Q&A: Sleep-friendly routines may help child fall asleep more easily

Dear Mayo Clinic: My 12-year-old son goes to bed each night around 10 p.m. but usually cannot fall asleep until 1 or 2 in the morning. Is this normal for a "tween," or should I talk to his doctor? What are some things that could cause insomnia in someone his age?

A: Lots of children your son's age have trouble falling asleep easily at night. In many cases, the reason for this can be traced back to habits a child has developed that interfere with good sleep. Less often, it may be due to a sleep disorder.

Before you see a doctor, check to make sure your son's routines are sleep-friendly. For example, one of the best ways to ensure healthy sleep is setting a consistent wake-up time and sticking to it. The wake-up time doesn't have to be exactly the same time every day, but it should be within a two-hour window.

Although it may seem helpful to let your son sleep in on the weekends, it actually disrupts his internal clock. That makes it much tougher to get back into a weekday sleep routine on Monday. Sleep deprivation then gets worse during the week.

Also, consider your son's use of electronic devices before bedtime. Many tweens and teens have televisions and computers in their bedrooms. They keep their cellphones close by at all times. These devices can make it hard to disengage from stimulating activities.

For the best sleep, children should turn off all electronic devices at least 30 to 60 minutes before bedtime. This gives the brain time to relax and wind down, making it easier to fall asleep. I strongly recommend that computers and TVs be kept out of a child's bedroom. It is best for cellphones to be shut down and stored in another room at night.

Your son should avoid any food or beverages that contain caffeine or sugar at least two to three hours before bedtime. Daily exercise and other physical activity can aid sleep. But have him finish those activities at least two hours before he goes to bed. Also, even if he is sleepy during the day, encourage him not to nap. Naps do more harm than good when it comes to getting good sleep because they often make falling asleep at night harder than ever.

For some children, when they lie down at night worries and concerns creep into their minds, making it hard to relax and fall asleep. To help clear his mind, it may be useful for your son to take a few minutes before bedtime to write down anything that's on his mind or tasks she needs to do. Once they are on paper, sometimes a child is better able to let their concerns go and get to sleep more easily.

Although it is not a common condition, another source of your son's problem could be a sleep disorder related to the workings of his internal, or biological, clock. The most common such problem at your son's age is called delayed sleep phase syndrome. Children who have this sleep disorder are "night owls." According to their internal clock, their day is longer than 24 hours. As a result, they tend to fall asleep at progressively later and later times each night and then have difficulty waking up in time to go to school.

It is important for your son's sleep problem to be addressed. Too little sleep can make it hard for a child to concentrate and pay attention at school. It can lead to mood swings and irritability, and can increase a child's tendency to accidents.

Try to first address any habits that may be interfering with your son's sleep. If changes in his habits don't help, make an appointment to see a sleep specialist to have his condition evaluated.

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