As part of an ongoing series on behavioral insomnia in children, I discussed sleep onset association problems last week. That problem tends to occur in kids less than three (although it can be an issue in older children as well). The most difficult part of sleep onset association problems is frequent awakenings at night, although the root cause is issues with bedtime.
This week, I’m going to talk about an issue with bedtime that presents with . . .problems at bedtime. (This is a lot easier to get your head around). The technical terms include “bedtime resistance” and “behavioral insomnia of childhood, limit setting subtype”. Kids with this problem tend to range in age from 2-8 years of age. It usually isn’t prominent until children are switched from a crib to a bed.
The first hallmark of this disorder is prolonged fighting and struggling around bedtime. In some kids, this usually starts around the time of transitioning from post dinner activities to bedtime activities. (In my house, this means going upstairs for a bath). Other children wait to start to complain once they are in their rooms. The resistance may be obvious (crying, yelling) but is commonly more subtle resistance that prolongs bedtime and delays sleep onset well past the delayed bedtime.
Once you leave your child’s room, breathing a sigh of relief and dreaming about doing the dishes and then catching up on that episode of Mad Men you recorded, you hear the door open and the patter of little feet. Thus begins a series of curtain calls, the second hallmark of bedtime resistance. These are repeated requests after bedtime for attention. Some classics I have heard:
- “I want a drink of water”
- “I need another hug”
- “Will you rub my back some more?”
- “Another song/story”
- “I need to go to the bathroom”
- “I’m scared” (without any apparent fear or distress)
- “I need to go to the bathroom again”
- “Can you check the closet and make sure there are no monsters there?”
- “I really need to go to the bathroom. I promise it’s the last time”
Now, every parent has had a child try to delay bedtime a bit or encountered a rare curtain call. That is perfectly normal. Behavioral insomnia (limit setting type) is characterized by prolonged delay of sleep onset, often more than an hour or two past the desired bedtime.
What if my child fights bedtime and then wakes up multiple times at night?
In the classic form, kids with bedtime resistance do not have problems with staying asleep. However, many of them may develop inappropriate sleep onset associations. He may fight bedtime until his dad relents and rubs his back until he falls asleep, then he wakes up multiple times needing his dad to rub his back again.
The key to understanding both of these issues is that the problem in either case is bedtime. Next week: How to fix bedtime so your child falls asleep on their own, with a minimum of fuss, and sleeps through the night.
Parents, I’m a connoisseur of creative stalling tactics in kids: any great stories your kids have come up with to keep from going to bed at night?
Having quiet time/sitting still with out television and play at intervals during the day helps children and adults learn to settle themselves at night.
Great post, Dr. C. Our 2 year old’s most creative stall tactic so far is calling from his room, “I’m dreaming, I’m dreaming” accompanied by pretend crying. When we go in to calm him, he is sitting up, clearly fully awake, and smiling.
Look forward to your next installment.
My niece Julia would famously say, “Julia’s hurt” until someone came in, or, when her Aunt Loli was babysitting, “Loli! I have a present for you!”
True story ….
My son always asks to get ‘cozy’. He’ll lie down and want us to put all of the blankets on him and tuck him in. He’ll fight this by refusing to lie down, so we’ll just drape the blankets over him and tiptoe out.
Hey Jason. Good to hear from you. Sounds like you guys are playing it exactly right. Acknowledge your child’s concern but ignore unreasonable requests.
The stall tactics are impressive. Sometimes, when I step back from my frustration, I’m impressed by their creativity. Negotiation skills point to some solid cognitive function going on those little heads. One recent one is fixating on any random owies from the day and begging for a bandaid or an extra kiss to make it feel better. My absolute fave though is when they call out “mommy, I love you so much… I missing you.” Boy that gets me every time.
But you know what’s been the most challenging actually? Having my kids (3.5 yrs and 2 yrs) share a room. The love-hate antagonism has affected our bedtime process as well. It was our choice to have them share a room, but now sometimes I wonder if it’s more trouble than its worth for the sake of encouraging closeness. Do you have tips on bedtime with shared rooms?
@Yolanda. I’m not aware of any research RE best practices for shared bedtime. Obviously, a shared room has positives (freeing up an extra room, perhaps some improved closeness with siblings) if it is an option. Your children have comparable ages to their sleep schedules are likely compatible. Certainly, siblings close in age can struggle with sharing parental attention. If both parents are available for bedtime, at least for a transitional period, it may be helpful. Can you elaborate more on the problems you are having?
They do have similar sleep schedules (at least we keep it that way). We have consistent bedtime routines and they know when it’s bedtime. I think the main issues are 1) one or the other might try to bother the other, such as climbing into his/her bed, 2) they don’t want to miss out on anything if the other is still awake, so they end up riling each other up into a fit of giggles, and 3) there is a residual desire for more attention since the day has been spent sharing/competing for my attention and energy. I suspect I have hit a stage in life when I just need to tire them out more (both kids are very active) and I may need to find more one-on-one time with each of them. Their hearts seem to just crave it, and it hits hardest at bedtime. The difficulty with the attention issue is that once one wants it, then the other feels the need to demand it as well. I don’t stay with them until they fall asleep though, and they do eventually fall asleep on their own. But it’s a bit of a drawn-out process due to various permutations of the above on any given day.
Sibling dynamics are a new thing for me since I am an only child. The ways they love each other one minute then hate each other the next is just as new to me as I’m sure it is for them. I want them to share a room, but some nights I do wonder if it just makes the sibling rivalry worse.
I have an upcoming post on sleep training techniques, but you might find that moving bedtime 30 min later (bedtime fading) may help you out a bit. Being a bit more tired can help with these issues.
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