David Coleman: My daughter is having chronic difficulties getting to sleep
My 11-year-old daughter is having terrible problems getting to sleep at night. She keeps going in and out to the toilet to pass urine, sometimes up to five times in a row.
She says she gets anxious that everyone is going to be asleep before her and that she will be the only one left awake in the house. Some nights this could go on for hours.
I have taken her to the GP and there isn't anything wrong with her urine or kidneys.
Sometimes she wakes during the night and can't get back to sleep without me getting into bed with her. This is going on nearly a year now and prior to this she had no problems. I would appreciate your advice.
I have often observed that sleeping is one of the first areas of children's lives to be disrupted by anxiety. It certainly seems that your daughter is anxious about something and that her anxiety is showing itself especially at nighttime.
It makes real sense that sleep is so easily disrupted since we do need to feel fully relaxed and secure in order to be able to settle to sleep. I am intrigued to know what may have been happening in your daughter's or your family's lives about a year ago when she first became unsettled at night.
If it was the end of the summer when this began could it have been her anticipation of school and the change of teacher? It may equally have been something within your family circumstance or her friendships. I could be guessing at many triggers for her anxiety without success, but it will really help you and her if you can track back to try to pinpoint any stresses or traumas that she experienced that coincided with the sleep disturbances.
Helping her to process and deal with any such stresses will help reduce her overall anxiety. Learning anxiety management techniques like meditation or deep abdominal breathing may also help with any anxieties that are present.
But even with that you will still have to work with her about how she settles to sleep. Even without anxiety she has now probably developed a real behavioural habit of getting up to go to the loo repeatedly.
It is interesting that her regular toilet trips are followed by comments about being the only person left awake in the house. It is like she gets up to go to the loo but also has the underlying desire to check that you or others in the family are still up and keeping an eye on her. Naturally the act of getting out of bed to go to the toilet is disruptive.
So you want her to be able to stay in bed to increase the likelihood she'll just fall asleep. To relieve her need for a greater sense of security you could set up a system of 'checking visits' with her. This approach can be very successful with children who need, or desire, the attendance of parents to help soothe them to sleep and who will otherwise come looking for their parents.
In the first instance you can arrange to visit her every five minutes until she falls asleep. You need to help her build trust that you will follow through and so setting a repeating alarm on your phone means that you won't miss out on a visit and she will quickly come to trust that you will indeed visit her as agreed.
It may seem like a heavy investment of your time, but it is only for a short period.
Also, if you think about it, you are already investing time in the hours it currently takes her to fall asleep so you are not really adding to your workload at night.
By going to her to check on her regularly you should alleviate her need to get up out of bed. As her sense of security grows, knowing that you will come to visit her, she should fall asleep easier and sooner. When this happens consistently you can increase the length of time between visits, but again keeping it reliable and regular.
Over the period of two months, or so, you should find that you have been able to increase the time between checks to every 20 minutes and that she will often be asleep by the first check.