Bedtime Resistance or Refusal

Bedtime can become a problem for children when they transition from a crib to a bed. They may not want to go to bed or may resist going to sleep. In their minds, it is simply much more fun to be up. This is normal. It is part of growing up. However, toddlers and school-age children need about 10 to 12 hours of sleep each night. Otherwise, they may have trouble waking up in the morning or may get sleepy during the day. You can help make sure that your child develops good sleep habits.  

CAUSES

  • Separation anxiety.

  • A child may want to test your limits to gain control.

  • Fear of being alone or the dark.

  • Not feeling well.

  • Not being tired.

  • Emotional or mental health issues.

SYMPTOMS

Children who resist going to bed may:

  • Take a long time to fall asleep. Most young children should be asleep in 15 to 30 minutes.

  • Not wake up easily in the morning.

  • Cry at bedtime.

  • Have a temper tantrum at bedtime.

  • Stall by asking questions or wanting to perform a task.

  • Get out of bed once you leave the room.

  • Crawl into bed with you.

TREATMENT

Most of the time, adults and children can work together to fix bedtime problems. Sometimes, medical treatment is needed. This may be the case if the child's anxiety, fear, or other conditions are very strong. Treatment may include different types of counseling for parents, caregivers, or the child. If the child is suffering from mental health problems, a psychiatrist may be needed.

HOME CARE INSTRUCTIONS

You may be the best person to help your child learn good sleep habits. To do this, it may help to:

  • Figure out why your child tries to put off going to bed. Be sure the child has no real fears or problems. If he or she does, treatment may be needed.

  • Keep bedtime as a happy time. Never punish your child by sending him or her to bed.

  • Keep a regular schedule and follow the same bedtime routine. It may include taking a bath, brushing teeth, reading, saying prayers. Start the routine about 30 minutes before you want the child in bed. Bedtime should be the same every night.

  • Have bedtime rules. Talk about these with your child. Explain what you expect. Rules may include:

  • Going to bed on time.

  • Not crying or screaming.

  • Not getting up, except to go to the bathroom or if there is an emergency.

  • Offer praise when your child follows the bedtime rules.

  • Let your child make simple choices at bedtime. This could be what pajamas to wear, what stuffed animal to bring to bed, or what book to read in bed.

  • Make sure your child is tired enough for sleep. It helps to:

  • Limit your child's nap times during the day.

  • Limit how late your child sleeps in.

  • Have your child play outside and get exercise during the day.

  • Do not allow active play right before bedtime. This includes television and video games that are lively or scary. Quiet activities will help the child be ready for sleep.

  • Make the bed a place for sleep, not play. Allow only 1 favorite toy or stuffed animal in bed with your child.

  • Make sure the child's bedroom is quiet and dark.

  • Be gentle, but firm about saying goodnight. Give your child a kiss and a hug, say goodnight, and leave the room. Do not stay around to answer lots of questions.

  • If your child is fearful, tell him or her that you will check back in 15 minutes, and do so.

  • If your child is screaming or crying, tell the child that you are going to close the door until the screaming or crying stops. When he or she stops, open the door. Praise the child for being quiet.

  • If your child leaves the bedroom, take him or her back to bed right away. Warn your child that you will need to close the door if this keeps happening.

SEEK MEDICAL CARE IF:

  • You have tried all ideas for at least 2 weeks, and your child still does not fall asleep in 30 minutes.

  • Your child cannot stay asleep.

  • Your child has very bad fears about bedtime.

  • Your child has frequent nightmares.

  • Bedtime problems are making your child sleepy during the day.

  • Lack of sleep is causing behavior problems. This may be happening at home or at school.