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Recently, I had a discussion with a mother who had brought her toddler to see me. She appeared stressed and exhausted as she described her nighttime struggles with her son – every night she would try to put him to bed at 8 p.m. and yet he often wouldn’t fall asleep until 5 in the morning. 

No matter what she tried, he would fight, cry and scream all night until finally he fell asleep. This was affecting the entire family because nobody could get the sleep they needed. I advised her to start her son’s bedtime at a later hour and as he gets used to a bedtime slowly push it up so eventually he’ll be going to sleep at a reasonable time.

There are many similar cases in other homes. Bedtime resistance can be a problem that starts early in childhood and affects us throughout our lives. Sleep is essential for the physical and mental well-being of young and old alike, and children need even more sleep than adults. Lack of sleep can cause problems like anxiety and depression, obesity, diabetes, a weakened immune system, and even hyperactivity and worsening ADHD. However, children are often resistant to going to sleep, making bedtime one of the most stressful times of day for some parents, especially this time of year. 

First, we had to adjust to the lost nighttime hour due to daylight savings time. Then, kids are affected by the combination of spring break, more evening activities such as youth league sports and the later sunset times, all making it more difficult to stick with a healthy bedtime routine.

The first step in establishing good sleeping habits is to set up the right environment. Bedrooms should be dark and cooler in temperature, with the lights dimmed before bedtime. The bed should be comfortable and used only as a place for sleeping, not for playing. You should limit distractions in the bedroom such as televisions, tablets or smart phones; the light from any of these screens before bed will suppress melatonin, which is key for helping the body fall asleep.

In general, the best way to establish a healthy bedtime routine is to define a bedtime schedule and stick with it, regardless of the day of the week or time of year. Kids usually need calming activities to help them wind down before bed, such as taking a bath/shower, brushing teeth and reading a story together in bed. They should avoid watching or reading anything too scary or exciting an hour before bedtime, and screen time should also stop in that same period, so that their bodies are able to relax and prepare for sleep.

One of the most common ways kids try to put off sleep is by fighting this bedtime routine. They may cry or scream when placed in bed, they may try to run out of the bedroom, or they may be more devious by taking a long time to decide which stuffed animal to keep in bed with them or to choose which book to read. 

While it is good to allow for some flexibility, it is more important to maintain control by limiting these options. If they cry, it’s OK to comfort them and remind them that you’re there so they feel safe to fall asleep, but you should be brief, so they learn to comfort themselves. By starting these habits at an early age, you can help promote healthy sleep and well-being, which should last throughout adulthood.

Dr. Laura Shefner writes about pediatric care for the Cleveland Jewish News. She is a pediatrician at The MetroHealth System and practices in Beachwood and Parma. 

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