If you are a parent, you can remember those sleepless nights caring for a newborn. That cute little bundle of joy is not so joyful early in the morning when you have to get up for work in a few hours. Unfortunately, poor sleep behaviors can likely follow a child into adulthood.

As providers, we encourage adult patients to keep a regular sleep schedule so as to set circadian rhythms and improve sleep. We practice should be no different for children.

A child’s sleep issues may be directly related to their caretaker’s parenting skills. Despite this, some parents may not insist that their children go to bed on a set schedule and may not be teaching their children proper sleep hygiene. These poor behaviors may continue as the child ages.

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Parents may share with you that their child objects going to bed on schedule. Often, parents give in to a child’s demands because they are also sleep-deprived and tired. Children are smart and know this.

Developing positive routines before bed is important. Encourage parents to set aside a certain time at night for things like bathing, or doing soothing activities such as reading a book or telling a story to the child. These activities not only help improve sleep but encourage a strong bond between the parent and child.

It is important for health-care providers to remember that all families are not idyllic. Some children are part of very dysfunctional families. These children can become hyper-vigilant and can have fear about going to sleep. They often develop insomnia issues.

Encourage parents to create a safe environment for the child where they are not afraid to go to sleep.  A child who is a product of divorce may worry about what will become of their families at night. These are very real issues a child and should not be overlooked. Even happy events for families, such as the birth of a sibling, can be upsetting to a child and their sleep.

More severe sleep disorders such as obstructive sleep apnea and restless leg syndrome do occur in children. If a child has symptoms of attention deficit disorder, consider sleep apnea. A child can have difficulty voicing what he or she feels. Depending on the child’s age, he or she may not know how to say “I am fatigued” or “I don’t feel rested.”

A change in a child’s behavior can be related to their sleep. If a child is snoring loudly, complains of leg pain, and is moving around a lot in their sleep, ask the parents to consider a sleep study for further evaluation.

Sharon M. O’Brien, MPAS, PA-C, is a practicing clinician with an interest in helping patients understand the importance of sleep hygiene and the impact of sleep on health.