Sleep and anxiety

Sleep and anxiety

Anxiety is probably a common cause of difficulties settling to sleep at both the start of the night and overnight. Find out about strategies you can use to help your child.

Sleeping sound in primary school children - anxiety management

Anxiety is probably a common cause of difficulties settling to sleep at both the start of the night and overnight. Many children cannot say exactly what is worrying them but may be anxious about day-to-day life in general.

Listen and understand

Try to understand your child's fears. Do not ignore or make fun of them because fears that seem silly to you may be very real to a child.

Discuss your child's fears during the day

Acknowledge that being scared or worried is normal and that all people feel scared or worried sometimes. Let you child know that they can always talk to you about things they feel worried about and together you can work out a solution. Try discussing fear during the day (not just before bedtime). Talk about how they can be less scared at night and reassure them that their bedroom is a safe place. Get them to practice getting rid of their fears by imagining their favourite colour as a big cloud that pushes 'fear' away or making fear into a big balloon that they can prick with a pin to make disappear.

Have them stay in bed

Encourage your child to stay in bed. They should stay in bed and find out they are safe, which will help them get over their fears. Letting your child leave the room sends the message that their bedroom isn't really safe. If your child is too scared to stay in their room alone, it is okay to sometimes stay by their bed until they fall asleep. Do not do this too often because they may come to depend on you being there. If your child is anxious about you leaving, check on them. Begin by briefly checking and comforting them, and then increase the time in between checks until they fall asleep. Leave the bedroom door open and think about using a nightlight to decrease your children’s fears.

If your child wakes up during the night and can't go back to sleep because they are frightened, go and reassure them that they are safe. If they leave their room and come into yours, take them back and put them back into bed. Tell them again that their room is safe.

Comfort your child

It is important to comfort children who are scared. When your child holds onto you as they are being tucked in, or calls out in fear, you should go back to their bed and find out what is wrong. Say something like, “You are safe; we are here to make sure you stay safe.” Be sure to tell them that they are safe.

Teach them how to get over their fears

Teach your child skills to get over their fears. For example:

  • discuss ways to respond to nighttime fears, such as by 'being brave' and thinking positive thoughts (for example, 'monsters are just pretend')
  • tell your child how you deal with something that frightens you
  • read stories about children who are afraid and conquer their fears (for example, for younger kids - 'David and the worry beast'; 'Huge bag of worries' and for older kids - 'Mind your mind'; 'What to do when you're scared and worried')

Introduce a security object

Help your child become attached to a security object like a toy or blanket. They can keep this in bed with them to help them feel more relaxed during the night.

Avoid scary television shows

Avoid scary TV shows, including the news or videos, or stories that may add to your child's fears. Avoid talking about their worries just before bedtime.

Help your child learn to relax

Teaching your child to relax can help them to fall asleep at bedtime. Below are some ideas of how to do this. Giving them something else to think about while lying in bed can help to distract them from their fearful thoughts. Remember, it is impossible to be relaxed and scared at the same time!

Relaxation ideas for your child include:

  • lying down with their eyes closed and then tightening and relaxing all the muscles of their body, one after the other - some children find it helps to do these muscle exercises whilst thinking about their favourite (relaxing) place, such as the beach, a park, in granny’s back yard ...
  • closing their eyes and thinking about a cloud pushing away the fear (see below)
  • asking them to draw a picture of their fear and putting it away in a 'scary thoughts' box for the night

Reward positive behaviour

A reward chart for trying to be brave can be helpful: at first this may be for not getting out of bed, and just calling out if they really feel they need you, and then later, as your child feels safer, to reward them for staying in bed all night and not calling out. Reward and praise your child as soon as they wake up in the morning 'for knowing that their bedroom is a safe place to be' and remind them they can always talk to you when they feel worried. The reward should be something small and could involve collecting a certain number of stickers leading to a reward the child will enjoy (such as a lucky dip prize, trip to the park). This will vary depending on the age of your child. The reward should be easy to achieve for the child to begin with to increase the chance of your child being able to succeed.

Acknowledgement and copyright

Thumbnail of first page of 'Anxiety management' handoutStarship Foundation and the Paediatric Society of New Zealand thank the Centre for Community Child Health at the Murdoch Childrens Research Institute and Royal Children’s Hospital, Melbourne, Australia, for making this content available to parents and families.

© Copyright – Centre for Community Child Health at the Murdoch Childrens Research Institute and Royal Children’s Hospital, Melbourne, Victoria, Australia 2014. Except as permitted under the Copyright Act 1968 (Cth), no part of this fact sheet may be reproduced by an process, electronic or otherwise, without the specific written permission of the Murdoch Childrens Research Institute.

This page last reviewed 23 October 2014.
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