Anxiety at Night in Children: Causes, Symptoms, and Treatment

According to the American Academy of Pediatrics (AAP), 59% to 87%  of kids and teens struggle to fall asleep or stay asleep. There are many potential reasons for sleep disturbances in kids. But anxiety at night can be a major player.

Anxiety can cause difficulty falling asleep, frequent waking, and reduced sleep quality. All of these issues can impact a child's daily functioning and well-being.

Bedtime routines and strategies to manage nighttime anxiety can help a child cope with anxiety-related sleep issues and get better sleep.

What Causes Anxiety at Night in Children?

The connection between anxiety and sleep is deeply intertwined, particularly in children. Your child may often wonder, “Why do I get anxiety at night?” This question may actually increase stress around their sleeping habits.

Other factors that contribute to worries around sleep for children include:

• Separation fears
• Fear of the dark
• Routine changes
• Overstimulation
• Academic or social stress
• Parental stress

Even though they don't have adult hardships like job loss or relationship troubles, children are perceptive. They often sense parental stress. Heightened stress triggers increased cortisol levels and disrupts natural sleep-wake cycles. 

Nighttime anxiety varies by age. Babies and younger children often seek comfort and closeness to their parents during sleep time due to fear or unease. Older children may struggle to fall asleep or experience fear of sleep as they ruminate over the day’s worries. Sleep patterns can also be disrupted by changes in school schedules, canceled activities, and increased screen time. 

Symptoms of Anxiety at Bedtime

In children and teens, anxiety at night might show up in their sleep in the following ways.

Difficulty Falling Asleep

Anxious thoughts can make it hard for children to relax. They might experience racing thoughts or worries that interfere with their ability to fall asleep.

Increased Night Wakings

Children dealing with anxiety may wake frequently during the night. These awakenings can stem from nightmares; specific or generalized fears; or restlessness caused by anxiety.

Poor Sleep Quality

Anxiety can result in lighter and less restful sleep. Often, this leads to fragmented sleep patterns, reduced time in restorative sleep stages, and an overall lower sleep quality.

Sleep-Related Disorders

Long-term anxiety may contribute to sleep-related disorders like insomnia. A child with insomnia struggles to fall asleep or stay asleep, impacting their daily functioning and well-being.

Daytime Fatigue

Children with anxiety at night may experience disrupted sleep, which leads to daytime fatigue. In turn, this fatigue causes irritability, difficulties concentrating, and mood changes. ‍ Addressing the underlying causes of anxiety in children can improve a child’s sleep quality and overall well-being.

How to Help a Child With Anxiety at Night

Managing nighttime anxiety in children is crucial for ensuring better sleep quality. Start with the following strategies for managing nighttime anxiety:

• Establish a calm bedtime routine. Create a consistent, calming bedtime routine that you and your child practice every night. This routine could include activities such as reading a book, taking a warm bath, or practicing deep breathing exercises. 
• Create a relaxing sleep environment. Ensure your child's bedroom is conducive to sleep by making it comfortable, quiet, and dark. 
• Thoughtfully address worries. Encourage your child to express their worries or fears. Talking about their concerns can help alleviate anxiety. 
• Limit screen time. Reduce exposure to screens (TV, computers, tablets, smartphones) at least an hour before bedtime. The blue light emitted by screens can interfere with the body's natural sleep-wake cycle.
• Encourage relaxation techniques. Teach and practice relaxation techniques with your child. Try deep breathing, progressive muscle relaxation, or guided imagery. 
• Promote physical activity. Engage your child in physical activity during the day. Exercise can help reduce anxiety and improve sleep quality.
• Use positive reinforcement. Praise your child for their efforts in managing their symptoms of anxiety at bedtime and achieving better sleep.
• Create a safe space. Offer reassurance by letting your child know they are safe. One way to do this is by creating a "worry box" where a child can write or draw their worries. Explain they are leaving their worries safely in the box before bedtime.
• Seek professional help if necessary. If your child's anxiety persists or significantly affects their sleep or daily life, consider seeking guidance from a pediatrician, therapist, or counselor who specializes in working with children and anxiety. 

Consistency and patience are key when implementing healthy sleep strategies. Keep in mind that every child is unique. It may take time to find what works best for your child. Try out different strategies for managing nighttime anxiety to find what best suits your child's preferences and needs. Your goal is to create a supportive and calming bedtime routine that works for your family.

Creating Bedtime Routines For Anxious Children

Anyone who’s spent time with a sleep-deprived child knows that sufficient sleep is critical for a child's health and happiness. The American Academy of Sleep Medicine recommends children aged 6-12 need 9-12 hours of sleep per day. Teenagers aged 13-18 should get 8-10 hours.

A consistent bedtime routine can help alleviate anxiety and promote better sleep. But there's no need to follow a rigid template. Instead, get to know your child's unique needs by involving them in crafting their very own bedtime routine. 

Two important aspects of promoting relaxation at bedtime include:

• Establishing a regular bedtime. When determining a feasible bedtime, consider your child's daily schedule. Think about school activities, meals, homework, and the need for relaxation and fun. Remember to also leave time for connection with you! Finally, remember that sleep is an important part of their schedule, just like any other activity.
• Reading bedtime stories. Reading bedtime stories or listening to audiobooks together can foster connection and a peaceful atmosphere before sleep. This practice not only encourages peace and serenity but also offers a time for bonding and connection.

Overcoming Nighttime Panic Attacks in Children

A panic attack is an abrupt onset of overwhelming fear leading to an intense physical response. It often manifests without any actual threat or discernible trigger. A panic attack can be highly distressing. A child who is having a panic attack may feel as if they are losing control, undergoing a heart attack, and or experiencing imminent death.

Nocturnal panic attacks in children can be especially upsetting for both children and caregivers. In this section, we'll provide tips on how to calm an anxiety attack at night. 

There are several helpful strategies to support children as they manage their nighttime panic attacks. The two most important things to remember: Create a safe space for your child, and seek professional help if needed.

Other helpful techniques to manage nighttime panic attacks in children include:

• Fostering open communication about a child’s fears
• Identifying triggers that might lead to a panic attack
• Maintaining a sleep diary to track patterns and triggers
• Teaching and using relaxation techniques
• Ensuring a safe sleep environment
• Offering your reassuring presence during episodes of panic
• Reminding your child that anxiety is uncomfortable but not dangerous
• Encouraging positive coping methods
• Modeling calm behavior when anxiety creeps in
• Providing consistent support 
• Seeking help from a licensed therapist if needed

Patience, understanding, and a comforting bedtime environment can all play crucial roles in helping children manage nighttime panic attacks.

It's also helpful to establish a regular sleep routine as discussed above. Create a secure, comfortable sleeping space for your child. Encourage relaxation techniques. Remind them you are always there to listen to their fears. These strategies can help minimize anxiety at night in children.

It's never a bad idea to seek additional support from a licensed professional. A therapist can provide additional coping techniques to help you and your child deal with nighttime anxiety. Don't hesitate to reach out for a free consultation from a licensed Handspring Health therapist today.

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