Quick Answer: Childhood sleep problems affect an estimated 25 to 50 percent of children at some point. Common types include bedtime resistance, frequent night waking, night terrors, sleepwalking, and sleep apnea. Most behavioural sleep problems respond well to consistent routines and sleep training approaches. Medical causes (sleep apnea, restless legs, ADHD) require a paediatrician's evaluation.
In This Guide
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Types of Childhood Sleep Problems
Childhood sleep problems fall into several broad categories. They are not all the same, and recognising which type your child is experiencing points toward the right approach.
| Sleep Problem | Age Range | Key Features | Primary Approach |
|---|---|---|---|
| Bedtime resistance | Toddlers to school age | Refuses to go to bed, repeated curtain calls | Consistent routine, clear limits |
| Night waking (behavioural) | Infants to toddlers | Wakes and requires parental help to return to sleep | Sleep training, self-soothing skills |
| Night terrors | 2 to 6 years (peak) | Sudden screaming, eyes open, child not awake, no memory | Safety, consistent schedule, reassurance |
| Sleepwalking | 4 to 12 years | Gets up, moves around, does not respond normally | Safety measures, consistent sleep schedule |
| Nightmares | 3 years and up | Wakes upset, recalls scary dream | Reassurance, stress management |
| Obstructive sleep apnea (OSA) | Any age, peak 2 to 8 | Snoring, mouth breathing, witnessed pauses, daytime hyperactivity | ENT referral; tonsils/adenoids evaluation |
| Restless legs syndrome (RLS) | School age and teens | Uncomfortable leg sensations at rest, urge to move | Paediatrician assessment, iron levels |
| Sleep onset delay (circadian) | Adolescents | Cannot fall asleep before midnight, difficult morning waking | Light therapy, sleep hygiene, school schedule discussion |
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How Much Sleep Do Children Need?
Before addressing sleep problems, it helps to know what sufficient sleep looks like by age. Many "sleep problems" resolve when parents realise their expectations are misaligned with developmental norms, or conversely, when they recognise their child is consistently getting far less sleep than needed.
Canadian Paediatric Society Sleep Recommendations
The CPS aligns with the American Academy of Sleep Medicine recommendations for children's sleep duration per 24 hours (including naps for younger children): Infants 4 to 12 months: 12 to 16 hours. Toddlers 1 to 2 years: 11 to 14 hours. Preschoolers 3 to 5 years: 10 to 13 hours. School-age children 6 to 12 years: 9 to 12 hours. Teenagers 13 to 18 years: 8 to 10 hours. Consistently sleeping less than these ranges is associated with increased risk of obesity, emotional dysregulation, and reduced school performance.
Behavioural Sleep Problems
The majority of childhood sleep problems have a behavioural component, meaning they are driven by learned associations and routines rather than an underlying medical condition. This is good news, because behavioural causes are generally responsive to consistent changes in approach.
Bedtime Resistance
Bedtime resistance is one of the most common complaints in preschool-age children. The child delays going to bed through requests for water, one more story, bathroom trips, or simply refusing to stay in bed. It is driven by normal developmental drives toward autonomy and a preference for parental attention over sleep.
The most evidence-based approach is a consistent, predictable bedtime routine (20 to 30 minutes) followed by clear expectations and consistent follow-through. Graduated approaches -- where the child earns praise or small rewards for staying in bed -- work well for many families without requiring extended negotiation.
Night Waking and Sleep Associations
Children who fall asleep with parental assistance (rocking, nursing, lying beside them) often wake fully between sleep cycles because the conditions that were present when they fell asleep are now absent. They may not be able to return to sleep without recreating those conditions.
The solution is teaching self-soothing: the child needs to fall asleep independently, in the sleep environment they will wake in. This is the core principle behind sleep training approaches used from infancy through toddler years.
Night Terrors
Night terrors are a partial arousal from deep non-REM sleep, most common in children aged 2 to 6. The child may sit up suddenly, scream, have their eyes open, and appear awake but is not fully conscious and will not respond normally. The episode ends, the child returns to sleep, and has no memory of it in the morning.
Night terrors are not nightmares. They do not indicate psychological distress or trauma. They tend to run in families and most children outgrow them by adolescence. The appropriate response is to ensure the child's safety (prevent them from falling or injuring themselves), speak calmly without trying to fully wake them, and wait for the episode to pass. Reducing sleep debt, consistent sleep schedules, and ensuring adequate total sleep often reduces frequency.
Medical Sleep Conditions in Children
Obstructive Sleep Apnea in Children
Childhood OSA is more common than many parents realise, affecting an estimated 1 to 5 percent of children. Unlike adult OSA, which is often associated with obesity, childhood OSA is frequently caused by enlarged tonsils or adenoids that partially obstruct the airway during sleep.
Signs to watch for include: loud snoring (not occasional light snoring, but consistent loud snoring), mouth breathing during sleep, witnessed breathing pauses, restless sleep, and daytime symptoms including hyperactivity, behavioural difficulties, or difficulty concentrating at school. These symptoms are sometimes misattributed to ADHD.
A paediatrician or ENT (ear, nose, and throat specialist) assessment is the appropriate first step. Treatment often involves removal of tonsils and adenoids, which resolves OSA in the majority of cases.
Restless Legs Syndrome
RLS in children causes uncomfortable sensations in the legs (often described as "creepy-crawly," "itchy inside," or "ants in the legs") that occur at rest and are relieved by movement. Children may not be able to articulate the sensation clearly, instead becoming fidgety, refusing to stay in bed, or complaining that their legs hurt at night.
RLS in children is associated with iron deficiency in some cases. A serum ferritin level below 50 mcg/L is considered a possible contributor. Treatment may include iron supplementation if levels are low, and a paediatric referral for evaluation and management.
The Sleep Environment
The sleep environment is not the cause of most childhood sleep problems, but it is a contributing factor that is often worth examining.
Optimising the Child's Sleep Environment
- Darkness: Children are sensitive to light, and early morning light can trigger early waking. Blackout curtains make a meaningful difference for many families.
- Temperature: The same 18 to 20 degree Celsius range recommended for adults applies to children. Overheating fragments sleep and can trigger night waking.
- Noise: A consistent low-level white noise machine can help children sleep through household sounds and reduces the sensitivity to intermittent noises that trigger arousals.
- Mattress: A mattress appropriate for the child's size and weight provides spinal support and comfort. A child who complains of back or shoulder pain in the morning, or who consistently sleeps better in other beds, may need a different mattress. Children move frequently during sleep, so a mattress that handles movement without bouncing is generally preferable.
- Screen-free bedroom: Devices in the bedroom are consistently associated with shorter sleep duration and later sleep onset in children and adolescents. The blue light from screens suppresses melatonin, and content keeps the mind stimulated when it should be winding down.
When Brantford Families Ask About Children's Mattresses
We occasionally have parents come in specifically for a child's mattress. The most common trigger is a child who has started complaining of back or neck pain, or who is waking cranky and stiff. Children's sleep needs and body proportions change considerably between ages 5 and 15, and a mattress that was right at age 7 may not be adequate for a heavier, taller teenager. We look at the child's weight, sleep position, and current mattress condition the same way we would for an adult. A medium-firm mattress is generally a good starting point across most age ranges for children. Call us at (519) 770-0001 if you want to discuss what makes sense for your child.
When to See a Doctor
Most childhood sleep problems respond to consistent behavioural approaches, routine improvement, and sleep environment optimisation. See your child's paediatrician if:
- The child snores loudly on most nights, or you have witnessed breathing pauses during sleep
- Daytime behaviour, mood, concentration, or school performance has noticeably declined
- The child is very difficult to wake in the morning despite going to bed at an appropriate time
- The child complains of uncomfortable leg sensations at night that prevent settling
- Night terrors or sleepwalking are happening very frequently or involving dangerous behaviour
- Sleep problems are lasting more than a month despite consistent home-based approaches
- You are concerned about the child's growth, development, or overall wellbeing
This article is for general information only and does not constitute medical advice. Always consult your child's healthcare provider for concerns about sleep or development.
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Call 519-770-0001Frequently Asked Questions
How common are sleep problems in children?
Childhood sleep problems are extremely common. Studies estimate that 25 to 50 percent of children experience sleep difficulties at some point in their early years. Behavioural insomnia of childhood, sleep apnea, and parasomnias (night terrors, sleepwalking) are among the most frequently reported issues in paediatric practice.
What causes childhood sleep problems?
Causes vary by type. Behavioural sleep problems usually stem from inconsistent bedtime routines or sleep associations formed in infancy. Medical causes include obstructive sleep apnea (often from enlarged tonsils or adenoids), restless legs syndrome, or ADHD. Anxiety and stress are significant contributors in school-age children.
When should I talk to a doctor about my child's sleep problems?
Speak with your child's doctor if sleep problems last more than a month, the child snores loudly or gasps during sleep, daytime behaviour or school performance is affected, or the child is very difficult to wake in the morning despite adequate bedtime. These may indicate a medical cause that needs assessment.
Does a child's mattress affect sleep quality?
Yes. A mattress that is too old, too soft, or too firm for a growing child's body can cause discomfort and disrupted sleep. Children who complain of back or shoulder pain on waking, or who sleep better at other locations, may benefit from a mattress assessment. A medium-firm mattress appropriate for the child's weight and sleep position supports healthy spinal alignment.
How much sleep do children need?
The Canadian Paediatric Society recommends: infants (4 to 12 months) 12 to 16 hours including naps; toddlers (1 to 2 years) 11 to 14 hours; preschoolers (3 to 5 years) 10 to 13 hours; school-age children (6 to 12 years) 9 to 12 hours; teenagers (13 to 18 years) 8 to 10 hours.
Sources
- Mindell, J.A., & Owens, J.A. (2015). A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems (3rd ed.). Lippincott Williams & Wilkins.
- Owens, J.A. (2005). The ADHD and sleep conundrum: A review. Journal of Developmental & Behavioral Pediatrics, 26(4), 312-322. doi.org/10.1097/00004703-200508000-00011
- Marcus, C.L., et al. (2012). Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 130(3), e714-e755. doi.org/10.1542/peds.2012-1672
- Picchietti, D.L., & Picchietti, M.A. (2008). Restless legs syndrome and periodic limb movement disorder in children and adolescents. Seminars in Pediatric Neurology, 15(2), 91-99. doi.org/10.1016/j.spen.2008.03.005
- Paruthi, S., et al. (2016). Recommended amount of sleep for pediatric populations. Journal of Clinical Sleep Medicine, 12(6), 785-786. doi.org/10.5664/jcsm.5866
- Canadian Paediatric Society. (2020). Screen time and young children: Promoting health and development in a digital world. Paediatrics & Child Health, 22(8), 461-468. doi.org/10.1093/pch/pxx123
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Related Reading
- Sleep Training Baby: Methods and When to Start
- When Do Infants Sleep Through the Night?
- Crib Death (SIDS): Safe Sleep Guidelines for Parents
- Difficulty Waking Up in the Morning
- Shop Mattresses at Mattress Miracle
- Plus-Size Sleep Guide: Positions, Mattress Types, and Comfort Solutions
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If you have a child whose sleep problems may be related to their mattress, or if you are a sleep-deprived parent looking for a better night yourself, we are happy to help you find the right fit.