Settling

Children have to learn to fall asleep at socially appropriate times

• the development of an appropriate sleep routine is facilitated by drowsiness, calmness, a bedtime routine in order to provide cues, and the presence of a parent to diminish separation anxiety and fears of the dark if present. However, the ultimate goal must be for the child to be able to settle and fall asleep without the presence of an attachment figure. The inability to fall asleep without an attachment figure is not an uncommon problem of childhood. This occurs in about 15% of 3-4 year olds and 10% of 8 year olds.

Factors associated with difficulty in settling include:

• displaced sleep-wake cycle
• lack of routine
• overwhelming separation anxiety
• excessive fears of the dark
• inadvertent or stress-related stimulation of arousal

Reference:

• Inamdar S et al. Phenomenonology associated with depressed moods in adolescence. American Journal of Psychiatry 136:156;59.