Periodically I get emails from subscribers to my list. I like to share some of the more interesting questions that people have. These entries are edited for privacy and brevity, and shared with permission.
S. writes:
Our youngest, Tommy, is almost five. Being the youngest of four, getting him into bed before 8 is almost impossible as he doesn’t want to miss out on what his older siblings and parents are doing (our home is one floor, so he can hear everything). The trouble is, that he doesn’t fall asleep for at least two hours. He’s probably over-tired by then. He wants to play, drink, eat (we don’t let him eat, of course, but I’ll bring him water if he needs). We need to lie with him to get him to fall asleep eventually, and he will come into our room to cuddle many times during the night.
He naps for 40 minutes in school but it is done by 2 PM. If we let him sleep in, he will sleep until 9:30 AM. It’s difficult to get him up in the morning.
How do we get him to fall asleep before 10-10:30?
Generally, when we think about five year olds, we imagine them to be early risers. They are typically the first ones up in the morning. The reason for this is that most children have a strong body clock preference for early to bed and early to rise.
However, some children are on a later schedule. It is usually due to lifestyle, a biological preference for a night time schedule, or both. It also commonly occurs over summer vacations.
Lifestyle is clearly a factor in this case given the fact that he seems to be on the schedule of the older children.
Given his preference for late sleep onset and late wake up, there is likely a body clock preference as well. He is sleeping 11 hours when allowed to be on his preferred schedule (10:30 PM-9:30 AM) which is age appropriate.
There is nothing inherently wrong with this schedule, but it sounds like it is inconvenient for the family to have him up so late, and he may be sleep deprived as he frequently has to be woken up. (It’s a good rule of thumb that children who need to be woken up either have insufficient sleep, a problem with sleep (like obstructive sleep apnea) or both.
If Tommy were my patient, here’s what I would consider.
- I would use a sound machine for sound masking in his room so that he would not hear the rest of the family.
- He will wake up when he has had sufficient sleep. But we need to move his schedule earlier. It is always easier to get someone to stay up later that to go to bed earlier. The best way to move someone’s body clock earlier is to get them up earlier and ensure morning light exposure and exercise. You could go gently (move his wake time earlier by 15 minutes a day) or just get him up consistently at his desired wake time going forward. Consistent wake times and morning light exposures will move his sleep onset time earlier but it will take a week or two. This will likely result in some irritability as he will be sleep deprived.
- His target schedule will be based on the usual time you need him up on school days to allow an eleven hour sleep opportunity. So if he can sleep until 8 AM on school days, his target bedtime is 9PM.
- I would also try moving his bedtime earlier by 15 minutes each day, with the goal of him falling asleep within 20 minutes of lights out. I would avoid any napping after 3 PM and not allow him to sleep in the early evening.
- Once Tommy is on his desired schedule, then you can work on his sleep onset association disorder, using any number of sleep training techniques.
- You will need to be very consistent about maintaining his schedule as he likely has a preference for an evening schedule and will shift back if you keep him up for a few nights on weekends or a vacation.
I would discuss this and any adjustment to your child’s sleep with your pediatrician before proceeding, as this is provided for information and is not medical advice.
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