Child sleep problems

Children and young people need sufficient, good quality sleep to support healthy development. But many parents are concerned their children don’t get enough quality sleep.

How much of a problem is child sleep?

The Parenting Today in Victoria study, conducted by the Parenting Research Centre, has provided insights into the support needs of Victorian parents. Data was collected from representative samples of Australian parents in 2016 and 2019. At each time, 2,600 parents (including over 1,000 fathers) of children aged 0-18 years were surveyed, highlighting the strengths, needs and experiences of parents.

The 2019 study found that nearly half of all parents surveyed (44%) thought their child’s sleep patterns or habits were a problem. Sleep was particularly troubling for some, with 20% saying it was a moderate or large concern (Parenting Research Centre, 2019). Similar results regarding the extent of problematic child sleep were reported by parents (36%) in the previous Parenting Today in Victoria study, held in 2016 (Parenting Research Centre, 2017).

Past research has also found moderate to high levels of sleep problems in children. For example, between 30% and 40% of fourth grade children in Germany were reported by their parents to have sleep difficulties (Fricke-Oekermann et al., 2007). A large population-based study in Belgium found that 62% of caregivers said their children (aged 6-12 years) had a least one problematic sleep behaviour (Spruyt et al., 2005). In a Swedish study of sleep in younger children (6-18 months), 48% were reported by their parents to have had sleep problems (Thunstrom, 2007). A slightly lower prevalence of sleep concerns was found in a Dutch study of children aged 2-14 years, with 25% of parents indicating their children had at least one sleep problem (van Litsenburg et al., 2010).

Are sleep problems the same for children of different ages?

The 2019 Parenting Today in Victoria survey found sleep was a challenge for children of all ages (Parenting Research Centre, 2019). While sleep was a problem for many parents of very young children, it was also of concern for parents of adolescents. Reasons for problems with sleep varied across age groups, with children aged 0-2 years waking during the night, children 3-5 years wanting to sleep with their parents, children 6-12 years taking a long time to get to sleep, and adolescents (12-18 years) using electronic devices during the night.

Are parents of particular children more likely to be concerned about sleep issues?

Both Parenting Today in Victoria surveys found parents of children with complex needs were three times more likely to say their children have sleep problems than parents of typically developing children. This was particularly so for parents of autistic children (50%) and children with behavioural problems (57%) and anxiety (44%), who found their child’s sleep to be a moderate or large problem (Parenting Research Centre, 2019). This is consistent with previous research into children with complex needs (e.g., Horwood et al., 2019; Sivertsen et al., 2011; Sung et al., 2008).

Is there a relationship between child sleep and parental mental health?

Through the 2019 Parenting Today in Victoria data, the Parenting Research Centre has identified a strong and significant relationship between parental mental health and child sleep.

The study found parents with a history of mental health concerns were more likely to report problems with their child’s sleep. One-third of parents who experienced symptoms of stress, anxiety or depression since having children felt like child sleep was a moderate or large problem for them. Past research has also found an association between child sleep and poor mental health in parents (e.g., Martin et al., 2007; Martin et al., 2019).

However, the direction of the association between sleep and mental health is still unclear. For example, child sleep problems may impact on parents’ mental health concerns, or parents with poor mental health may be more inclined to view child sleep as an issue (Parenting Research Centre, 2019). However, previous research (e.g., Hiscock et al, 2007, 2008; Symon & Crichton, 2017) shows an improvement in parents’ mental health when their children’s sleep challenges are addressed. Therefore, it seems likely that difficulties with children’s sleep lead to distress in parents.

What can professionals do?

The 2019 Parenting Today in Victoria survey found parents often turn to accessible and familiar avenues for parenting information and support, such as GPs (56.7%), other health professionals (55.6%) and educators (72.3%). Therefore, it is clear that professionals can play a vital role in supporting parents.

Professionals can support parents in the following ways:

• Ask parents about their child’s sleep habits

This may include number of hours of sleep, what time they fall asleep and what time they wake, if they sleep through the night, if they nap, and if they need help to get to sleep. Keep in mind that sleep needs and habits vary across different individuals and age groups. However, by asking parents about their child’s specific habits, you will be able to determine if there is problem that can be addressed.

• Ask parents how they feel about their child’s sleep

Parental concerns about sleep are subjective. This means that some parents may be more concerned about sleep than others, even amongst parents of children with similar sleep habits. The important consideration is how parents feel about their child’s sleep. Be particularly mindful that if parents are experiencing mental health concerns, or if they have children with complex needs, they may be more likely to feel child sleep is an issue. Parents can be asked directly if their child’s sleep is a problem for them: ‘Is your child’s sleep causing you concern?’ ‘Are your child’s early starts impacting on you or the family?’ ‘How do you feel when your child is on their phone until 1am?’ ‘Is your child’s waking during the night affecting your wellbeing?’

• Ask parents to explain the ways in which their child’s sleep is impacting on them

As well as finding out if the parent thinks the child’s sleep is a problem, you can also explore the nature of this impact. Child sleep problems may affect various aspects of the parent’s life, or life for the child and the rest of the family. Enquiring further will help you get a better understanding of how big a problem this is for the parent and the family and where support might be needed. For example: ‘In what ways is your child’s sleep causing problems for you?’ ‘Do you feel like you’re getting enough sleep?’ ‘Does your child’s sleep habit impact other family members? Does it cause problems for you at work or for your child at school?’

• If parents are concerned about their child’s sleep habits, offer reassurance and information, and a referral to specialist support if needed

Talk to them about how their child’s sleep is impacting on them and their family, including their mental health. Normalise their concerns about sleep (e.g. ‘Many parents feel this way about their child’s sleep. It’s great that we’re talking about this today. There as some things we can do that might help.’). Provide the parent with information about typical sleep patterns for children of different ages, along with resources and tips to promote good sleep habits (e.g. healthy eating, regular exercise, and establishing bedtime/naptime routines). The Raising Children website provides credible information on all aspects of parenting – you can find information about sleep and settling that you can share with parents yourself, or refer parents to www.raisingchildren.net.au to do their own research. If sleep is causing a significant impact on the parents’ wellbeing, there are options for them to get more support. The family’s GP will be a good starting point, or the family could consider whether an early parenting centre, sleep clinic or mother-baby unit is suitable for them.

References

Fricke-Oerkermann, L., Plück, J., Schredl, M., Heinz, K., Mitschke, A., Wiater, A., & Lehmkuhl, G. (2007). Prevalence and course of sleep problems in childhood. Sleep, 30(10): 1371-1377. Available here.

Horwood, L., Li, P., Mok, E., Shevell, M., & Constantin, E. (2019). A systematic review and meta-analysis of the prevalence of sleep problems in children with cerebral palsy: How do children with cerebral palsy differ from each other and from typically developing children? Sleep Health, 5(6), 555-571. Available here.

Martin, J., Hiscock, H., Hardy, P., Davey, B., & Wake, M. (2007). Adverse associations of infant and child sleep problems in parent health: An Australian population study. Pediatrics, 119(5), 947-955. Available here.

Martin, C. A., Papadopoulos, N., Chellew, T., Rinehart, N. J., & Sciberras, E. (2019). Associations between parenting stress, parent mental health and child sleep problems for children with ADHD and ASD: Systematic review. Research in Developmental Disabilities, 93. Available here.

Parenting Research Centre. (May 2017). Parenting Today in Victoria: Technical Report 2016. Melbourne: Parenting Research Centre. Available here.

Parenting Research Centre. (October 2019). Parenting Today in Victoria: Technical Report 2019. Melbourne: Parenting Research Centre. Available here.

Sivertsen, B., Posserud, M. B., Gillberg, C., Lundervold, A. J., & Hysing, M. (2011). Sleep problems in children with autism spectrum problems: A longitudinal population-based study. Autism, 16(2), 139-150. Available here.

Spruyt, K., O’Brien, L. M., Cluydts, R., Verleye, G. B., & Ferri, R. (2005). Odds, prevalence and predictors of sleep problems in school-age normal children. Journal of Sleep Research, 14(2), 163-176.  Available here.

Sung, V., Hiscock, H., & Sciberras, E. (2008). Sleep problems in children with attention-deficit/hyperactivity disorder. Archives of Pediatric Adolescent Medicine, 162(4), 336-342. Available here.

Symon, B., & Crichton, G. E. (2017). The joy of parenting: Infant sleep intervention to improve maternal emotional well-being and infant sleep. Singapore Medical Journal, 58(1), 50–54. Available here.

Thunstrom, M. (2007). Severe sleep problems among infants in a normal population in Sweden: Prevalence, severity and correlates. Acta Paediatrica, 88 (12), 1356-1363. Available here.

van Litsenburg, R. R. L., Waumans, R. C., van den Berg, G., & Gemke, R. J. B. J. (2010). Sleep habits and sleep disturbances in Dutch children: A population-based study. European Journal of Pediatrics, 169, 1005-1015. Available here.