Sleep Disorders Causes & Risk Factors Behavioral Causes of Insomnia in Children Behavioral and Medical Problems May Lead to Difficulty Falling, Staying Asleep By Brandon Peters, MD facebook twitter Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist. Learn about our editorial process Brandon Peters, MD Medically reviewed by Medically reviewed by Jonathan B. Jassey, DO on March 03, 2020 facebook Jonathan B. Jassey, DO, is board-certified in pediatrics. He has been in private practice at Bellmore Merrick Medical in New York since 2007 and is the co-author of "The Newborn Sleep Book." Learn about our Medical Review Board Jonathan B. Jassey, DO Updated on November 21, 2020 Print Insomnia is the inability to fall or stay asleep or experiencing sleep that is not restorative. The causes of insomnia in children may overlap with those for insomnia in adults, but there are also some unique conditions that may predispose your child to difficulty sleeping. Didier Robcis / Getty Images Sleep issues are one of the most common frustrations of new parents. Taking preventive measures focused on sleep routines and the sleep environment can be very helpful. Many books have been written about this, the most famous of which is probably Dr. Ferber's Solve Your Child's Sleep Problems. How Behavioral Problems Result in Insomnia Perhaps the most common and frustrating of the causes of insomnia are difficulties related to your child’s behavior. Babies and toddlers may enjoy being comforted as they transition to sleep, but if they awaken and you are not there, this can be a source of great distress. This may result in frequent tearful tantrums in the middle of the night. This sleep-onset behavioral insomnia can be remedied by letting your child fall asleep alone. Another potential problem is toddlers and young children who refuse to go to bed. They will insist on a litany of needs prior to going to sleep: a drink of water, a trip to the bathroom, another bedtime story, a few more minutes with the light on, and the list goes on. This limit-setting insomnia is overcome by setting appropriate boundaries and asserting parental authority. Moreover, children need to have a set of healthy sleep habits and a bedtime routine that will ensure a smooth transition to sleep. This includes appropriate sleep hygiene, which eliminates disruptions to sleep and makes the period of time just prior to falling asleep a time of relaxation. In addition, many distractions should be eliminated from the bedroom to ensure an appropriate sleep environment. The Role of Medical Problems There are a number of medical problems—including neurologic and psychiatric conditions—that may lead to insomnia in children. In general, these are rare disorders and other signs would exist beyond insomnia. Some of these possible disorders include: DepressionPost-traumatic stress disorder (PTSD)Attention deficit hyperactivity disorder (ADHD)Autism spectrum disorder In addition, some children (especially teenagers) may have circadian rhythm disorders such as delayed sleep phase syndrome that result in insomnia. These conditions lead to difficulties falling asleep at night and a desire to oversleep in the morning. This occurs because the desired sleep phase is shifted later than is standard. This may interfere with school performance and some school districts are actually shifting the start times to allow teens to sleep in. The use of phototherapy and melatonin may also help to shift these troublesome sleep patterns. Other Causes Aside from the causes described above, there are a few other possible situations that may result in insomnia in children. Some children may experience insomnia as the result of medication use, especially the use of stimulants in ADHD. Finally, precocious children (those who are intellectually gifted) often have insomnia. If your child is having difficulty falling asleep, and simple changes to address behavioral causes are ineffective, you may want to speak to your pediatrician about exploring other possibilities to improve your child’s sleep. Was this page helpful? Thanks for your feedback! Tossing and turning night over night can have a big impact on your quality of life. Our free guide can help you get the rest you need. Sign up for our newsletter and get it free. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Durmer, JS and Chervin, RD. "Pediatric sleep medicine." Continuum. Neurol 2007;13(3):153-200.