The Chronicles of Insomnia

When my daughter Anna was a baby, she slept like a baby.

Her bedtime battles—hours spent trying to fall asleep in various locations from bed to couch to floor, night after night, on weekdays, weekends, and vacations—began about the time she started middle school. But that transition wasn't the reason she couldn't sleep. She wan't lying awake because she was worried about school. She had friends. She wasn't being bullied. She was liked by all her teachers and did well academically. She had healthy extracurricular interests. No major family upheaval was going on at our house.

I started dreading the creak of her bedroom door opening. Late into the night, Anna would cry from frustration and exhaustion, telling me, “All day long, I worry about not sleeping.” It was a nightmare, but we could never wake up from it.

Over the course of the years Anna and I battled together in the insomnia trenches, we tried what felt like every possible solution for helping her get to sleep. (And this was mostly her problem: once she got to sleep, she was usually okay.) Of course, you're not going to try any of these options with your own child until you have checked with your pediatrician. But maybe something that worked for us will work for you, too, if nighttime is a nightmare at your house.

Good sleep hygiene. This doesn't have anything to do with taking a shower before bed (although some people find this helps...we didn’t). Sleep hygiene usually has to do with these bedtime basics: 

• A very dark room. Any natural outside light creeping in, that alarm-clock glow, even a nightlight can interfere with getting your child’s brain to accept the #1 message you are trying to send: IT’S TIME TO GO TO SLEEP ALREADY! My daughter hides her digital alarm clock under her dresser at night and keeps a battery-powered model with a push-activated light near her bed. If your child is wary of sleeping in a total blackout, look for a very dim nightlight with a soft, warm glow—you’re trying to get your child to sleep here, not perform brain surgery.
• A quiet room, possibly with the addition of white noise. “Quiet” and “noise” in the same sentence might seem contradictory, but the use of a fan or sound machine—both of which produce consistent, non-stimulating sounds—can block out other, unpredictable, rousing sounds (dogs barking, household noises, etc.).
• A relatively cool room. When body temperature drops, the brain gets the signal that it’s time to shift into sleep mode. Most experts recommend bedrooms be kept around 65 degrees Fahrenheit.

Blue-screen cutoff. All those laptop/iPod/cell phone screens your child is staring at up until they go to bed and even when they’re in bed? Yeah, they’re telling her brain: WAKE UP! Which is not the message you want it to get. Anna started pulling the plug (or battery) on all screens about 30 minutes before getting into bed and reading by gentle light or listening to audio books instead.

Natural light exposure. As opposed to the artificial light of tech devices, natural (outside) light can actually promote sleep by influencing the body’s natural sleep/wake cycle. We try to make sure Anna has some exposure to natural light every day in hopes it will set her body clock to the right time—as in, “It’s 9 o’clock! Let’s fall asleep!”

Exercise. Most sleep doctors agree that physical activity promotes sleep but not if it’s done too close to bedtime. This was the one area we didn't even try to do right. Anna loves dance and takes a couple classes a week that run until 8:30 at night. She's physically active much closer to bedtime than experts want her to be. More than once, I warned my budding ballerina that if we didn't find a solution to her insomnia, dance would have to go. The horror of this alone motivated her to try everything else I proposed.

Caffeine elimination. Anna wasn’t consuming much, if any, in the first place, but if your child is having trouble sleeping, you might want to check not only their caffeinated beverage consumption but also any medications they may be taking for other ailments. Some have nighttime alertness as a side effect.

Guided imagery, “mind games,” and meditative breathing. Anna tried counting backward from 200 by 3’s; prayer for specific things in a specific order; various “ABC” games; mental repetition of short phrases, such as “I can and will go to sleep;” guided imagery apps; and conjuring up a scene in her mind with as many sensory details as possible (e.g., a beach with the sound of crashing waves, the feel of sand underfoot, the smell of a campfire). The intent was to occupy her mind with relaxing but not terribly thrilling thoughts, in hopes of tricking it into beginning the night shift. Eventually, we settled on a very intentional, relaxation-promoting breathing pattern: inhale slowly through the nose, hold the breath for 5 seconds, and exhale slowly through the mouth—all in hopes that both mind and body would relax and GO TO SLEEP ALREADY!

Delayed bedtime. A common reaction to insomnia is to spend more time in bed. Many times, I advised Anna that if she would only go to bed as early as possible, her brain and body would relax because she would know she had plenty of time to fall asleep. But this never worked for us. For one thing, I believe her adolescent (read: hormone-heavy) body had already begun shifting into the well-established teenage preference for staying up and sleeping in late. For another thing, the longer she was in bed but not asleep, the more anxious and uptight Anna became. So we tried the opposite approach: I stayed up with her while she read or just relaxed on the couch until she felt she was almost ready to fall asleep. Many nights, she didn't reach this point until an hour that would horrify the bedtime police. But getting in bed—even at a late hour—and quickly falling asleep increased Anna’s confidence that she could sleep.

Time-in-bed restriction. Lying in bed trying without success to sleep for hours on end had to go. In general, I told Anna that if she’d been in bed for about 20 minutes but was not asleep, she needed to try something else for a few minutes. The something else could be reading in bed, getting up and having me rock her, listening to quiet music or an audio book, journaling, etc. After a few minutes of the alternative activity, she could try falling asleep again.

Essential oils. I bought a couple bottles of essential oil blends from our local health food store that included such sleep- and relaxation-promoting oils as lavender, chamomile, cedarwood, sandalwood, and ylang-ylang. I shook a few drops into a glass votive candle holder and positioned it on Anna’s dresser in front of the fan blowing on her (see also: white noise and cool bedroom). I've also had friends recommend rubbing a few drops into the bottoms of the feet.

Vitamins and supplements. Most OTC and prescription sleep aids are not options for children. My mom (obviously, a parent from a different generation) often said, “Can’t you just give her Benedryl?” In fact, yes, I could—if she was battling allergies or a runny nose! However, some desperate digging did reveal a few options, and we tried them all. (Remember, you're going to check with your doctor before implementing any of these, right?) 

• Melatonin. This hormone, which the body produces naturally, is available in supplement form. I was wary of giving it to Anna because my mom research kept turning up such warnings as “interferes with adolescent brain development.” But upon hearing everything else I had tried, our pediatrician immediately prescribed a low dose of melatonin in a sublingual (under the tongue) version. Now, my teen takes Vitafusion™ Melatonin gummies, which have sleep-promoting (and mind-calming) passion flower, chamomile flower, and lemon balm leaf in addition to the melatonin.
• Pantothenic acid. Don’t panic. While this sounds like a street drug, it’s actually vitamin B5 and is reputed to counteract stress and anxiety. In desperation, I went looking for it at our grocery store and eventually found it in the list of ingredients in the children’s vitamins I was also buying. Thinking it might help Anna to have this vitamin in her system closer to bedtime, we switched Anna’s multivitamin consumption from morning to night.
• Herbal teas. Teas meant to promote sleep are common alongside coffee and hot chocolate in the grocery store; in addition, we found Yogi Soothing Caramel Bedtime tea, which actually seemed to help Anna, in the vitamin aisle.
• Calms Forte. I do not understand the name of this homeopathic product, but it is relatively inexpensive, doesn’t require a prescription, offers dosing information for children, and comes in a pill small enough for Anna to swallow as needed on rough nights. At my grocery store, Calms Forte is stocked near other sleep-aid products.
• Tart cherry juice. Reputed to stimulate the body’s natural melatonin production, I bought a bottle and added a couple tablespoons to a glass of diet lemon-lime soda for Anna at bedtime. The entire bottle save those two tablespoons is now languishing in the murky depths of my refrigerator after Anna declared she’d rather not sleep than take it again.
• Powdered supplements. One option on my radar since a friend highly recommended it is FitFormula Blueberry–Flavored Sleep Formula, a powdered supplement intended to be dissolved in water.

Prescription medication. After trying everything else, I finally asked our doctor if there was anything she could suggest that—obviously—was safe for a child. She did prescribe something (it's now been so many years, I can't honestly remember what it is) that could be taken on an as-needed basis and did not cause carryover drowsiness. If you're at last-resort status with your child, you might ask your pediatrician about a prescription option, too. 

Consistent routine. This is not the same as a observing a consistent bedtime—a classic piece of advice that drives me crazy. Like most families, we have different events going on at different times of the week. One night, Anna may be able to get into bed at 8:30, another at 10:30. And I am not forcing her to get up on weekends and holidays at 6 a.m. as she does on school days. Sleeping in is fun, and if there’s one thing we need around here, it’s sleep that’s more fun. Instead, Anna’s routine is a carefully crafted series of steps she takes every night when she’s gearing down for sleep.

Control and empowerment. Ultimately, Anna and I achieved victory over her insomnia by giving her tools that make her believe she can sleep. Everything—from her special bedtime routine, to the clock she can check but does not have to see, to the supplements she takes—helps her feel she's in control of her sleep. 

These days, I don’t usually have to dread the creak of my daughter's bedroom door (and not just because my handyman dad fixed it). When I tell her goodnight as she settles into her cozy bed, she often says, drowsily and happily, “I love bed." Which feels like a sweet dream come true.