Healthy Sleep Habits, Happy Child
124
Will Children Outgrow their Sleeping Problems?
March 27, 2023

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Healthy Sleep Habits, Happy Child

5th Edition: 
A Step-by-Step Program for a Good Night's Sleep

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Healthy Sleep Habits, Happy Child

5th Edition: 
Chapter 1 (only 16 pages!) outlines everything you need to know about your child's sleep.

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Introduction

A Healthy Child Needs a Healthy Brain, A Healthy Brain Needs Healthy Sleep

If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial. I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. This is a reference book. Read only the topic of interest to you.

Blog 124Will Children Outgrow their Sleeping Problems?

What he said to me was so chilling, I wrote it down. It was 2001. I was on a bus, on an adventure, in Patagonia, and I discovered that the man across the aisle was also a physician. He said that he also cared for patients’ sleep problems. He had been trained as an adult pulmonologist (think obstructive sleep apnea) at a famous Boston hospital, but he decided that he didn’t want the cold academic life in New England. Instead, he wanted to enjoy playing tennis in warm Florida. He also said that he needed to see patients only three days a week. I asked how he could be successful working only three days a week. He explained that his practice was only retired Medicare recipients with sleep problems. He said that Medicare paid him for even very short patient visits during which he prescribed sleeping pills. Thus, he could see many patients a day. Sadly, Medicare did not pay him well for long visits that would have been needed to advise life-style changes for healthier sleep. He added, even if he did spend more time at each visit, these older patients were so set in their ways, they would never change their life-style habits. Additionally, because of his high patient volume, and because the adult sleeping pill industry/market is so huge, pharmaceutical firms paid him very handsomely to enroll his patients in clinical drug trials for new candidate sleeping pills for adult insomnia. He said that his patients were the adult version of the children I write about who have persisting sleeping problems. He described his patients constantly cycling from one adult sleeping pill to another new sleeping pill every several years because the beneficial effect of the older pill eventually wore off. So, there was a constant availability of many patients for him to see and for the pharmaceutical industry to experiment with.  Here’s what he said:

“If you don’t have your child sleeping well, he will become a drug dependent incurable insomniac chronically disabled from sleepiness.”

Is this true? Don’t many pediatricians say to parents who complain that their child is not sleeping well, “Don’t worry, he’ll outgrow this.”  

Let’s look at a 2022 published study to ask the narrow question, do sleep problems persist or disappear as the child gets older. Here are some of the results:

At 8.6 years of age, 24% of children were diagnosed with insomnia symptoms. Among this group of children with insomnia symptoms, at both 16.5 and 24 years of age, 43% continued to have insomnia symptoms. So, sleeping problems tend to persist. That is, 43% of 24 children with insomnia symptoms, or 10 children out of 100 children, had persistent sleeping problems.

Does this mean that the 76% of children without insomnia symptoms at 8.6 years are not at risk?  No.

Among this group of children without insomnia symptoms, after age 8.6 years, insomnia symptoms developed by 16.5 years and continued to 24 years, in 15% of children. That is, 15% of 76 children without insomnia symptoms at 8.6 years, or 11 children, developed insomnia symptoms after 8.6 years that were present at age 16.5 years and continued to age 24 years.

Also, among this group of children without insomnia symptoms at 8.6 years, after age 16.5 years, insomnia symptoms developed by age 24 years in 21% of children.  That is, 21% of 76 children, or 16 children, developed insomnia symptoms after age 16.5 years and continued to age 24 years.

So, among the 76% of children with no insomnia symptoms at age 8.6 years, a total of 36% had developed insomnia symptoms by age 24 years. That is 36% of 76 children, or 27 children out of 100, developed insomnia symptoms by age 24 years.

Take home message:

Around 8-9 years old, among 100 children with insomnia symptoms, about 10 children will have persistent insomnia symptoms at age 24 years.

Among 8-9 years old, among 100 children without insomnia symptoms, about 27 children will have insomnia symptoms by age 24 years.

Healthy sleep habits are taught by parents throughout their child’s growing years. Like personal hygiene habits (hand washing, tooth brushing, etc.) and safety habits (don’t play with matches, wear a helmet when biking, etc.), healthy sleep habits change with time and need to be taught again or reinforced. Baby sleep training and child sleep training is an ongoing process, not a one shot and done affair. The failure to teach healthy sleep habits to your child puts your child at a higher risk for developing the disabling chronic adult disease called insomnia.

Comments

  1. Dear Dr. Weissbluth,
    Hope you’re doing well. I reached out to you last year in August and your advice was very helpful in establishing healthy sleep patterns for my now 20 month old baby boy.
    In fact, he has been napping well and sleeping through the night ever since (after we sleep trained him). We’ve kept the routines we established and the bedtime the same (around 7.30-8.00 pm) also during vacation this summer and everything was going great up until around 10 days ago. He started waking up at night 2/3 times crying, we ignored him and he went back to sleep but, around a week ago, he started getting anxious around bedtime at night. It seems that he doesn’t want to go to bed alone (you can clearly see the anxiety on his face when we start finishing the bedtime routine) and needs our presence (both mom & dad) to fall asleep. He also does not want to sleep in his own bed anymore. He has been sleeping in his own crib in a separate room for a year now without any major problems.
    If I think about any recent changes in our family organization, the following comes to mind:

    We moved to another home at the end of June but, again, he was sleeping soundly and going to sleep on his own after the bedtime routine up until 10 days ago.

    We have a nanny go pick him up at kindergarden (started doing so at the beginning of September) but we made sure the transition was smooth by being present at the beginning and almost always home when they arrive from kindergarden.

    His dad was away for a week on a business trip 3 weeks ago but things seemed fine while he was away and for a week after he was back.

    At kindergarden they tell me he sleeps fine and around 2 hours per afternoon from around 13.00 to 15.00. During the rest of the day he’s playful and in a good mood as always.

    We did not notice any changes in his behaviour during the day on weekends and evenings either.

    The past 3 nights have been really tough because we tried letting him cry and last night he cried for 2 hours straight until we picked him up and put him on the couch where he immediatly fell asleep after seeing that we were close. Same thing this afternoon, crying intensly in his crib for 30 minutes until we went to get him and went all together to nap on the couch. So it seems that he wants to sleep but needs reassurance to fall asleep.

    I’m torn because I definetly do not want to go back to having him fall asleep only in our presence as this will undo everything we worked for and achieved last summer.

    Any advice would be highly appreciated.

    Thank you in advance,
    Nour

    1. Thank you for your detailed description. Here are some thoghts that might help clarify what is going on.
      1. Have your pediatrician or caregiver do a thorough examination to see if anything is amiss.
      2. Temporarily, forget about sleep habit formation and for a few nights (maybe 3-5 nights) do whatever works to maximize night sleep and minimize crying, even if this means allowing him to sleep with you in your bed at night in order to provide reassurance and allow him to be really become well rested.
      3. Would it be possible to devote a few days (for example, Thursday-Monday or Saturday-Wednesday) when there is no nanny involved and one of you do the kindergarten pick-up? How does he respond when he first encounters the nanny? Is he less anxious around bedtime on Sunday nights?
      4. At kindergarten, ask if he has recently become more shy or anxious or showing more stranger danger or separation anxiety. Is there any strong family history of anxiety symptoms?
      5.. If there is no suspicion of a medical or nanny issues or anxiety issues, I will give you some additional suggestions.

  2. Dear Dr. Weissbluth,
    Here are our updates.
    1. The pediatrician did not give us an apointment to do a check-up in the end because she did not see the need but suggested I use melatonin just for a few nights to help him relax around bedtime. I did not agree, so I did not follow her advice. No health issues are evident until now.
    2. We let him sleep with us for a few nights but it wasn’t ideal because nobody was sleeping except him due to fear of him falling off the couch or the bed so we resorted in the end (4 nights ago) to putting a matress on the floor in his room and using it temporarily as his bed
    3. & 4. No nanny issues and kindergarten staff (I talked seperately to 3 of his caregivers) did not have anything new/ strange to report. No history of anxiety in the family that I know of either.

    So now we have the same old routine at bedtime except for 2 changes:

    1. Matress on the floor
    2. Falling asleep on the matress next to either mom or dad in the dark after we turn off the lights together

    Once he is asleep we leave the room and he sleeps through the night (20.30 to 7.00 approximately). 2 nights ago he woke up twice and called for mom but I didn’t go to him and he fell back asleep on his own in very little time.

    So I’m starting to think that it’s going to be hard to get him to sleep in his crib again. Also because, before putting the matress on the floor, we tried putting him in his crib when he was obviously drowsy and ready to go to sleep and sat next to the crib on a chair to give him reassurance. He wouldn’t lay down and after around 30′ of almost falling asleep while standing up he started crying. We tried this twice, a few days apart each time.

    I forgot to mention last time that, when we drop him off at kindergarten in the morning, he is usually very cheerful and goes inside without having second thoughts. Can seperation anxiety come out only at bedtime in some children?

    I would really appreciate your thoughts and any advice.

    Thank you in advance,
    Nour

    1. A child psychologist can answer your question, “Can separation anxiety come out only at bedtime in some children?” for your child. Based on this answer, you will have clarity on how to proceed with choosing a sleep solution as described in my book.

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