The amount of sleep a child needs at night varies from about 9 to 12 hours according to age and individual requirements (seeSleep requirements in childhood). Lack of sleep rarely affects health but may affect behaviour during the day or performance at school. However, refusal to go to sleep at what you think is a reasonable time and/or waking in the middle of the night can be disruptive and distressing for the family if it occurs regularly. A number of factors, including physical illness, emotional upset, nightmares, and lack of a regular bedtime routine, may cause such sleeping problems.
1Does your child seem to need less sleep than other children of a similar age?
Possible cause and action Children vary widely in the amount of sleep they need (seeSleeping requirements in childhood). If your child seems well, there is unlikely to be anything wrong. If your child's sleeping patterns are causing you difficulties, consult your doctor.
16
Possible cause A problem sleeping that goes back to when your child was a baby may be due to lack of a bedtime routine.
Action Try to stick to a regular bedtime routine, and follow the other self-help advice for getting your child to sleep. If your child is still not sleeping better after a few weeks of the new routine, consult your doctor.
17
Possible cause Difficulty in settling is often the result of anxiety over a temporary upset.
Action Try to discover and deal with any worries that your child has. Provide extra reassurance and support. Your child will probably settle more easily once the upset is over. However, if your child is still not sleeping better in a few weeks, consult your doctor.
18
Possible causes Your child may be afraid of the dark or of being left alone.
Action Reassure your child. A night-light or leaving the bedroom door open may help. A regular bedtime routine may also make your child feel more secure. If your child is still not settling properly within a few weeks, consult your doctor for advice.
19
Possible cause and action An unwell child is unlikely to sleep through the night. If your child has specific symptoms, consult the relevant chart in this content. Otherwise, consult your doctor. Once better, your child should sleep through the night.
20
Possible cause and action Sleepwalking is most common between the ages of 6 and 12. There is no need to worry as long as you ensure that your child is safe, for example by locking all outer doors. Do not try to wake your child, but guide him or her back to bed if necessary. Children usually grow out of it by age 12.
21
Possible cause Symptoms of conditions such as asthma or eczema that do not bother a child during the day can disturb his or her sleep. Consult your doctor.
Action Your doctor will examine your child and prescribe appropriate treatment. If your child is already receiving treatment for a condition such as asthma or eczema, it may need to be adjusted. Once the symptoms have been treated, your child should sleep better.
22
Possible causes Waking more than once or twice during the night to pass urine may be a sign of an underlying disorder - for example, a urinary tract infection. However, the most common cause is drinking too many fluids.
Possible cause and action Certain drugs, such as some used to treat asthma, can cause disturbed sleep as a side effect. Consult your doctor. Meanwhile, do not stop giving your child his or her prescribed drugs.
24
Possible cause Your child is probably having night terrors, a condition in which a child seems to be awake and terrified, although he or she is actually asleep and will not remember the incident in the morning. Night terrors are most common in 4-7 year olds.
Action You may be able to prevent a night terror by waking your child in the restless period that often precedes it. Night terrors usually occur about 2 hours after falling asleep. However, once one has started, there is little you can do except stay with your child. If he or she has frequent night terrors, consult your doctor. Night terrors will become less frequent as your child grows older.
25
Possible cause Your child is probably having nightmares. Bad dreams are common in children aged 5-6 and may be triggered by a frightening experience or events on television or in stories. Nightmares may be caused by anxiety.
Action Comfort your child until he or she manages to go back to sleep. In some cases, it may help to talk about the dream. If your child's nightmares are persistent or frequent, consult your doctor.
26
Possible cause and action Children are often ready to start their day earlier than their parents and may go through a phase of early waking. If you want your child to go back to sleep, follow the self-help advice for getting your child to sleep. If your child is old enough, you may wish to leave him or her to play quietly instead.
27
Possible cause Your child may be being disturbed by others in the room.
Action If possible, place your child in a separate room to sleep so that he or she is able to sleep through the night without being disturbed. After a few weeks, he or she may be able to share a room again without waking up at night.
28
Consult your doctor if you are unable to identify a cause for your child's sleeping problem from this chart.
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Consult your doctor if you are unable to identify a cause for your child's sleeping problem from this chart.
Self-Help Getting your child to sleep
If your child is not sleeping well, the problem frequent as your child grows older. may be lack of a fixed bedtime routine. Try to establish a regular pattern that is followed every night, such as a bath and then a story. Often, children do not sleep well because they are afraid of the dark. This problem can be solved by a night-light or leaving the bedroom door open. If you have difficulty in getting your child to sleep, settle him or her, say goodnight, and leave the room. If your child cries, leave him or her for a few minutes before returning. Reassure your child briefly and then leave again, resisting the urge to stay. Repeat this procedure until your child falls asleep. The time needed will shorten each day.
If your child wakes during the night, only get up if he or she is truly crying. (A child who is only whimpering may drift back to sleep.) Go into the room to make sure nothing is wrong, reassure your child, and leave again. If your child still cries, try the method above. He or she will eventually settle back to sleep.
Self-Help Sleep requirements in childhood
Children vary in the amount of sleep that they need, and it is normal for some children to sleep more than others of a similar age. In general, children sleep less as they grow up. The proportion of sleep spent dreaming also goes down, from about half in a newborn to about a fifth in a teenager. You should only worry about your child's sleeping if he or she seems unwell or if excessive sleepiness interferes with his or her activities.
Age
Average total sleep per 24 hours
Up to 3 months
16 hours
3-5 months
14 hours
5-24 months
13 hours
2-3 years
12 hours
3-5 years
11 hours
5-9 years
10 1/2 hours
9-13 years
10 hours
Amount of sleep according to age
This table shows the average number of hours of sleep needed by babies and children at different ages.
Family Doctor Health Advisor is for information purposes only, and is designed as a general reference and catalyst to seeking further information.
The RACGP is not engaged in providing medical or other advice or services, and is not responsible for the results of any actions taken by any person on the basis of any information in this publication, or for any error in, or omission from, this publication.
Publication Date: 31 March 2009 Authorised By: RACGP
