Insomnia and Sleep Issues

You may have thought that you would be finished putting your kids to sleep once they emerged from the pre-school years. Think again! The reality is that even school-age children often need to be settled to sleep. This age group suffers from various sleep challenges like excess energy and difficulty winding down or over-excitement, or anxiety or other troubled emotions. Many kids cannot fall asleep, others sleep fitfully and others wake several times a night. And given that the responsibilities of being a student require that kids are not just physically awake but are also mentally alert during the day, parents will want to help their kids sleep well at night. A good night’s rest is important to academic success. Parents can do much to help their youngsters achieve this goal.

In this article, we will discuss some tips and strategies parents can use to help school-age children fall asleep. We will start off by discussing what might be preventing your child from getting a good night’s sleep.

Possible deterrents to sleep include:

Physical Discomfort
Being too hot or too cold can interfere with sleep. An environment that is too noisy may also cause sleep problems for some adults and children. Babies can’t tell you about their comfort levels, unfortunately. When they cry, however, you might try adjusting their blankets or clothing to see if it makes a difference. Opening or closing a window, adjusting lights, shutting or opening the door – any of these environmental changes might make a positive difference.

Deflated and Elated Emotions
Depressing and troubling situations like death in the family, or very good news like winning the lottery (or another exciting development), makes the body produce chemistry that may linger beyond the time we need at which we normally go to sleep. We only need to settle this chemistry back to normal in order to put both the mind and the body to rest and eventually enter the state of sleep. Babies who’ve had an unusually active day may be more alert at night even though parents may think that they should be more exhausted than usual. Similarly, children may have trouble settling down after a particularly exciting day at the amusement part. Teenagers who are prone to experience strong emotions relating to their social lives may also have trouble settling down; too much chemistry is running through their bodies. Parents going through stress or trauma inevitably have sleeping challenges, as do those who experience tremendously positive events. Most of these kinds of sleep issues are temporary.

If a noisy mind, emotional stress, or agitated emotions are what’s keeping your child (or yourself) up at night, you may wish to consider Bach Flower Remedies. Try “Rescue Sleep” – a mixture of Bach Remedies available at health food stores and online, consult a Bach practitioner for an individually tailored remedy, or learn more about Bach Flowers on this site. Another  fast and effective intervention for emotional stress is EFT – Emotional Freedom Technique. You can learn this technique  yourself from Internet resources and books or you can consult a therapist who uses this technique in the clinical setting.  You can treat your child with it before bedtime, spending only a couple of minutes to release anxiety and stress or, you can teach an older child how to use the technique independently. Stress that doesn’t respond to self-help can be addressed effectively by a mental health professional.

Change in Sleeping Pattern
Our sleeping pattern is determined by our daily routine. As we normally sleep at a certain time everyday, our body gets used to this pattern and eventually remind us to sleep at that particular time, the same way we get hungry during lunch or dinner time. It does this by producing sleep hormones. When we suddenly try to change our time of sleep, we find it hard because our body is not used to producing sleep hormones at that time. When you change your child’s sleep time (as in the seasonal changing of the clock) be prepared for a week or so of poor sleep. Similarly, when you remove your toddler’s nap time, or go on vacation – expect disrupted sleep patterns. When the new pattern is established, sleep will be restored.

Change in Environment
Just as the body is affected by sleeping routine, it gets used to certain sleep settings. When we switch beds or when we put the lights on when we’re used to sleeping with the lights out, our body takes time to adapt to this new setting. We’ll go through sleepless nights and days before our body gets used to the new environment. When you change sleep locations due to vacations and visits, expect sleep disruption. When you move to a new house or even change your room within your old one, expect some sleep disturbance for a couple of weeks. Children and adults are similarly affected. Be patient and wait for the body to adjust.

Chemicals
Substances like caffeine and nicotine, as well as certain medications with stimulating effects enhance the activity of the brain. Take chemicals into consideration when serving kids food in the evening (cut down on sugar, caffeine, food colorings and highly processed snacks).

Over-stimulation
In the hour before bedtime, wild behavior, intense exercise, scary or intense media and other sources of stimulation can make it hard for kids and teens to settle down. It’s best to use that pre-sleep hour for calming the body and mind, rather than rousing it up!

Strategies for promoting sleep include:

Change the Bedtime
“Bedtime” is the time at which a person is tired enough to go to sleep. If you’ve set a 7:30p.m. bedtime for your child who isn’t sleepy until 9, then consider the possibility that you’ve set the wrong bedtime. Not all kids need the same amount of sleep. Some children, like some adults, can get by well on fewer hours than you might think is normal. Maybe you thought that every kid needs 9 hours sleep, but it turns out that YOUR child only needs 7! If your child can get up in the morning fairly easily and function well at school all day and maintain a decent mood until the evening, then he or she is getting enough sleep. But what if your child ISN’T doing well on just 7 hours, but has to get up for school on time anyways and still isn’t tired at the time that would allow him or her to get those important extra hours of sleep? In other words, what if your child does need  8 or 9 hours sleep but is only getting 7?   If this is the case, you haven’t set the bedtime too early. You need to find a way to help the child feel more tired at the right time.

You can Increase the Child’s Sleepiness
Some parents find that they can “tire their child out” by making sure the youngster has had plenty of fresh air and exercise in the daytime. Although this doesn’t work for every kid, it might work for yours – so give it a try. Encourage your older child to do sports, dance or other forms of exercise after school each day. Take your younger child to the park if possible, or for swimming lessons, skating lessons, karate or other active sports or physical activities. Try to arrange outdoor time – walking to and from school or friends or lessons. Try not to drive the child everywhere – let him or her walk or bike instead.

Teach Your Child to Relax and Wind Down for Sleep
To help ready a child for sleep, reduce stimulation in the half hour or hour before bedtime. Help the child turn his or her attention away from the activities of the day toward a quieting down, readying for sleep focus. You can teach the child (or have someone else teach the child – like a yoga teacher or a psychological practitioner) how to use the breath to induce deep relaxation and restfulness. Herbert Benson’s Relaxation Response is one excellent breathing tool that is so simple even very young children can use it and so effective that it helps people of all ages learn to deeply relax and fall asleep. The technique involves breathing normally, but on the “out” breath, think the number “one.” That’s all there is to it. Yet breathing this way for a few minutes, alters all the rhythms of the body and mind and settles them into patterns conducive to profound relaxation or sleep.

Try Natural Sleep Aids
There is a reason why parents give their kids milk before going to bed. Milk has a very calming effect on a drinker, and taking it before going to sleep can help facilitate some zzz’s. You may also consider natural herbs that are known for helping people get a good night’s rest. There are many herbal preparations (teas, lollipops, syrups) that are safe and healthy for kids. A special blend with sedative properties can be prepared by a professional herbalist or you might be able to find a pre-mixed blend in your local health-food store or on-line. The more days the herb is used, the stronger its effects become. Sometimes the herb is to be taken in the evening to help the child to unwind, and sometimes the herb is taken during the day, to help the entire nervous system become more calm and settled, which will facilitate normal bedtime sleepiness in the evening. Consult a herbalist to learn about which herbs are appropriate for children or teens and which ones should be avoided. Learn about dosage and safety issues.

Nutritional supplements can have similar effects. Some feeds are sedative and calming in nature and can even induce fatigue. Arrange a consultation with a holistic nutritionist or dietician who may be able to guide you. Naturopaths may also be able to advise you on the selection of foods and nutritional supplements that can help calm and settle the child or teen for sleep. Similarly, homeopaths, acupuncturists, Bach Flower practitioners and other types of alternative healers may be able to offer interventions that can improve your child’s circadian rhythms (sleep cycle), or help relax an overactive body or mind.

Consult a Doctor
Sometimes a doctor will prescribe melatonin to help the child experience fatigue at the right time. If the child’s wakefulness is caused by ADHD, medications can be altered or added to induce sleepiness. Other physical and mental health conditions that cause the child to be hyperalert can also be addressed with medication.

Create a “Parking Bay” for Nightly Concerns
There are occasions when kids have trouble sleeping because they have so many worries about the next day. If this is the case, parents can help their child by starting a ritual of listing down all these worries before going to bed. Create a pact: once a concern is listed on paper or on a white board, it means that it is to be temporarily set aside until the next day. This way your child gets to unload from their mind all the things that are bothering them before going to bed. However, after writing down worries, be sure to write down some positive thoughts, memories of the day and things to look forward to. You want to help the brain go to sleep peacefully and happily.

Set a Schedule
You know how kids are with their assignments; if you leave your child to accomplish their homework when they want to, they will play all afternoon and evening, and then try to finish their assignments way into the night! If you want your school-age child to sleep on time, set a regular time for homework and a regular time — with justified limitations — for their play. If kids are conditioned from an early age that the day ends at bed time, then they are less likely to stay up well into the night. Make the transition to bedtime with a period of quiet time – bathing, stretching, reading in bed. Teach your child a few yoga postures and breathing patterns to dispell stress and physical tension.

Be Strict about Lights Out Policy
Lastly, one effective way parents can get their children to sleep on time is to implement a daily lights out policy at a reasonable bed time. Lights outs should include no computer or TV time after bedtime. In a house of parents and teens,  everyone may go to bed at the same time – or not!. However, when there are younger kids in the family, there will always be several different bedtimes going on. As each person hits their bedtime zone, everything must quiet down around them. The quiet and stillness itself is a cue to the brain to settle down and get ready for sleep.

Consult a Mental Health Professional
If you have done all you can to help your child establish good sleep habits but your child is still having trouble falling asleep, then make an appointment with a mental health professional who can guide you further.

Child Won’t Go to Bed

There are some young children who can’t wait to get into bed at night – but they are few and far between! It is far more common for children of all ages to try to stay up later than their bedtime, whatever that bedtime might be. In fact, a lot of adults have the same problem! Everyone wants just a little more time to finish playing that game, reading that book, watching that movie or whatever. Maybe it’s not a bad thing – at least everyone who wants to avoid bedtime is excited about life and all that it has to offer!

However, there is one down side to all this wakefulness: daytime fatigue. Kids (and adults) who go to bed too late, often have trouble getting up in the morning and/or functioning well during the day. Physical health and emotional well-being also tend to suffer when there is long term sleep deprivation. As everyone knows, lack of sleep can cause irritability and impaired decision-making. All in all, a shortage of sleep cannot be recommended. Kids NEED to go to bed on time.

If your child isn’t cooperating with his or her set bedtime, consider the following tips:

Set a Realistic Bedtime According to the Unique Needs of the Child
Children – like adults – have varying needs for sleep. Some children and teens function best on 9 or 10 hours sleep, while others do very well on 7 or 8 hours. When a child can wake up on time in the morning with little struggle and function well during the day, maintaining appropriate focus, good health and a decent mood, then he or she is getting enough sleep. On the other hand, a child who can’t wake up in the morning, is always late due to sleeping in, is chronically ill, cranky and/or underfunctioning, and is simply not getting enough sleep. Specific health issues also impact on the amount of sleep needed. For instances, many kids with ADD/ADHD and other biological disorders seem to have more trouble settling down to sleep or staying asleep at night – they may do better with a later bedtime. Wake your child up at the same time every day – the time that is most appropriate for getting to school on time after getting dressed and eating breakfast. If your child does well, he or she is currently getting enough sleep. Therefore, continue with whatever bedtime you have established. If your child is struggling, create an earlier bedtime.

In setting an appropriate bedtime, try to find a time which is only a few minutes away from the child’s ability to fall asleep. For instance, if you set a 9 p.m. bedtime, your child should easily fall asleep somewhere between 15 and 30 minutes later. You may permit your child to read until he or she gets tired. You would establish “lights out” by 9:30. However, if you put your child to sleep at 9 and he or she remains awake tiil 10 or later (despite your “lights out at 9:30” policy), the bedtime is much too early. This is true only when you have been consistently waking the child at the same time every day (the ideal time for getting ready for school).

Be Consistent
Once you establish a reasonable bedtime, be sure to stick to it. Try not to change it except on very special occasions such as vacations or holidays.

Reduce Stimulation
Parents can help their kids go to bed by helping them to wind down for the night. Reduce the excitement available around the house about one hour before your child’s desired bedtime. This means implement rules like “computer is off one hour before bedtime” and “no movies or T.V. in the hour before bedtime” and “no snacks larger than a single non-caffeinated beverage an hour before bedtime.” Your goal is to help the child’s nervous system settle down. You might permit the reading of books or the doing of puzzles in the hour because these activities are both interesting and fatiguing. They involve mental work and therefore exhaust the mind after awhile.

Help Your Child Get Ready for Sleep
For children under 10, expect to spend 45min to an hour helping your child settle down to sleep using a daily sleep routine. This routine normally includes a bedtime snack, bath, teeth brushing, getting into pj’s, and story time or talking time. Depending on the age of your child, you may follow all this with a good night kiss and allow the child to read on his or her own for awhile longer (until “lights out”), or you may actually dim the lights and lie down quietly with the child for another 10 or 20 minutes until the child has drifted off to sleep, or you may sit in the child’s room with lights off until the child falls asleep.

Address Your Child’s Fears
Some children are afraid to sleep in their own rooms alone. Help your child to feel safe and comfortable by leaving night lights on, providing intercom, and/or comfort toys. The Bach Flower Remedies Aspen (for fear of the dark, monsters and ghosts) and Mimulus (for fear of robbers or being separated from parents) can be helpful. These can be purchased from any health food store. Two drops of each in a small amount of liquid (water, milk, juice, etc) given 4 times a day, can help erradicate night time fears. (See more on Bach Flowers in the Bach Flower article on this site.)

Use the CLeaR Method to Reinforce Cooperation
When your child is cooperative with any step of the bedtime routine, acknowledge this. “I see you got your pajamas on already!” or “You came right away when I called!” This is the “C” step of the CLeaR Method (“comment”). Use an appropriate label (the “L” step of the CLeaR Method). “That was so Speedy!”  “You’re such a good Listener!”  For settling into bed at the end of the routine, consider using a reward (the “R” step of the CLeaR Method). “Since you went to sleep so nicely, you can have your special cereal/muffins/T.V. program or whatever in the morning.” Learn how to use the CLeaR Method step by step in “Raise Your Kids without Raising Your Voice” by Sarah Chana Radcliffe.)

Create a Reward Chart for Younger Kids
If bedtime problems have been chronic or severe, more intense corrective measures can be taken. One such measure is the use of reward charts. Sit down with your child and design a reward-based program of encouragement. Design something that has an escalating system of points and rewards. For instance, if your child currently NEVER cooperates with bedtime, suggest that each struggle-free night earn a special small treat in the next day’s lunch or a special small privilege to occur after school the next day. As the child becomes more compliant, put him or her on a point system, having the child earn 2 points (one for each struggle-free night) and a larger prize (for instance – a $2.00 chocolate treat or gift at the dollar store). When the child can easily earn 2 points in a row, raise the bar: have 3 points be necessary for a prize – but again, the prize is better than the previous ones (for instance, a $3.00 treat or gift at the dollar store). Then have the child earn 5 points for an even better payoff (i.e $5.00 worth of goodies) and then 5 in a row (i.e. a special one-on-one outing with Mom or Dad), 7 points (a trip to the toy store to buy some small item) and finally – for the final GRAND PRIZE – 7 struggle-free nights in a row (which earns a fantastic gift or privilege that the child has long pined for).

Similarly, uncooperative pre-teens and teens can be positively encouraged to get into bed on time. Again, set up the “payoffs” with the youngsters themselves. Say something like the following, “I really don’t want to ask you to get to bed more than once in a night. I’d be willing to work with you to help you get out of the habit of delaying your bedtime. For instance, perhaps there’s some privilege or material object that could be an incentive. I know you’ve had your eye on that new (app, purse, digital whatever). I’d be happy to give you five (two, or whatever) dollars  for every night that you just go peacefully and promptly off to bed. In two weeks (or a month…) you’d be able to buy yourself that (whatever) from that money alone! Incentives do not have to be material objects. Work with your child to see what the child would find motivating. Using incentives is a jumpstart for changing the bedtime habits of your youngster – it is not meant to be a permanent way of life! Once the child is in the habit of going to bed on time and cooperatively, it’s just a whole lot easier for him or her to continue doing it.

Use Discipline if Necessary
If all the “nice” techniques haven’t led to improvement in bedtime cooperation, now is the time to use formal discipline. Display a “no-nonsense” attitude regarding the bedtime. After the child’s bedtime has arrived, follow the rule that the child may no longer call for you or leave his or her room (unless there is a true emergency). If the child calls out or leaves the bed, use the 2X-Rule. Tell the child, “you must stay in your room quietly once your bedtime has arrived.” When the child calls out or leaves the room, repeat the rule and add the warning of a negative consequence. This can be any consequence, but a good one for bedtime problems is “from now on, when you call out or leave your room, you will have to stand against the wall for (the number of minutes of the child’s age, minus 2). Then you’ll go back to bed. Each time you call out, you’ll have to stand against the wall again, but for 1 minute longer than before.” (If the child is 7 years old or older, the increases can be 2 minutes more each time). Normally, this cures the child’s bedtime issues within a couple of days. If the child refuses to stand against the wall, review the instructions for applying the 2X-Rule in the discipline section on this site (and in Raise Your Kids without Raising Your Voice, by Sarah Chana Radcliffe ).

If you have picked a different consequence (i.e. “no cookies in your lunch tomorrow”), you will have to handle it differently. To begin with, consequences that occur “tomorrow” require waiting. Once the child has left the room and received the consequence, there is nothing more that you can do TONIGHT. The child may now wander around the house all night. This is because you only get to pick ONE consequence. If the one you picked is happening tomorrow, then you have to wait until tomorrow and then apply the consequence (and make sure that you DO apply it!). Use the same consequence at least 3 times before deciding whether or not it is effective. If after the third use, the child is still calling out or getting out of bed, you know that the consequence is not effective. Choose a different one and start again. See “Raise Your Kids without Raising Your Voice” by Sarah Chana Radcliffe for detailed instructions on how to create and employ negative consequences.

Refrain from Showing Anger or Irritation
Bedtime should be a pleasant time for a child. Try your hardest not to raise your voice in order to scare your child into bed at night. If, after trying all approaches, your child is still refusing to go to bed, consult a parenting consultant or psychologist for assistance. There can be complicating factors you are not aware of and/or more strategies to try.

Dawdlers

Some kids take forever to get moving. They take their sweet time getting up in the morning and must be reminded ten times before completing any given task. They take an hour or so getting a small sandwich down! And just when you think that they’re dressed and ready to go, they’re glued to the TV screen, wearing no shirt and only one sock on, begging for 5 more minutes. Dawdlers drive their parents mad. Unfortunately, the morning rush just won’t wait – school starts at 9. The evening schedule presents its own demands and deadlines – homework, dinner, bath & bed. . Yet dawdlers are oblivious, taking their own sweet time, moving in their own little universe. What can parents do to decrease dawdler-induced stress?

If you have a child who drags his or her feet in the morning or at other times, consider the following tips:

Helping Your Dawdler
Particularly, with young dawdlers, it’s fine for parents to gently move the child along – hand the child his shirt, point him toward the kitchen table and so on. Younger children might respond to incentives or races. Some dawdlers are “spacey” (and might benefit from an assessment to make sure that ADD or some other type of challenge, isn’t at play). If the child is otherwise healthy, the Bach Flower Remedy Clematis can help increase focus and decrease spaciness, leading to a reduction in dawdling behaviors. If the child is easily distracted from his focus, the Bach Remedy Chestnut Bud can be helpful. (You can learn more about Bach Flowers online or throughout this site). If you need to insist on performance (for instance, the carpool ride is coming and the child MUST be ready on time), use a fair form of quiet discipline such as the 2X-Rule (see below and in more detail in the book Raise  Your Kids without Raising Your Voice by Sarah Chana Radcliffe).

Use Positive Strategies
Instead of nagging and yelling, parents can use positive strategies to help their slow-poke youngsters. While nagging and yelling can greatly harm the parent-child relationship and even increase mental health problems for kids, good-feeling techniques can strengthen the parent-child bond and facilitate healthy development while encouraging more appropriate, timely behavior.

Positive attention itself is one such strategy. As a child is moving (ever so slowly), a parent can NOTICE and ACKNOWLEDGE progress. For instance, the parent can say, “I see you’ve got one sock on. That’s a great start.” Every time the child completes a step of his morning routine, the parent can give this sort of positive attention. On the other hand, the parent should refrain from talking to the child about his slow behavior. For instance, when the child is moving slowly, the parent should NOT say, “Hurry up – you’re moving too slowly.” Rather, the parent should wait until he or she can make a positive comment.

Positive reinforcement can also be used. If the child happens to have completed a step in a timely fashion, the parent can offer a concrete reward. “I see you’ve finished brushing your teeth before 7:30 – that means there’s time for me to give you that special breakfast treat I bought for you.” Of course, any reward can be offered, such as an extra few minutes to watch T.V., a story, a game, a kiss or any privilege. When rewarding a timely step, the parent needs to ignore other aspects of dawdling. This means that the child might still be running late but has received a reward for being on time in the early part of the schedule. The trick here is to ignore slow and late behavior and only give attention and rewards to timely and prompt behavior.

The CLeaR Method (Comment, Label, Reward) can be very helpful as well. For instance: when your child is on task, make a positive comment (“I see you’re getting dressed!”). Then offer a positive label for the behavior (“You’re a fast mover this morning!”). Finally, offer a small reward (“I think you deserve an extra treat in your lunch.”). The label “fast mover” can be very helpful in building a healthier concept of your child as a person who CAN move efficiently. Be sure to NEVER use negative labels such as “slow poke,” “dawdler,” and so on. In fact, don’t talk about “dawdling” at all – never use the words “dawdle,” “dawdler,” or “dawdling.” The CLeaR Method is explained in full in Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe.

Use Consequences
Setting time limits can help reduce dawdling behavior. Limit setting can be accomplished with the ‘“2X Rule.” The first step of this rule is to give the time limit: “You have until 7:45 to brush your own hair.” Then, just before the deadline, repeat the limit and name the consequence: “It’s almost 7:45 sweetie – if your hair isn’t brushed in another minute, I’ll have to come and give it a quick brush for you.”  Even if the child would be angry, the parent would gently, kindly but quickly brush the hair if necessary. A steady rule can also be employed such as “From now on, if your hair isn’t brushed by 7:45, I’ll have to come in and give it a quick brush.” Such a rule can be employed for any deadline, varying the consequences: toothbrushing, bedmaking, eating, being at the door in time. The consequences must be delivered quietly, without any fuss, anger or upset. “You haven’t got any more time to make your bed, so I’ll be making it this morning and you’ll lose your T.V. show tonight (or whatever consequence you have pre-arranged with the child). When first introducing consequences to a dawdler, only concentrate on one deadline. After it is established, you can pick a second on and so on. The key to using consequences effectively is to let the consequence teach  the lesson, rather than using anger, lecturing and so forth (see Raise Your Kids without Raising Your Voice for a detailed explanation on the constructive use of consequences using the 2X Rule).

Consider Possible Reasons for Lethargy
If your child has a tendency to move too slowly on a regular basis, not just during the morning rush, then consider possible medical and psychological reasons for lethargic behavior. For example, your child may lack energy and needs a carbohydrate boost. Or your child might be suffering from depression. Sometimes apparent dawdlers are really obsessors and ritualizers. If your child is taking too long because she does things over and over again to get them “just right” then a professional assessment can help you determine whether anxiety might be the culprit. If so, there are good treatments that can help put an end to the problem. If you suspect that your child’s dawdling is due to more than a bad habit, do consult your pediatrician or a child psychologist.

Baby Wakes Up at Night

You can’t blame exhausted parents for trying – they want their 8 hours of sleep back! So they read every book on the market and scour the online resources. “Rock your baby, don’t nurse her,” “Walk your baby till she falls asleep and then gently lay her in her crib,” “Sing to your baby while patting his back until he drifts off,” “Don’t pick her up again, just talk to her,” “let her cry 10 minutes before you come to her and then don’t pick her up,” and so on and so on. Many people offer advice about how to get a baby to sleep through the night because somewhere, for some baby, this advice actually worked at least once. However many, if not most, babies will defy your get-him-to-sleep strategies and continue waking up several times a night for—brace yourself—several years.

Why aren’t people aware of this fact? Because the popular culture suggests that if parents just do it right, their babies will be sleeping through the night by 4 – 6 months of age. Feeling embarrassed and inadequate, most parents with wakeful 8 month-olds or 2 year-olds simply don’t tell the truth to anyone. “Is your baby sleeping through the night?” the mom at the Moms & Babes group asks.  “Oh, yes. He sleeps quite nicely,” lies the other mom for fear of admitting what a failure she is at this tender stage of the game. Her lie only goes into the large pile in the sky that makes other normal parents feel guilty and ashamed. She should have answered, “Gosh no! Babies aren’t supposed to sleep through the night! Yours doesn’t, does he?”

Why Do Babies Wake Up?
Infants need things in the night. Their little bellies empty every couple of hours and for the first year or so, they actually get hungry in the night. In addition, when babies cycle into light sleep, they “realize” that they are alone; they crave warm body contact and cry out for it. In the second year of life, nursing babies suckle for the same reason—no longer just out of hunger (because their tummies have grown and can hold more food), but now out of longing for physical contact. Some babies are sensitive to the sensations of their own bodies and will wake with discomfort from a wet or dirty diaper.

All of this waking has been programmed into babies for their survival. If you were a paraplegic without a wheelchair or other equipment, unable to speak the local language and unable to get yourself from point A to point B,would you want to be left alone for 8 hours at a time? Probably not. You would want to know there was someone near by who could meet your needs. Have you ever been stuck in a dentist’s chair or other restraining medical device for 15 minutes without someone in the room? Did you feel a twinge of the panic of helplessness in that situation? What if you needed something? What if you wanted to tell someone something?

Babies are in that position until they become toddlers. They are helpless. To top it all off, they are like foreigners—unable to speak the local language. They open their mouths but they cannot put their needs and wishes into words; they can just make noise.  For all these reasons, babies are programmed to be distressed about finding themselves alone. It just isn’t safe for them to be alone. There are serious survival issues going on. They wake up for contact to in order to assure that they will be looked after. This is not something that we want to program babies out of any more than we would want to program adults out of their scream response when faced with life-threatening danger.

Training Babies to Sleep Through the Night
Nonetheless, removing survival instincts can be accomplished, if we only persevere long enough. By ignoring a baby’s cries consistently, the baby will learn that no one will come and there is no point in crying anymore. If this experience only occurs at night, the baby learns that there is no point waking up at night. For parents, this translates into a baby who sleeps through the night. If it happens both day AND night, the baby goes into a hopeless depression (as seen in “failure to thrive” syndromes), since he “realizes” that he has been abandoned and there is no further hope of getting his needs met (and therefore no further reason to keep trying to bring help through crying). Fortunately, for most babies, the “abandonment” experience is happening only at night. However, the newly subdued baby has still learned that there is no point in crying. This will not lead to hopeless depression. In fact, in babies who are now enjoying a better night’s sleep, we may even see improved daytime mood.

Here is the problem however: if a baby quickly catches on to the idea that crying at night is a waste of time, there is minimal suffering on the baby’s part. However, if the baby has the “not-so-good sleep genes” that cause him to put up a royal battle, screaming for weeks or months  before he finally submits to the new regime, then it could be that the child is truly suffering. What this does to his long term development is simply not known. Some say it does nothing. Others say that it causes trauma. More research is required before we will know the truth.

Tired Parents
Even if parents do not want their babies to feel abandoned, it is not clear that responding to their every cry at night is the action of choice. After all, tired parents also pose a risk for babies. Tired parents have less patience with their children and are therefore more likely to engage in poor parenting techniques like snapping at the kids (including the baby), yelling or speaking in a harmful way. Fatigue causes more daytime errors including driving more dangerously, forgetting to turn off electric elements and putting the baby down in unsafe locations “just for a moment.” Exhausted parents can even dose off during the day when they need to be alert. Therefore, it is essential that parents find a way to balance their own needs for sleep with their babies’ needs for night-time wakings. This is especially important because night-time waking happens, as stated earlier, in the majority of homes—not the minority. And, it continues for the early years of childhood in many homes. Therefore a coping strategy is badly needed!

Here are some strategies that parents have found to be helpful. Not all will be practical for your own situation, therefore simply choose any that might fit into your own lifestyle:

  • Keep the baby in bed with you and DON’T get out of bed the entire night (see Dr. Sears’ books on attachment parenting for details of co-sleeping techniques and strategies). Although you’ll still be waking in the night to tend to the baby’s needs, you’ll need to expend less energy doing so.
  • Keep toddlers on a small crib-size mattress on the floor near your bed. At first, they can start in your bed and when they fall asleep, you can gently place them on the floor mattress beside you.
  • Have the baby or toddler sleep on a large mattress on the floor in her own room. When you wake up, go to the child’s bed and sleep there the rest of the night.
  • Tend to the baby in his crib when he cries at night. In the daytime, hire a daily baby-sitter and take a nap for a couple of hours. If the baby is in play group or daycare and you are at home, take your nap during those hours.
  • Alternate “baby duty” with your spouse. Whoever tends to the baby at night, gets a one or two hour evening nap the next day while the sleeping spouse takes responsibility for house & childcare.
  • Alternate night-time shifts with your spouse so that neither of you gets completely exhausted. For example, one answers cries until 2 a.m. and one answers cries after 2 a.m.
  • Use weekends to catch up on sleep. One spouse sleeps in late on Saturday; the other sleeps in late on Sunday.

As you can see, all of these strategies address the problem of night-time waking by assuming it is going to happen, parents are going to be tired and they will need to make up the sleep somehow. This approach is more in line with reality than trying to get babies and young children to stay asleep all night long. But here’s the good news: once kids are around 4 years old, there are effective strategies that can be used to really keep them in their beds throughout the night. By the time a child is this age, he can speak and walk; he is no longer totally helpless. He is familiar with his world and is achieving a level of competence. No harm will be done now by insisting that he stay in his own bed. So just hang in there. Sleep is coming. That is, until your child turns 15. Then you’ll be up at night again—waiting for him to come home. Sigh.

Bed-Wetting

Bed-wetting (also called “nocturnal enuresis”) is not a “behavior problem” – rather it is a physical problem. There are many possible reasons for nighttime accidents, including:

  • Small bladder. If a child’s bladder isn’t fully developed, it may not be big enough to hold all the urine produced during the night.
  • Genetic factors. Parents who were bed-wetters themselves have a higher chance of having children who are bed-wetters. When nocturnal enuresis is genetically inherited, the problem can persist for longer than usual. For instance, it can be a family tendency that the kids still wet their beds past 7 or 8 years of age. Indeed, in some cases bed-wetting can continue right through adolescence (and even into adulthood). Medical treatments can usually provide significant relief.
  • Poor signals. The child fails to awaken when the bladder is full because the brain is not registering the “full” signal.
  • Slow or delayed nervous system development.

Bed-wetting may also be an indication of another medical problem, including sleep apnea, diabetes, urinary tract infection, problems with the urinary system, or constipation. If wet nights are consistent, talking to a doctor about the problem is recommended. Bed-wetting can also result from emotional stress such as occurs when parents are fighting frequently, someone in the family is ill, there are significant changes in the child’s life, he or she is being bullied or abused, a new baby is born into the family, or when any other form of stress is present in the child’s life.

Distinguishing between Normal and Not Normal Bed-Wetting
Bed-wetting is common in households with young children. At which age can parents expect bed-wetting to stop? How can parents tell if their child is going through a normal developmental phase or if their child has some sort of problem that requires professional attention?

Bed-wetting is common and normal for children under the age of 5. However, by the age of 6, bed-wetting should be a rare occurrence. If it is still happening twice per month in this age group, it can be considered a medical problem that should be attended to. Although the doctor may find that everything is perfectly normal and simply prescribe “patience,” it is important to rule out possible medical issues at this stage.

In addition, if a child starts wetting his bed after long periods of dry nights, or if he experiences pink or painful urination, unusual thirst, or snoring, he should be seen by a doctor.

Stopping Bed-Wetting
Bed-wetting in young children usually stops on it’s own so it’s best not to start any treatment until the child is six or seven years-old (although it is sometimes started earlier if the bed-wetting is damaging the child’s self-esteem and/or relationship with family/friends). Helpful treatments and techniques may include:

  • Bed-wetting alarms – these sound a loud tone when they sense moisture and can help by conditioning the child to wake up at the sensation of a full bladder
  • Decreasing the consumption of liquids before bedtime
  • Praising the child when he has a dry night
  • Avoiding punishments, reprimands and other signs of disapproval
  • Waking the child at night  to empty his bladder
  • Encouraging the child to go to the bathroom before bedtime
  • Diapers, pull-ups or absorbent underwear can be helpful in managing bed-wetting (and is especially helpful in avoiding embarrassment at sleepovers or similar activities)

Some medications such as anti-diuretic hormone nasal spray or tricyclic anti-depressants may also help. If the bed-wetting is occurring due to emotional stress, consulting a child or adolescent psychiatrist or psychologist can be helpful.

Family Rituals and Routines

Rituals and routines add stability to family life and contribute to the smooth running of the household. Let’s look at some examples of rituals and routines that many people find helpful.

Bedtime Rituals
Bedtime rituals are useful for helping children’s minds and bodies settle down to prepare for sleep. Many parents start the bedtime ritual an hour or 45 minutes before the child’s actual bedtime. This allows for a leisurely transition from a high level of energy and activity to a slower paced rhythm and winding down for the night. A typical beditme ritual for young children consists of the following activities:

  • bedtime snack
  • wash face & brush teeth (with some nights including a full bath)
  • getting into pajama’s
  • bedtime stories
  • quiet time
  • lights out

Bathtime Rituals
Some people have a bathtime ritual for their young children. It helps kids focus on the task at hand – getting clean! Once the bathtime ritual begins, children stay in the bathroom until its completion (no running down the hallway). When children do the same thing in the same order each time, the process of cleaning up becomes automatic and easy for them. Here are some components of a bathtime routine:

  • wash face and brush teeth
  • get undressed as bath is filling
  • play with bath toys for a few minutes
  • wash hair
  • wash body
  • play a few minutes more
  • get out of bath and get dressed

Dinner Rituals
When families sit down to eat together – whether that is once or twice a week or whether it is every night – they may observe some rituals that foster decorum and civilized behavior at the table. For instance, in some households each child sits in the same chair every night. This makes for efficient seating instead of a nightly battle about who sits where. Some people may have prayer rituals before and/or after eating. This makes the meal a sanctified activity connected to something even larger than the family itself. Some people have a ritual of talking about the events of their day at the table, or sharing some positive news, or discussing a hot topic in politics, religion or current events. Instead of everyone talking at once, the father or mother may be designated as the “chair person” who helps initiate and maintain the flow of conversation. Some parents ask their children to wait until everyone (including the parents) have been served their meal before they start to eat. In some households, some meals are selected for special routines. For instance, some people celebrate Sabbath meals or weekend meals. These may have several courses such as a soup or salad course, a main course and a dessert. Some people assign tasks to each child or each person in the family: one sets the table, one serves the entree, one serves the main course, one serves dessert, one clears the table and so on. Or, a family might have a different routine altogether – for instance, it might be expected that each person takes off his or her own plate and washes it or puts it in the dishwasher. Whatever the particular routines and rituals, automatic processes at the dinner table help the meal run more efficiently and smoothly.

Special Rituals
Having unique family rituals can be both fun and emotionally enriching. Families can create any rituals they like – having popcorn every Saturday night, going on a drive every Sunday afternoon, going to a particular beach every weekend in the summer, having a favorite meal every Monday night and so on and so forth. Pleasureable weekly, monthly and seasonal rituals help family members bond and create wonderful memories to treasure for a lifetime.

Household Routines
Routines can be established for virtually anything: how laundry gets organized, washed, folded and put away; how rooms get cleaned; how food shopping happens, how people pack for trips and so on and so forth. All routines help tasks flow more quickly and smoothly. As children grow older and can participate in household routines, they are able to incorporate important self-care routines into their consciousness. In adulthood, they will find it easy and natural to look after themselves and their homes. The less routine there is in a household, the more difficult it can be for children to pick up the rhythms of household management. In fact, the more chaotic a household is (lacking routines), the more challenging it can be for the children to decipher and learn the steps involved in self-care and household management.

Some families have routines for meals: dinner on Monday is always chicken, dinner on Tuesday is always pasta, dinner on Wednesday is always ground meat and so forth. Establishing this sort of routine makes shopping easy and routine as well (i.e. go food shopping once a week and always purchase one chicken, one type of pasta, ground meat etc.). There can be routines for making lunches, routines for getting out the door for school and routines for cleaning up toys and other messes. Routines do not have to be rigid, inflexible sets of rules and laws. They can be fun, flexible and loose. The main characteristic of a routine is that it contains certain elements that are repeated over and over again. It is the repetition that causes routines to be easily learned and applied.

Wakes Up Soaking Wet

It’s only natural for babies and untrained toddlers to urinate during the night. This is why toddlers and preschoolers normally wear diapers in the night even when they’re toilet trained during the day. But what if your child tends to wake up soaking wet? That is, your child wets his diapers so thoroughly that all the sheets are also wet or damp in the morning?

Consider the following tips:

Your Child Drinks Too Much Fluid Before Bed
Frequent urination during the night can simply be due to a large intake of water before going to bed. To minimize the possibility that your child will wake up soaking wet, limit your child’s drinking 2-3 hours before bedtime. In addition, discourage your child from drinking known diuretics, like caffeine-based soda, coffee-based drinks, and juices (many parents find that apple juice increases urination in their youngsters). And it also helps to encourage your child to pee right before going to bed.

Your Child Has a Tendency to Hold His/Her Bladder During the Day
Is the frequency of your child’s daytime urination within normal range (around 3-5 times a day)? If your child barely pees in the morning, then consider the possibility that he may be holding it in, which can lead to more frequent urination at night. Encourage daytime urination by taking your toddler or pre-schooler to the toilet at regular times throughout the day. Limit juice intake to the morning time, and give generous amounts of fluids up until mid-afternoon. Give a small glass of liquid with dinner and an even smaller drink in the evening if the child expresses thirst.

Consider Medical Conditions that Cause Frequent Urination
If your child has been waking up soaking wet for awhile, it’s best to visit a pediatrician. Although it is most likely that your child simply urinates heavily, it is important to rule out possible health issues that may be responsible. There are many conditions that can cause frequent urination in a child, one of which is diabetes. Early diagnosis will obviously be helpful way beyond solving the bed-wetting problem.

Maybe Your Child Has Outgrown a Diaper
Sometimes the problem is as simple as a diaper that is too small or poorly fitted. Experiment with different sizes and brands to see if a more absorbent product with a better fit helps to prevent leakage and wet sheets. Woolen diaper covers are very absorbant and help to prevent leakage through clothing and bedding. Although these can be found in speciality shops and online catalogues, you can also knit them up easily yourself: use machine-washable wool to knit a rectangle to fit your baby’s diaper area. Sew together at the sides, leaving an opening for the legs. Thread elastic through the top, to adjust to waist size. If you are a more proficient knitter, use some shaping at the crotch (knit 2, purl 2 for that portion) or go as fancy as you like!

Consider Nightmares and Night Terrors
If your child’s morning wetness is accompanied by anxiety, fear or other symptoms of nightmares or night terrors, then consider an emotional reason behind frequent nighttime urination. Changes in the child’s routine, moving home, birth of a new baby, parental conflict, starting nursery, changing babysitters – any stress can affect the operations of the body and particularly the digestive system. If the soaking is a relatively new situation, consider the possibility of stress and see if there are ways to help the child through it. A child psychologist may be helpful as well.

Can’t Get Up in the Morning

Lots of kids have trouble waking up in the morning – especially teenagers. However, youngsters are supposed to be in school by 9 a.m. in most places. Some localities have actually changed the starting time of school to 10 a.m. for adolescents because so many kids in this age group are still groggy at 9! No matter what time school starts, many parents have to leave the house early in the morning so they can get to work on time. For this reason alone, they may need their kids to get up bright and early.

If your child has trouble getting up in the morning, consider the following tips:

Trouble Waking Up Can be Related to the Amount of Sleep Your Child Got
Unsurprisingly, if a child doesn’t get enough sleep, he or she will simply be too tired to get up when the alarm goes off. A lot of kids – and maybe ALL teenagers – go to bed too late. Nowadays, with the constant hum and beep of computers and cell phones, kids stay up to all hours. They’re always “on” and don’t know how to turn off. Of course they’re exhausted!

Getting your child to sleep on time is critical to getting him or her to wake up easily in the morning. Make firm rules about bedtime. Help your child settle down in the half hour before bed by prohibiting stimulating activities like computer games and action movies. Quiet time for bath, stories and tucking in should start long enough before the target bedtime so that the child can be closing his or her eyes at the actual bedtime. Teens, too, need limits around bedtime. Computers and cell phones can be OFF in the twenty minutes before bed. Shower, quiet reading and into bed by bedtime can be the rule for your teenager as well as for your younger child. Failure to comply can cost privileges like use of the family car (“Sorry – I can’t let you drive the car on so little sleep”), allowance, and so on. (See Raise Your Kids without Raising Your Voice, by Sarah Chana Radcliffe for ideas on how to design effective and appropriate negative consequences.)

Trouble Waking Up Can be Related to the Quality of Sleep Your Child Got
Some kids are in bed on time and theoretically sleeping the correct number of hours, yet they are exhausted upon awakening. They can’t drag themselves out of bed. This can happen when the quality of sleep has been impaired. Illness such as ear infections, colds, flu’s and certain chronic physical health conditions (such as sleep apnea!) can affect the quality of sleep. Medications as well as illegal drugs and alcohol may cause morning exhaustion. Chronic mental health conditions such as ADD/ADHD., Asperger’s Syndrome, autism, depression, bipolar depression, and anxiety can impair sleep. Stress and trauma can impair sleep as well.

See your pediatrician for help in addressing the physical conditions that interfere with restful sleep. Your naturopath, herbalist, Bach Flower therapist, reflexologist or other alternative practitioner might also be able to help. Similarly, have your child’s emotional health assessed and treated by a qualified mental health practitioner. You might also be able to find CD’s for children’s sleep issues to help them get a better quality of sleep.

Trouble Waking Up Can be Related to Power Struggles between Parent and Child
Many parents get pretty worked up in the morning. When their child doesn’t immediately jump out of bed, the parents feel irritated, then annoyed and finally enraged. The child accidentaly discovers a way to passively “get back” at parents. The child can see how easy it is to make Mom and/or Dad “go crazy” in the morning and it’s sort of fun to get them to disintegrate this way! The child may not consciously be trying to provoke parents, but people who are relatively powerless (like kids) do love to discover that they have some power after all!

If your child is getting enough sleep but is unresponsive in the morning, TAKE YOURSELF out of the equation. DON’T be your child’s alarm clock! Instead, get a really loud or effective alarm clock (there are many new ones on the market that do all kinds of neat things to force the child to get out of bed). Try to find a clock WITHOUT a snooze alarm. Children who use the snooze feature can often turn it off a dozen times without getting out of bed! Putting the alarm out of arm’s reach can help address this problem as well. If the child has to get out of bed and climb on a stool to turn the thing off, it is less likely that he’ll fall right back asleep. Be sure not to “help” the alarm by also trying to wake up the child. If the child senses your annoyance in the morning, chances are higher that the problem will persist for a long time. Help yourself stay relaxed by being busy in the morning with other activities. Just be too busy to notice that your child is still in bed.

A completely different approach to ending morning power struggles is to be humorous and playful in the morning with your child. Sometimes coming into the child’s room with a joke book and sitting and reading it aloud for a few minutes, is enough to encourage the child to get out of bed in a good mood, ready to start the day. Or, perhaps giving your child a foot massage (only if the child likes this sort of thing), may help him or her start the day in a relaxed and positive mood.

Trouble Waking Up can be Related to a Lack of Real Consequences
Some kids attend schools that do not immediately punish tardiness. Eventually there may be a number of “late days” marked on the quarterly report card. But who cares? On the other hand, when a school gives an immediate punishment for arriving late (like an after-school detention), children work hard to be there on time. Of course, some parents drive the child to school in order to help the child avoid the consequences of being late; such a practice encourages difficulty getting up in the morning. If the school doesn’t have a policy about immediate punishment, it may be possible to take up this isdea with the classroom teacher. The teacher may be able to let you know on a daily basis whether the child was late and you may be able to construct a punishment at home (a consequence that happens every time the child is reported to be late) or the teacher may be able to suggest a punishment that will occur in school.

Help Create a Morning Atmosphere
It may help to change the night atmosphere of the room to a day atmosphere. Open the curtains and the window – let in some fresh air. Turn on the lights. Turn on the computer if there is one, and put some music on. For younger kids (or teens if they have given you permission), pull back the top layer of blankets so that the child isn’t so warm and cuddly. Start chatting to the child in an upbeat, friendly way.

Offer Incentives
It may be possible for you to offer the child incentives for waking up independently and on time. For instance, chocolate milk may be allowed if the child got up by himself or after the first call. Or, a child might be able to earn cash prizes for each cooperative morning wake-up. Or, the child may be able to earn “points” or “stars” and after accumlating a target number, then earn a gift that he or she would not have gotten otherwise.

Teach Your Child How to Set His or Her Internal Alarm
Teach your child to set an alarm clock and then to tell his or her brain to wake up 5 minutes before the alarm goes off. All the child has to do is send this instruction to his or her mind while in a relaxed state. Tell the child to picture the time on the clock that he or she wants to get up at. The child should see the time and picture him or herself getting out of bed then. Make this a game or a challenge. Let the child know it can take some days before the brain catches on, but it WILL catch on. Right now, the child’s brain is actually programmed to get up late!

Doesn’t Sleep Well at Night

Lots of kids (and adults!) don’t sleep well at night. Of course, this affects their functioning, their behavior, their health and their mood in negative ways.

If your child has disturbed sleep, consider the following tips:

There are Many Reasons for Disturbed Sleep
Some causes of disturbed sleep are physical in nature while others are stress-related or caused by various mental health conditions. For instance, depression can cause a teenager to wake up at 2a.m. and remain awake for a couple of hours, or cause her to wake up at 4:30a.m. and not be able to get back to sleep at all. Anxiety can cause youngsters to have trouble falling asleep or cause them to have restless sleep. Stress can interfere in similar ways and yes, even children have stress! In fact, kids can be disturbed by many life events such as the condition of their parents’ marriage, starting a new grade or new school, having social problems, worrying about academic performance and on and on.

If your child is waking up many times in the night or not feeling rested in the morning, then make sure he or she is seen by a medical doctor. Before assuming stress is the culprit, rule out physical causes of sleep disturbance such as drug use, caffeine sensitivity, hormonal difficulties, health issues, sleep apnea, allergies, restless leg syndrome, nightmare disorder, chronic fatigue syndrome, fibromyalgia, Lyme’s Disease, ADHD, Asperger’s Syndrome, Tourette’s Disorder and so on. Your doctor may refer your child to a sleep disorders clinic for further assessment. If your child is physically and mentally well and still experiencing sleep disturbances, consider having him tested for food intolerances. Also consider an assessment by a mental health professional. Post-traumatic Stress Syndrome and related disorders of stress can go undetected by parents while a child psychologist will readily be able to diagnose such conditions.

Many Times, No Reason is Discovered
Many people of all ages who suffer from various types of disturbed sleep never receive a diagnosis of any kind. If your child is fully assessed and no reason is discovered for his poor quality of sleep, do take advantage of the many types of alternative medicine that people have found useful. For instance, many people benefit from herbal medicine when it comes to sleep issues. A qualified herbalist can prepare teas and syrups for children that can help improve the quality of sleep. Also, acupuncturists, homeopaths, nutritionists, cranial sacral practitioners, chiropractors and other naturopathic healers each have something to contribute when it comes to improving sleep.

Sometimes, however, no one is able to help. If this is the case, there is still help available! Twenty minutes of deep relaxation can be equivalent to many hours of restful sleep. Have a specialist teach your child techniques for deep relaxation. This specialist may be a child psychologist, medical doctor, professional relaxationi teacher, yoga instructor, hypnotherapist or other type of practitioner. Meditation is equivalent to deep relaxation and there are many child-friendly types of meditation that can help the system calm down and discharge stress. In addition, there are many types of recordings available to help children sleep better including hypnotic-type CD’s & MP3’s, guided imagery, bilateral stimulation products and more. If the child is not getting restful sleep, he can still get deep and healing rest using these kinds of products and techniques.

Child Kicks While Sleeping

Does your child frequently complain of odd sensations in his or her legs, cure particularly at night? Do you notice that your youngster tosses and turns, shakes or kicks a leg, has to get up and move – when he or she is supposed to be sound asleep? Perhaps your youngster has Restless Leg Syndrome.

What is Restless Legs Syndrome?
Restless Legs Syndrome (RLS), also called Wittmaack-Ekbom’s Syndrome, is a medical condition characterized by an urged to move the limbs in order to gain relief from uncomfortable sensations. It usually affects the legs, but can also be found in the arms and in rare occasions, the torso. Restless Legs Syndrome is believed to affect around 12 million Americans, including children.

The main symptom for RLS is dysesthesias: unpleasant, abnormal sensations in the limbs that may at times be painful.

Dysesthesia in RLS differ from patient to patient. Some people report a feeling of numbness on their arms or legs, as if the limbs are falling asleep. Others feel a burning sensation. Others experience a sensation something like insects crawling under their skin. But while the exact symptom differs from patient to patient, one thing is common: the uncomfortable sensation is relieved by moving the limbs, e.g. by walking or stretching. Symptoms are also worse during nighttime or moments of rest.

RLS may have a sudden onset, or it may gradually grow in intensity.

What causes Restless Legs Syndrome?
It is not known what causes Restless Legs Syndrome but chemical processes within the basal ganglia are one suspected cause. Genetic factors may also be involved, especially when onset is before age 40. Certain medications can trigger episodes as can certain diseases.

Research has associated the cause of Restless Legs Syndrome with various biological conditions such as iron deficiency, sleep apnea, diabetes, Parkinson’s Disease, auto-immune conditions and irregular electrical impulses in the brain. In more than half of the reported cases of Restless Legs Syndrome, the condition runs in the family. RLS also sometimes occurs in pregnant women, smokers and persons with obesity.

Diagnosis and Treatment
It’s important that you consult a physician for proper diagnosis of Restless Legs Syndrome. This is because there are many illnesses and conditions that mimic the symptoms of RLS, and differential diagnosis by a professional can help verify if what you have is really RLS. The condition is diagnosed through a thorough medical history and interview.

Treatment for Restless Legs Syndrome includes medication and prescribed physical movement. The neurological explanation appears the strongest, which is why dopamine agonists (drugs that regulate the brain chemical dopamine) are first line management. Other medications typically prescribed for RLS include opioids, diazepam and ropinerol. Supplements that can address specific vitamin and mineral deficiencies known to be associated with the symptoms may also be prescribed.

To relieve symptoms, even temporarily, patients are also taught movement techniques specific to the sensation they are experiencing. Non-traditional schools of medicine, such as osteopathy and acupuncture also offer holistic techniques for relief of RLS.

To be safe, always consult a licensed medical practitioner before availing of advertised treatments.