Insomnia in Children

Reviewed by: HU Medical Review Board | Last reviewed: June 2020

A child that has trouble falling asleep, staying asleep, or waking too early may have insomnia. Just like in adults, a child’s insomnia can be short-term (acute) or long-term (chronic). Between 2 and 3 out of 10 children have sleep problems.1-4

Short-term insomnia may be caused by sickness, a drug taken for a short time, stress, or unfamiliar surroundings. Long-term, or chronic, insomnia occurs 3 times a week for a month or longer. Chronic insomnia in children may be caused by depression, anxiety, pain, or other health problems such as the itching of eczema, a stuffy nose, growing pains, or autism.1-2

What causes insomnia in children?

The causes of insomnia in children are much like the things that cause insomnia in adults. These include:1-2

  • Stress
  • Certain health conditions
  • The sleeping environment
  • Poor sleep habits
  • Caffeine, smoking, or alcohol
  • Certain drugs, such as antidepressants or steroids
  • Another sleep disorder such as restless legs syndrome or sleep apnea

Children may also learn poor sleep habits from their families. For instance, a parent who worries about poor sleep can unknowingly teach this anxiety to their child. This, in turn, makes their child anxious about their own sleep, which can lead to insomnia.5

What are the signs of insomnia in children?

The signs that a child is not sleeping well are similar to the signs in adults. Signs include:1-2

  • Daytime tiredness, sleepiness, and fatigue
  • Problems concentrating
  • Irritability or mood swings
  • Lack of motivation
  • Depression
  • Hyperactivity
  • Having accidents
  • Poor impulse control or poor decision-making
  • Social problems at school, with friends, or with family
  • Worry about going to bed and falling asleep

You should talk with your pediatrician if your child’s insomnia lasts for more than a few weeks.

What is behavioral insomnia?

The most common type of insomnia in children is learned and called behavioral insomnia.

Common examples include resisting going to bed or only being able to sleep under certain conditions. For example, a child may expect a bottle, toy, or to be rocked to fall asleep. Or, a child may expect to get into their parent’s bed if they wake up in the middle of the night.3

Keeping to a sleep schedule and enforcing bedtime rules often help fix behavioral insomnia.3

Insomnia and autism

Between 50 percent and 80 percent of children and teens with autism have trouble falling asleep and staying asleep. Some studies show that autism behaviors can get worse with lack of sleep. As with other children, parent education about good sleep habits is the first choice for treatment.4

How is insomnia treated in children?

Just as with adults, the first line of treatment for insomnia includes learning good sleep habits and cognitive behavioral therapy for insomnia (CBT-I). CBT-I is a special type of therapy that teaches someone a variety of ways to get better sleep. CBT-I may include relaxation techniques, deep breathing exercises, and positive self-talk. These techniques can be helpful for a lifetime.1

Good sleep habits include:1

  • Keeping a regular sleep schedule for waking up and going to bed
  • Making time to get enough sleep
  • No TV or electronics in the bedroom
  • Avoiding caffeine 4 to 6 hours before bedtime
  • Avoiding stimulating activities within 1 hour of bedtime (TV, computer games, homework, exercise)

Insomnia drugs are usually not recommended for children. Supplements like melatonin may be helpful for short-term use. However, talk to your pediatrician before giving your child any supplement. Old-fashioned remedies like warm milk, chamomile tea, a warm bath, or massage may work too.1

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