.

Brandon Peters, MD, is the author of Sleep Through Insomnia, a neurology-trained sleep medicine specialist at Virginia Mason Medical Center in Seattle, and former adjunct lecturer at the Stanford Center for Sleep Sciences and Medicine.

How to Wake and Get Up Early

By Brandon Peters, MD

It can be downright painful to drag yourself out of bed at an hour earlier than you are used to waking. Sometimes it is simply necessary to wake and get up early, however. What are the best ways to wake and get up early? Discover how to accomplish this with simple changes—such as alarm clocks, morning sunlight, and caffeine—that you can implement immediately that may have lasting benefits.

Changing Your Wake Time May Depend on the Purpose

Consider whether you need to wake up early once, such as to catch an early flight, or if you are adapting to a new schedule that shall persist. This will help determine what solutions or techniques should be considered to help you get up early. It may also be helpful to reflect on what your relationship to your alarm clock says about your personality. Difficulty waking may suggest underlying problems with the amount or quality of sleep.

Making Long-Term Changes to the Timing of Sleep

If possible, especially if this is a long-term adjustment to your sleep schedule, try to make changes gradually. For children or adolescents getting ready to resume school as the summer draws to a close, it is much easier to plan ahead and start waking earlier in the week or two before the first day back.

Begin by setting an alarm in the morning that is close to your current, natural wake time. Then, day by day, move the wake time earlier by 15 minutes. This could be adjusted as quickly as necessary or as slowly as comfortable. As a general rule, it takes 1 day to adjust to every 1-hour change in the timing of sleep (such as with jet lag). The wake time may be comfortably moved earlier every few days, for example.

Try to keep a regular bedtime and go to bed when feeling sleepy to avoid insomnia. It will not be helpful to crawl into bed early without feeling sleepy: it will just take longer to fall asleep. This desire for sleep will gradually shift earlier in increments, too. Listen to your body, spend time relaxing in the hour before your bedtime, and go to bed when you naturally feel sleepy. These incremental adjustments may help you to wake up more easily.

To optimize your sleep, maintain a regular sleep schedule (with consistent bedtimes and wake times) even on weekends or days off. To reinforce the wake time, get 15 to 30 minutes of morning sunlight upon awakening. If possible, roll out of bed, throw on clothes, and immediately go outside. Do not wear sunglasses or a hat; let the light hit you in the face (especially your eyes). The fresh air will wake you and the light will help to align your circadian rhythm and sleep pattern. If necessary due to where you live, consider the use of a specialized light box. Getting morning light exposure can be especially helpful for night owls with delayed sleep phase syndrome.

Reinforcing the Wake Time with Solutions and Determination

Beyond making gradual adjustments and reinforcing the circadian rhythm with light exposure, there can be other solutions that may prove helpful to wake and get up early. Consider these potential options and solutions:

• Set a loud, obnoxious alarm that is disruptive to your sleep.

• Put the alarm clock across the room so that you physically have to get up to turn it off. Don’t go back to bed once you are up.

• Consider setting multiple alarms on different devices (alarm clock, phone, etc.).

• Set the alarm as late as possible so that you don’t have an option to hit snooze, but have to get up immediately—or be late.

• Recruit others to help you wake up, such as members of the household who may already be awake or someone who can call you until you are up.

• Once out of bed, immediately go to the shower.

• Morning exercise or getting outside may also help to keep you awake.

• Consuming caffeine may clear morning sleepiness until you naturally start to wake.

• Avoid the use of sleeping pills as these may cause morning hangover effects.

Once you are awake and out of bed, you may still have a desire to return to sleep due to sleep inertia. This may be profound if you are waking significantly earlier than your usual wake time. It may feel like the middle of the night, and you may just want to crawl right back into bed. If this persists, you may consider reasons that your sleep is not as restful as it should be.

Make certain that you get enough hours of sleep to feel rested. Sleep needs vary, but most adults need 7 to 9 hours of sleep. As we get older, beyond the age of 65, the average sleep need may decrease slightly to 7 to 8 hours. If you don’t get enough sleep at night, it will be more difficult to wake up.

Treating sleep disorders may also be necessary to make it possible to wake and get up early feeling rested. Insomnia may insidiously undermine sleep, reducing the total amount and compromising the quality. Restless legs syndrome (RLS) may make it hard to fall asleep. Obstructive sleep apnea may also fragment sleep, leading to excessive daytime sleepiness and other symptoms. If one of these conditions is present, testing and treatment may be necessary to resolve the difficult waking.

In some cases, morning sleepiness may require further treatment. When it is due to a sleep disorder (sleep apnea, narcolepsy, or shift work sleep disorder) and interferes with daytime function, prescription stimulant medications may be used. These medicines may include modafinil (Provigil), armodafanil (Nugivil), or others such as methyphyenidate (Ritalin). Speak with a board-certified sleep medicine physician if you feel like you are struggling more than you should be.

As you adopt these changes to wake and get up early, initially have a fallback plan. Don’t just start by setting one alarm 2 hours before you naturally wake up and expect to jump out of bed refreshed; it may not go well. Consider ways to adjust gradually and use the recommendations above to help reinforce this change. Get help from others, including a sleep doctor if needed, to keep you on the right path. It can also be helpful to acknowledge that with determination and grit you can do it. Don’t allow yourself to go back to bed. The first few days will be the most difficult, but it will get easier.

Brandon Peters, MD, is the author of Sleep Through Insomnia, a neurology-trained sleep medicine specialist at Virginia Mason Medical Center in Seattle, and former adjunct lecturer at the Stanford Center for Sleep Sciences and Medicine.

The Soothing Symphony: Exploring the Effects of Binaural Beats on Sleep Quality and Insomnia

In our fast-paced world, quality sleep has become an elusive luxury for many. With the rise of insomnia and sleep-related disorders, people are constantly searching for natural and effective remedies to improve their sleep quality. One such remedy gaining popularity is the use of binaural beats, an auditory phenomenon that claims to have a positive impact on sleep patterns. This article delves into the fascinating realm of binaural beats, investigating their effects on sleep quality and their potential to alleviate insomnia.

Understanding Binaural Beats

Binaural beats are an auditory illusion created by playing two slightly different frequencies in each ear. The brain then processes the difference between the two frequencies, resulting in a perceived beat frequency. For example, if a frequency of 200 Hz is played in one ear and 210 Hz in the other, the brain generates a binaural beat of 10 Hz. These beats are believed to synchronize brainwaves, and may induce a state of relaxation or focus, depending on the desired outcome.

The Impact on Sleep Quality

There is limited research suggesting that binaural beats may have a positive impact on sleep quality. When used during bedtime, these beats may help synchronize brainwaves, leading to a relaxed and calm state conducive to falling asleep. The beats may do this by stimulating the production of slower brainwaves, such as those in the theta frequency which are associated with deep relaxation and meditation. This synchronization of brainwaves may reduce racing thoughts, anxiety, and stress, helping individuals drift into a peaceful slumber more easily.

Furthermore, some small studies have shown that binaural beats can enhance the duration and quality of different sleep stages. One study conducted on adults with insomnia found that participants who listened to binaural beats before bedtime experienced significant improvements in their sleep efficiency, total sleep time, and decreased wakefulness after sleep onset. These findings suggest that binaural beats may help enhance normal sleep cycles, resulting in a more restful and rejuvenating night's sleep.

Combating Insomnia

Insomnia, a common sleep disorder characterized by difficulty falling asleep or staying asleep, can have profound effects on one's overall well-being. Binaural beats may offer a potential solution for individuals struggling with this condition. By reducing anxiety and promoting relaxation, binaural beats can address some of the underlying causes of insomnia.

Notably, binaural beats may have a particular impact on the brain's delta and theta brainwaves, associated with deep sleep and the transition from wakefulness to sleep. A study on older adults with insomnia revealed that listening to binaural beats before bedtime significantly increased their deep sleep duration and improved their overall sleep quality. Moreover, binaural beats have demonstrated the potential to enhance sleep architecture by increasing slow-wave sleep, a crucial phase for physical restoration and growth.

Additional Benefits and Consideration

Apart from improving sleep quality and alleviating insomnia, binaural beats offer several other benefits. They can reduce stress levels, increase focus, and enhance meditation practices. Some individuals also report enhanced creativity and improved mood after incorporating binaural beats into their daily routines.

While binaural beats show promise in improving sleep quality, they may not be equally effective for everyone. Individual responses to binaural beats can vary, and their efficacy may depend on factors such as personal preference, underlying sleep disorders, and overall health. It is crucial to experiment with different frequencies and find the ones that work best for each individual.

Conclusion

As the world grapples with sleep-related challenges, exploring natural remedies becomes increasingly important. Binaural beats offer a non-invasive and drug-free option to enhance sleep quality and combat insomnia. By synchronizing brainwaves and inducing relaxation, these auditory illusions can promote a calm state of mind and pave the way for a restful night's sleep. While further research is warranted, binaural beats present a promising tool in the pursuit of improved sleep and overall well-being. For those who continue to struggle with insomnia, consider participating in a cognitive behavioral therapy for insomnia (CBTI) program.

This article was created using OpenAI’s ChatGPT on July 8, 2023 and it was personally reviewed and edited by Brandon Peters, M.D. to ensure its accuracy. This use of augmented intelligence in this way allows the creation of health information that can be trusted.