The Child Who Can't Fall Asleep Because Their Brain Won't Stop
In our view, sleep trouble with worry is worth raising with your child's doctor. One study looked at children and teens with anxiety disorders (Alfano and colleagues, 2010). It linked bedtime racing thoughts with shorter sleep. That is a link, not a cause. We cannot tell you whether your child has an anxiety disorder. For worry, ask a mental-health professional.
TL;DR
- In our experience, some children lie awake going over the day, or tomorrow. In our view, sleep trouble with worry is worth raising with your child's doctor. For worry, ask a mental-health professional.
- One study looked at children and teens with anxiety disorders (Alfano and colleagues, 2010). Alfano's team linked racing thoughts before sleep with shorter sleep and more sleep problems. That is a link, not a cause. The study was not of children in general. In our view, sleep trouble with worry is worth raising with your child's doctor. We cannot tell you whether your child has an anxiety disorder. For worry, ask a mental-health professional.
- Meltzer and Mindell (2014) pooled studies of help for children's sleep trouble. The help changed habits and routines around sleep. Meltzer and Mindell found evidence for this help in young children. For older children, they found too few studies to say. Their review was not about worry. Some sleep problems are medical questions for a pediatrician. Trouble falling or staying asleep that keeps going. Loud snoring, or pauses in breathing. Severe sleepiness in the day. For worry, ask a mental-health professional.
- In our view, talk about worries earlier in the evening, not at lights-out. Keep the same wind-down at the same time each night. If the worry is about school, tell the teacher. These steps are our own practice. For worry, ask a mental-health professional.
When worry keeps a child awake
In our experience, some children lie awake going over the day, or tomorrow. A tired child is harder to start and harder to keep going.
In our view, sleep trouble with worry is worth raising with your child's doctor. For worry, ask a mental-health professional.
What one study found about racing thoughts
One study looked at children and teens with anxiety disorders (Alfano and colleagues, 2010). Alfano's team linked racing thoughts before sleep with shorter sleep and more sleep problems. That is a link, not a cause. The study was not of children in general. Alfano's team said sleep should be part of assessing anxious children. In our view, sleep trouble with worry is worth raising with your child's doctor. We cannot tell you whether your child has an anxiety disorder. For worry, ask a mental-health professional.
What a review of sleep help found
Meltzer and Mindell (2014) pooled studies of help for children's sleep trouble. The help changed habits and routines around sleep. Meltzer and Mindell found evidence for this help in young children. For older children, they found too few studies to say. Their review was not about worry. The steps on this page are our own practice. We do not claim their review tested them.
Some sleep problems are medical questions for a pediatrician. Trouble falling or staying asleep that keeps going. Loud snoring, or pauses in breathing. Severe sleepiness in the day.
For worry, ask a mental-health professional.
What we suggest at bedtime
- In our view, talk about worries earlier in the evening, not at lights-out.
- Keep the same wind-down at the same time each night.
- If the worry is about school, tell the teacher.
These steps are our own practice. For worry, ask a mental-health professional.
Our page on sleep and learning covers the hour before bed.
Who to ask about sleep and worry
In our view, sleep trouble with worry is worth raising with your child's doctor. For worry, ask a mental-health professional. Some sleep problems are medical questions for a pediatrician.
Sadness or worry that lasts is a reason to ask for help too.
When to ask for help
Each of these is a reason to ask for help on its own.
- Little change, even with steady practice and good teaching.
- Schoolwork well below what school expects.
- A teacher who raises a concern about learning.
- Extreme upset about schoolwork.
- Complete avoidance of school or learning.
- Hopelessness about learning.
- Sadness or worry that lasts.
- Significant delays in speech, language or motor development.
- A skill that was there and has gone. Our position is that a lost skill goes to a doctor first, not a tutor.
If no skill has gone, start with the teacher. Say what you are seeing at home, and what you have tried. Beyond the teacher, the right person depends on what it turns out to be about. If the work is too hard, someone who works on that school skill. If worry or mood is the thing, someone who works with children's mental health. In our view, delays in speech, language or movement are worth raising with your child's doctor. In our view, if you are worried enough to ask, a professional evaluation is worth asking about.
Any talk of hurting themselves is a same-day call to your doctor or a crisis line.
In the classroom
If a student often seems worn out in the morning, tell the family.
Two sentences for an email home: "She seemed very tired this morning and found it hard to start. How have her evenings been?"
Key Takeaways
In our experience, some children lie awake going over the day, or tomorrow. In our view, sleep trouble with worry is worth raising with your child's doctor. For worry, ask a mental-health professional.
One study looked at children and teens with anxiety disorders (Alfano and colleagues, 2010). Alfano's team linked racing thoughts before sleep with shorter sleep and more sleep problems. That is a link, not a cause. The study was not of children in general. In our view, sleep trouble with worry is worth raising with your child's doctor. We cannot tell you whether your child has an anxiety disorder. For worry, ask a mental-health professional.
Meltzer and Mindell (2014) pooled studies of help for children's sleep trouble. The help changed habits and routines around sleep. Meltzer and Mindell found evidence for this help in young children. For older children, they found too few studies to say. Their review was not about worry. Some sleep problems are medical questions for a pediatrician. Trouble falling or staying asleep that keeps going. Loud snoring, or pauses in breathing. Severe sleepiness in the day. For worry, ask a mental-health professional.
In our view, talk about worries earlier in the evening, not at lights-out. Keep the same wind-down at the same time each night. If the worry is about school, tell the teacher. These steps are our own practice. For worry, ask a mental-health professional.
Tonight, note what time your child falls asleep. Note what was on their mind, if they say. Take the notes to your child's doctor. This is a record, not a test.
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Common questions from parents
My child can't sleep because of worry about school. What should we do?
In our view, talk about worries earlier in the evening, not at lights-out. If the worry is about school, tell the teacher. These steps are our own practice. In our view, sleep trouble with worry is worth raising with your child's doctor. For worry, ask a mental-health professional.
Do racing thoughts at bedtime go with less sleep?
One study looked at children and teens with anxiety disorders (Alfano and colleagues, 2010). Alfano's team linked racing thoughts before sleep with shorter sleep and more sleep problems. That is a link, not a cause. The study was not of children in general. In our view, sleep trouble with worry is worth raising with your child's doctor. We cannot tell you whether your child has an anxiety disorder. For worry, ask a mental-health professional.
What if my child is anxious at bedtime?
The Centers for Disease Control and Prevention (CDC) is a US government health agency. The CDC describes when a child may be diagnosed with an anxiety disorder. One case is so many fears and worries that they "interfere with school, home, or play activities." It points to your child's doctor or a mental-health specialist for an evaluation. We cannot tell you whether your child has an anxiety disorder. In our view, sleep trouble with worry is worth raising with your child's doctor.