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My son has trouble sleeping on school nights. How can I help him overcome his anxiety?

You may be able to help with specific worries, but you can also help with an effective bedtime routine. 

Clark Goldstein, PhD

Associate Psychologist, formerly with the Anxiety and Mood Disorders Center
Child Mind Institute

Q:  My 5-year-old son has some anxiety about going to sleep at night when he has to go to school the next day. How can I help him overcome his anxiety?

A:  Thank you for your question. It would be helpful to know if your son has expressed any specific fears about school, as this might impact how you can help him. For instance, is he anxious about something that's been a recurrent issue that might require teacher or parent intervention, such as having conflict with a classmate, or not being comfortable using the bathroom at school? Is he anxious about separating from you, or about participating in class? Consider talking to your son and his teacher to get a better sense of what he might be worrying about.

In general, try to establish a regular bedtime and bedtime routine for your son. If you are having a difficult time getting him to bed, you can try making a game out of it, and award points on a nightly basis for being in bed on time. You may wish to make a sticker chart that helps you notice patterns (such as if Sunday nights are more difficult), track progress, and motivate you and your family to try to stick (no pun intended!) to your schedule. If you choose to do this, it is important that you do it every (school) day and give your son daily updates on how he is doing with earning stickers (or points toward rewards, if you choose to do that).

You may also want to make sure that your son has good sleeping habits. His bed should only be used for sleeping; watching television, playing videogames, and even doing homework (for older children) in bed can make sleep more difficult. We want our minds and bodies to associate bed with bedtime and sleep and not with other activities that might be exciting or require sustained attention. Refraining from drinking caffeinated products in the afternoon and at night can also be helpful for sleep. Dr. Donna Pincus offers an excellent CD to help children relax, which a number of children with whom I worked found helpful to use at night.

If your son's sleeping difficulties persist or worsen, consider consulting with a competent child psychologist in your area who has expertise in cognitive-behavioral therapy. This therapy can help children and their parents with the thoughts, feelings, and behaviors that are causing and maintaining excessive levels of anxiety.

For more from Dr. Goldstein, read What to Do (and Not Do) When Children Are Anxious.

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