Limit-setting insomnia is one of the two types of behavioral insomnia of childhood. It occurs when parents lose control of their child's behavior around bedtime and during awakenings from sleep. This condition often occurs in preschool-aged and school-aged children who stubbornly challenge their parents, especially at bedtime.
What is Limit-Setting Insomnia?
Insomnia is difficulty falling or staying asleep, and it may result from behavioral causes. As part of the basic guidelines of sleep hygiene, children need a regular routine and a relaxing sleep environment in order to sleep well. When there are a lack of parent-enforced boundaries regarding sleep, the bedroom may become a battlefield.
Younger children do not have the insight to recognize how much sleep they need or when they are not getting enough. If left unsupervised, they are unlikely to follow a regular sleep schedule. Bedtimes may vary from one day to the next, leading to a disrupted circadian rhythm for sleep. Parents should step in to set appropriate bedtimes and enforce these daily, including the weekends.
This may require a firm application of parental authority. Children respond well to consistent expectations, and keeping a familiar bedtime routine can help. If there is a lack of structure around bedtime, children may take advantage of this. Without limitations, children will make unending demands, including for:
- Food
- Drinks
- Attention
- Playtime
These may occur at bedtime or after awakenings during the night.
How to Treat Limit-Setting Insomnia
The solution is as one might expect: restoring your role as parent and setting limitations on your child’s behavior. This will require consistency. There are some simple guidelines that may be helpful:
- Bedtimes must be enforced on a daily basis.
- In the 20 to 30 minutes prior to bedtime, quiet activities should be undertaken, such as reading bedtime stories or taking a bath.
- Unreasonable demands during the period around and after bedtime should not be met.
Following these guidelines will allow your children to have appropriate expectations, and their behavior will quickly fall into line. Additionally, in older children, the use of positive reinforcement for acceptable sleep-time behaviors may be helpful.
Learn more about the types of behavioral insomnia of childhood.
Sources:
Durmer, JS and Chervin, RD. "Pediatric sleep medicine." Continuum. Neurol 2007;13(3):162.
Mindell, JA and Owens, JA. "A clinical guide to pediatric sleep: diagnosis and management of sleep problems." Philadelphia: Lippincott Williams & Wilkins, 2003.
Spruyt, K et al. "Odds, prevalence and predictors of sleep problems in school-age normal children." J Sleep Res. 2005;14(2):163-176.
Touchette, E et al. "Factors associated with fragmented sleep at night across early childhood." Arch Pediatr Adolesc Med. 2005;159(3):242-249.
