How anxiety disrupts children’s sleep

First Published: 15 Jan 2024. Last Updated: 24 Feb 2025

Helping Your Child Feel Calm and Sleep Better

Does your child struggle to fall asleep because of anxiety?

Do bedtime worries keep them tossing and turning long into the night? If so, you’re not alone. Many children experience bedtime anxiety, which can make settling to sleep a real challenge—for them and you. The good news is that there are ways to help.

In this blog, we’ll explore how anxiety can affect children’s sleep, why it happens, and most importantly, practical steps you can take to help your child feel calmer and more secure at bedtime. With the right approach, you can support your child in developing healthy sleep habits, giving them (and yourself) more restful nights.

Anxiety/Worries and Sleep

Anxiety can disrupt children’s sleep for various reasons, creating a challenging cycle that affects both their physical and emotional well-being.

Firstly, anxiety triggers the body’s stress response, leading to heightened arousal and difficulty winding down for sleep. This can result in racing thoughts, increased heart rate, and muscle tension, making it hard for children to relax and fall asleep. Additionally, anxious thoughts and worries may intensify at night when the distractions of the day fade away, leaving children feeling more vulnerable and unsettled. Moreover, anxiety can manifest in physical symptoms such as stomach aches or headaches, further disrupting sleep.

The fear of the dark, separation anxiety, or worries about school or social situations can all contribute to bedtime anxiety, making it a multifaceted challenge to address. Understanding the underlying causes of anxiety and implementing strategies to promote relaxation and security are essential steps in helping children overcome sleep disturbances caused by anxiety.

Often these fears only surface at bedtime, when the day is over and there are no distractions to divert their thoughts.

So how can you help your young person manage their sleep at this time…..well the good news is there are things you can do to help.

how to help my anxious child sleep

What causes worries or anxiety at bedtime?

There are numerous causes of anxiety in children that can impact negatively on their sleep. These include long-term unresolved sleep issues, overthinking or over-worrying, experiencing vivid and scary nightmares, fear of the dark and monsters, starting nursery or school, family breakdowns and bereavement.

Older school-aged children who struggle to sleep are often perfectionists and academic high achievers. They find themselves in a vicious cycle where they worry about how lack of sleep will affect their work, which stops them from falling asleep and in turn leads to negative thoughts or even fears about sleep itself.

Children with autism and ADHD may have more bedtime anxieties than their peers. Bedtime can be particularly challenging for children with ADHD who have difficulties quietening their racing minds from the stresses or worries about their day.

A typical bedtime

Children with anxiety at bedtime often struggle to fall asleep and can lie awake for hours.  They can reappear numerous times in the evening with excuses such as being hungry, thirsty, too hot, too cold or needling the toilet.  You take them back to bed, but in no time at all, they are back with more excuses.  This process happens night after night leading to cross and stressed parents and an even more anxious child; you all dread bedtime!

You eventually find yourself getting into your child’s bed just to get them to sleep and then in the night they wake and seek you out again to help them get back to sleep.  The perfect recipe for a tired and stressed family!

Have a stress-free bedtime that helps your child sleep well

Starting your child’s bedtime routine

  • About an hour before your child goes to sleep have quiet time. Tidy away the toys and turn off all screens. Research has shown that not only does light from computers, iPads etc. can interfere with sleep, but the content can have an alerting effect, delaying bedtime even further.

“Talking time”

  • This is the time to set aside 10 to 15 minutes of one-on-one calming and quiet time with your child.
  • Ensure you put your phone away and make sure you have nothing else you need to do at this point so you can give your child your undivided attention.
  • At Millpond we often call this “Talking Time”.
  • This will give your child the space to discuss any worries or fears they may have and just as importantly means they are less likely to need to bring them up just before you say goodnight.
  • If your child doesn’t have anything specific they wish to discuss, as an alternative you could help set a positive tone by discussing 3 positive things about that day. If possible try and find new things each evening.
  • Your child may like to write them in a notepad that you keep just for bedtime.

Get your routine right so your child settles to sleep calmly and happily.

  • Initially focus the bedtime routine around the time your child naturally falls asleep; even if this seems late.
  • For example, if your child usually falls asleep at 10.00 pm start your routine at 9.15 pm. This way you are allowing 30 minutes for the routine and 15 minutes for them to fall asleep.
  • Carry out the same series of steps every night – make this routine your bedtime routine ritual. Having a routine means your child’s body will start to prepare for sleep as soon as you start this process.
  • If your child is falling asleep well in 15 minutes, after a few nights, start your bedtime routine 15 minutes earlier. Repeat this pattern, slowly advancing the start time of your routine until you reach the time that works best for your child.

Have a warm relaxing bath.

  • Have a warm, relaxing bath lasting no longer than 10 minutes. Keeping the bath to a maximum of 10 minutes means bath time doesn’t become a stimulating playtime. The added bonus is coming out of the warm water allows the body to cool quickly triggering the sleep hormone melatonin.
  • Then go straight into your child’s bedroom; going back into the living area at this time will lose the focus and magic of the routine.

Dim the lights.

  • Pre-dim the lights in their bedroom, as this will also help with melatonin production. If your child is scared of the dark and requests you leave a light on it’s best to have one that emits a warm amber or orange glow. Turn it on at bedtime and leave it on all night. The warm low-level light will not interfere with their sleep and will offer them the reassurance they need.

Dress for bed.

  • Have their night clothes ready for their return from the bathroom so they can quickly get dressed and climb into bed.

It’s time for a story.

  • Even if your child can read to themselves, read a quiet calming story and have a cuddle and kiss goodnight then tuck them in with their favourite soft toy so they are warm and cosy.
  • Now that they’re drowsy, leave the bedroom so that they learn to fall asleep independently.

I want you to stay.

  • Your child may only be able to fall asleep happily if you stay with them. If this is the case you can help build your child’s confidence in falling asleep independently by implementing a slow gradual retreat programme at bedtime.
  • If you are sitting by the side of your child’s bed as they sleep, start by sitting just a little further away. Reassure them you will wait for them to be fully asleep before you leave their bedroom. After 3 to 4 nights, move just a little further away from their bedside; you may only move a foot at a time. Keep repeating this process very slowly moving in small incremental steps until you are out of their room and then along the landing as they go to sleep. This process should take about two weeks to achieve. 

Written by Mandy Gurney the founder of Millpond Children’s Sleep Clinic

Mandy has been advising on baby, toddler and school-aged child sleep issues for nearly 30 years. She is a qualified nurse, midwife and health visitor.

Blog updated Feb 2025

What to do if your child is having nightmares

How to help your child with nightmares:

nightmares

Nightmares can be a distressing experience for both children and parents alike, often leaving little ones feeling frightened and unsettled during the night. As parents, it’s natural to want to provide comfort and support to our children when they encounter these unsettling dreams.

In this blog, we will look at what causes your child to have nightmares and practical strategies to help you support your child through them.

What is a nightmare?

  • Nightmares are scary dreams that usually wake children leaving them scared and upset. As most of us will remember, common themes of nightmares are being chased by a monster or animal or being lost or stuck somewhere you can’t escape from. While the subjects can be extreme and frightening at the time, nightmares are perfectly normal reactions to the stresses and strains of growing up. They can involve feelings of anxiety, fear, sadness or anger and be triggered during particularly stressful times in a child or young person’s life. Very often they are simply caused by being overtired or the healthy development of a child’s imagination.

  • Nightmares are very common in children between the ages of 6 and 10 years, but can also be experienced by younger and older children and about a quarter of children have at least one nightmare a week.
  • As nightmares occur in Rapid Eye Movement sleep (REM) or ‘dreaming’ sleep, they usually happen in the second half of the night towards the morning, when REM sleep becomes more frequent.
  • Nightmares will feel very real to your child, who will need comfort and reassurance from you in the night and may even struggle to get back to sleep. Some children can be so scared at the prospect of a nightmare returning that they become anxious as bedtime approaches and resist going to bed.

If your child is having a nightmare give them comfort and reassurance

 

  • Your child is quite likely to call out or come to you in some distress following a nightmare.
  • The best thing to do is to comfort and reassure your child, letting them know they are safe and secure. Once they are calm and happy they will usually go back to sleep.
  • It is important to remember that under the age of four to five, children cannot tell the difference between a dream and reality, so it is particularly important to give them reassuring cuddles and comfort, rather than explaining the nightmare away at this time.
  • If your child has recurrent nightmares about the same thing, try talking through this the next day and help them think up a happy ending. This can help to defuse the power of the nightmare and the hold its repetition may have on your child.
  • If there is a reoccurring monster theme make the monster into a character of fun. During the day draw silly monster pictures with your child and make up silly monster songs: you could also set up a dream catcher in their bedroom to catch bad dreams.

Identify the cause of your child’s nightmare

  • Talk to your child to help identify what might be the cause of their nightmare. It is best to do this during the day well away from bedtime. Discussing your child’s worries just as they are going to bed could trigger worries or scary thoughts and prevent them from going to sleep. Instead have 10 to 15 minutes of undisturbed 1 to 1 time with your child earlier in the day, that you set aside especially to discuss their concerns.
  • After you’ve said goodnight consider using a relaxation and breathing technique or a simple hand or foot massage to help relax your child at bedtime.

Is your child getting enough sleep?

  • Children who don’t have enough sleep are more likely to have nightmares. Helping your child to have more sleep, could reduce the frequency of their nightmares.

I don’t want you to leave!

  • If your child gets anxious about you leaving at bedtime, explain that you will regularly check in on them. Return after only a minute or two and from the doorway, briefly reassure your child.  Keep repeating this until they go to sleep or are happy for you to leave.
  • Over time you can very slowly extend the time you leave the room until they are happy to go to sleep without you there.

A friendly bedtime toy

  • Having a security object in bed overnight such as a special cuddly toy can help your child feel more relaxed and happy at bedtime and throughout the night.

Scary books and media

  • Vet all the books, TV programmes and media your child could be watching or overhearing. Many traditional bedtime stories feature wolves, witches and bears and your child may well be quietly listening to things that you are not aware of.

Fears of the dark

  • This problem is widespread among young children and starts when their imagination kicks in. Children do eventually grow out of this fear, but in the meantime, it can make them reluctant to go to bed and can wake them at night.
  • Most children are reassured by the presence of a night light in their bedroom. Set up a dim amber or orange glow light in your child’s bedroom, this will not stop them from sleeping but will help the room feel less scary.
  • Go into your child’s bedroom when it’s dark and with a child’s eye look around the bedroom to see if there is anything in the room that could look scary at night. A favourite cuddly toy in the day can turn into a scary monster in the dark.

Seek  professional help

  • If your child is having regular severe nightmares you may need to discuss this with your GP.

My child’s afraid of the dark

My child’s afraid of the dark

It is normal for children to have nighttime fears and for the majority of them to surface at bedtime when it’s dark, at a time we all naturally feel more vulnerable. They are part of the normal development of a child’s imagination and usually start when children begin to understand the wider world and the fears that might bring.

Being afraid of the dark is common among children; in fact, research shows as many as 73% of children aged 3 to 12 years old struggle with nighttime fears. Studies also showed the prevalence of fears are related to age group; with fears being common in 4- to 6-year-olds, but becoming even more frequent in 7- to 9-year-olds and then remaining relatively stable in 10- to 12-year-olds.

The type of fear alters with age too. For younger children, they tend to surface when their imagination kicks -in and they struggle to differentiate between fantasy and reality. So, to them the monsters and witches they see in books and on screens are real and could easily appear in their darkened bedrooms at night when they’re alone.

For school-aged children fears tend to be related to more real-life events such as worrying about intruders coming into their home, hearing of local burglaries or starting school and separating from their parents.

The good news is children do eventually grow out of them but in the meantime, it can make them reluctant to go to bed and be a cause of night waking as well.

How to help your child who’s afraid of the dark:

Discuss worries and fears during the day

It’s important to take your child’s fears seriously as they are real to them and, depending on how old your child is, set time aside to discuss them. It’s best not to use bedtime to do this as this could trigger monster thoughts just as they are trying to go to sleep; instead have some quiet 1 to 1 chatting time with you earlier in the day and at bedtime consider using a relaxation and breathing technique to help relax them at bedtime and help them fall asleep.

Offer reassurance

It is important to reassure your child if they are scared. Their feelings are real and it’s important to recognise them and that they are scared. Reassure them that everything is ok, their bedroom is safe and you are there to protect them. You may need to do this at bedtime and again in the night if they wake.

 Building confidence

Help to build your child’s confidence and take the fear out of the dark encourage them to play games at home such as hide and seek and treasure hunts. Start with the games close to you and with time expand the hiding zone so they are happy to hide further away, with you remaining in another room. As they become even more confident encourage them to hide or look for treasure in dim light and then graduate to hiding or seeking treasure in the dark with torches. As your child is having fun they soon forget to be scared and start to build up their confidence in the dark

Night lights

No matter what your child is afraid of, a night light can help. Set up a dim amber or orange glow light in your child’s bedroom, this will not stop them from sleeping but will help the room feel less scary. Have it on at bedtime and leave it on all night. They may also be reassured by leaving the bedroom door open and the landing light on so that they don’t feel isolated from the rest of the family.

Go into your child’s bedroom when it’s dark and with a child’s eye look around the bedroom to see if there is anything in the room that could look scary at night. A shadow or a favourite cuddly toy in the day can turn into a scary monster in the dark.

A friendly bedtime toy

Having a security object in bed overnight such as a special cuddly toy can help your child feel more relaxed and happier at bedtime and throughout the night.

Scary TV and books

Three little pigs near their small houses and scary wolf Three little pigs near their small houses and scary wolf. Three pigs and house, fairytale story. Vector illustration wolf fairy stories stock illustrations

Vet all the books and TV programmes your child could be watching. Many traditional bedtime stories feature wolves, witches and bears!

I don’t want you to leave!

If your child gets anxious about you leaving at bedtime, offer a boring excuse as to why you need to briefly leave, e.g., explain that you are off to “have a wee” or “turn the tap off in the bathroom” etc, but that you’ll be back in a minute. Return after only a minute, and say “well done you were very brave, I’ll stay now until you’re asleep”. The following night repeat and briefly leave again, but this time leave for 2 minutes.

Keep repeating this process slowly extending the time you are out of the bedroom for until your child can happily fall asleep without you in their bedroom or is happy for you to leave.

Offer rewards

If your child has done well give them lots of positive feedback; “you’ve done so well, you were very brave, I’m very proud of you”……. You can also consider setting up a reward system such as pasta in a jar or stickers to reinforce their behavior.

Overcoming Bedtime Fears: Henry’s Journey with Bear Anxiety

Henry was scared of bears

Anxiety at Bedtime – Henry was scared of bears

Henry’s mum tells his story:

Three year old Henry was scared of bears.  His anxiety about bears was waking him up multiple times in the middle of the night and he was also taking a considerable time to go back to sleep.

I have never tolerated disturbances at night so responded by doing the controlled crying technique, which has always been successful in the past.  On this occasion it made his anxiety so much worse and we got to a stage where he could not be in a separate room from me during the day. We were all tired and cranky during as a result.

Mandy was hugely supportive at getting me to use the gradual retreat approach and helped me create a sleep fairy for Henry with realistic goals that he could achieve.  The anxiety gradually disappeared.

Now if he wakes in the night he goes back to sleep immediately!

So much better!

Millpond Logo

Contact Us

sleep@millpondsleepclinic.com 020 8444 0040

Follow us