Does my child have a sleeping disorder?

Dear Dr. Donya,

I would like to ask your advice in dealing with my daughter's sleeping problem. She is now 3 years and 5 months old. When she was still a baby she could fall asleep quite easily, but since she has been a year old, I have found it difficult to put her to sleep.

I have already tried to train her to go to bed early, but she ended up going to sleep late anyway.

Every morning I have to wake her up at 7 a.m. as she has to go to school, and it is always difficult to make her wake up. In the afternoon, after coming back from school and having lunch at home, I take her for a nap at about 1 p.m. but it will take about one hour to two hours until she finally dozes off and once she sleeps tight she can sleep for over two hours. Normally I will wake her up when she has already slept for two hours so that at night she will not stay up too late.

At night I try to be consistent in putting her to bed at around 9 p.m. or 10 p.m. at the latest, but of course occasionally she goes to bed as late as midnight if we have a night event on the weekend. In this case I will allow her to wake up late the next morning. Once we are on the bed, she always asks for a bedtime story and I always read one to her. But again, after the story is finished, it will still take a long time, about one hour to two hours, before she falls asleep.

Actually she is sleepy already as she keeps on yawning but she still tries to keep her eyes open and moves around on the bed, and she also keeps talking and asking about many things.

The situation in the bedroom is already dark, quiet and I pretend to have fallen asleep, but that still doesn't make her doze off quickly.

At times I tell her that if she cannot sleep in the bedroom she can sleep outside, but this "treat" does not help at all. Most of the time she sleeps with me but sometimes she wants to sleep by herself on her own bed. If I let her sleep alone it will take even longer for her to sleep.

Sometimes if we happen to be on the go, she will miss her afternoon nap, but no matter how tired she is, she will not sleep in the car, and without her nap she still can stay active until about 9 p.m. before she gets her night's sleep. If, without her nap, she happens to sleep as early as 7 p.m., she will wake up again at about 10 p.m.

Why can't she fall asleep easily, even though she is sleepy and tired already? Once she is asleep she will have a deep and sound sleep, except that when she is not feeling well, she may have broken sleep. So, usually she only sleeps for about eight hours at night and two hours in the afternoon. Is that enough for her ?

Could you please advise how to help my daughter sleep more easily, as we could have a more productive time doing other things together if she didn't spend such a long time just falling asleep.

I would appreciate your advice on this matter and thanks for kind attention.

--Yun Yun

Dear Yun Yun,

First of all, you have to ask yourself this: does your daughter have a sleeping problem at all?

This is the most important question, as a parent, if you suspect your child is not getting the sleep she needs.

Is your daughter relatively happy most of the day? Is she able to play independently for an appropriate period of time? When she wakes up from a nap or in the morning, does she seem to be rested? Is she healthy? Is she adaptable to new situations/environments?

If your answer is yes to the majority of these questions then you can feel quite confident that your child probably doesn't have a sleeping problem.

All children are different, so in turn their individual sleep needs can differ from one child to the next. Sure, your child could be the only one on the block, playgroup or school who takes short naps or has stopped taking naps much earlier than the majority of other children.

But, does that mean that your child has a sleeping problem? No, remember that every child has his/her own individual unique needs. You, as her parent, have to judge if your daughter's sleep needs are being met. Also, for parents who come home late, the child may stay awake to see the parent.

Control the wake-up time. Wake her up so that she never starts the day after 7 a.m. This is designed to make it easier for her to have an early naptime and an early bedtime.

Early bedtime: Lights out at 6 p.m. to 8 p.m., depending on nap or no nap, active versus quiet day. Be flexible and early.

Silent return to sleep. She is told that everybody needs their sleep and if she leaves her room then you will gently put her back to bed. And, although "we love you very much, when we put you back in to your bed, we are not going to talk to you". Your attitude is calm and firm, not sweet or stern. Silence is the key.

Do not reinforce her night waking. Let her learn to soothe herself to sleep if she awakens after bedtime. If you go to her at night, you interfere with the development of this skill.

In conclusion, if you answered most of the questions with a "yes" that's means your daughter has enough sleep.

--Dr. Donya