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Can't fall asleep?
Q: My 5-year-old has a hard time falling asleep. Sometimes he’s up until 11 or 12, and it’s hard to get him up for school in the morning.

When I get home from work we spend a lot of time together wrestling and playing video games. When it’s time for bed, he wants me to lie down with him. Then he asks for another glass of water, etc.

Once he gets to sleep he often wakes up with nightmares about “bad guys” chasing and shooting him. My wife is upset because she’s pregnant and needs to get some rest. Also, his kindergarten teachers say he seems wired at school and is having behavior problems. Any suggestions?
A: Isaac, it sounds like you and Devon have a close relationship and enjoy being together. You can feel proud that you play an important role in your son’s life and provide him with a nurturing male role model. Your special relationship will become even more important when his baby sibling is born and more of your wife’s attention will be focused on the baby.

A 5-year-old child typically needs between 10 and 12 hours of sleep a night. When children don’t get enough sleep, they can have difficulty waking up in the morning. They can also become sleepier during the day or, paradoxically, more active and irritable, leading to behavior problems at school and home. This may be happening with Devon. Getting him to bed earlier and helping him sleep better at night will probably make it easier for him to get out of bed in the morning, and might improve his behavior at school.

Ideas for improving sleep:
  • Choose calmer activities in the evening. Activities that are too stimulating—such as wrestling, playing video games and watching television—are better to do together during the daytime and on the weekends. On weekday evenings, try reading together, playing quiet games or cards, doing art projects, playing music or giving him a bath.
  • Keep the television and video games out of the bedroom. The screen in the bedroom is a constant reminder of the excitement and fear of video games, television shows and movies, which can make it difficult to fall asleep. Removing the TV and video games can make it easier for him to fall asleep.
  • Avoid violent video games, television and movies. Although nightmares are common at this age, consider reexamining the type of video games, television and movies that your son plays and watches. Games and shows that involve bad guys, chasing and shooting may be contributing to his nightmares. Consider taking a break from the violent games and shows, and see whether his sleep improves.
  • Avoid caffeine in the evening. For dinner, give your son milk, which has natural chemicals that cause sleepiness, instead of sodas that have caffeine, which causes wakefulness.
  • Have a consistent bedtime routine and bedtime hour. An evening and bedtime routine will help your son know what’s coming next. For example, you might give him a bath, play a game, read a book, and have a sip of water then put him to sleep between 8 and 9 p.m. When you follow a similar routine every night and put him to bed at a regular time, your son will feel more secure and comfortable falling asleep.

Also, be sure to talk with your son’s doctor about his sleep and his behavior at school. A full check-up of his health and development is important. The doctor might have additional suggestions for you.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician