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Curing Kiddie Insomnia

It's well past midnight when you're roused from dreamland by your 5-year-old: She's awake and can't get back to sleep.

Children are usually sound sleepers, says Charles Pohl, M.D., director of the Network of Apnea and Pediatric Sleep Program at Thomas Jefferson University Hospital, in Philadelphia. When they do experience insomnia, it's most likely a symptom of an underlying problem. To ensure that your child gets enough rest at night:

Vent anxieties

Kids sometimes feel uneasy about school, friends and family—any of which can keep them awake. If talking with your child reveals that worries about a specific issue—such as a new baby—are bothering her night after night, try to help her resolve them. Reassure her that you love her and her new sibling, for instance, and set aside some special time each day for just the two of you.

Sometimes insomnia itself becomes an anxiety. When Will Curless, of Scarsdale, NY, was 6, he worried that if he couldn't fall asleep, he wouldn't have enough energy for the next day—and that kept him up longer. "I told him that just by closing his eyes and resting, he'd store up enough energy," says his mom. "If that didn't soothe him, I let him read in bed until he was sleepy."

Keep a set schedule

Even on weekends, kids should go to bed near their regular turn-in time, since staying up late will make it harder to wake up in the morning and will push the following night's sleepytime even later. Wind-down cues—such as turning off the TV or wrapping up homework—should start soon after dinner.

Change sleep associations

We all wake during the night, take a quick, semiconscious assessment of our surroundings, then go back to sleep. These normal awakenings become problematic when a child depends on something—say, a music tape—for getting to sleep initially. When she wakes during the night, she may need that routine again. "Kids should fall asleep under the same conditions that'll be there in the middle of the night," says Deborah Givan, M.D., director of the Children's Sleep Lab at Riley Children's Hospital, in Indianapolis. Ideally, that means sleeping in their own beds in a quiet room.

Watch stimulants

Chocolate and colas both contain caffeine, so limit them after the late afternoon. Certain medications, such as antihistamines, theophylline (for asthma), and some antidepressants can also cause sleeplessness. If you suspect these might be a problem, consult your pediatrician.

Don't make it an event

When getting your child back to sleep, less is more. "Don't do anything that reinforces awakenings, such as serving snacks or letting her into your bed," says Dr. Givan. "The more a parent participates, the worse insomnia becomes. Calmly reassure your child and lead her back to her room."

To help her fall asleep, you might suggest she quietly sing a boring song to herself, or take deep breaths and count, with her eyes closed.

If insomnia seems to be chronic, consult your pediatrician to rule out more serious problems, such as sleep-obstructive apnea (a respiratory disorder that causes restless sleep).