From the Guidelines
If your seven-year-old is experiencing insomnia, start by establishing a consistent bedtime routine that includes calming activities like reading or a warm bath 30-60 minutes before sleep. This approach is recommended as the first line of treatment, after excluding medical contributors, as stated in the study by 1. Set a regular sleep schedule with the same bedtime and wake time every day, even on weekends. Create a sleep-friendly environment that's dark, quiet, cool (65-70°F), and free from electronic devices. Limit screen time at least one hour before bed as blue light can suppress melatonin production. Avoid caffeine and sugar in the afternoon and evening, and ensure your child gets plenty of physical activity during the day, but not right before bedtime. For most seven-year-olds, 10-11 hours of sleep per night is recommended.
Some key points to consider when addressing insomnia in children include:
- Establishing a consistent bedtime routine and sleep schedule
- Creating a sleep-friendly environment
- Limiting screen time and avoiding stimulating activities before bedtime
- Encouraging physical activity during the day, but not before bedtime
- Avoiding caffeine and sugar in the afternoon and evening
If these measures don't help within 2-3 weeks, consult your pediatrician. Medication is rarely recommended for children this age unless there's an underlying medical condition, as noted in the study by 1. Instead, your doctor might suggest behavioral approaches or possibly refer you to a pediatric sleep specialist. Childhood insomnia often stems from anxiety, poor sleep habits, or normal developmental changes, and addressing these underlying causes is typically more effective than medication for long-term sleep health, as discussed in the study by 1. Behavioral interventions are clearly beneficial for typically developing children experiencing significant insomnia, although few treatment trials have found consistent success rates in children with autism spectrum disorders, as mentioned in the study by 1.
From the Research
Treatment Options for Insomnia in Children
- Cognitive Behavioral Therapy for Insomnia (CBT-I) is a multi-component treatment that targets difficulties with initiating and/or maintaining sleep, and is typically delivered over six to eight sessions 2.
- CBT-I has been shown to be effective in adults, with studies demonstrating its efficacy in improving sleep onset latency, wake after sleep onset, total sleep time, and sleep efficiency 3, 4, 5.
- However, there is limited research on the effectiveness of CBT-I in children, particularly those as young as seven years old.
Potential Applications of CBT-I in Children
- The core components of CBT-I, such as sleep restriction therapy, stimulus control therapy, sleep hygiene, and cognitive therapy, may be adapted for use in children 2.
- Cognitive restructuring, sleep hygiene, and relaxation techniques may also be beneficial for children with insomnia 3.
- However, further research is needed to determine the efficacy and safety of CBT-I in children, and to develop age-appropriate treatment protocols.