The Most Common Reasons Behind Bedtime Anxiety

...and what to do about it

Jan 27, 2025

grayscale photo of girl sleeping on white pillow

No one knows sleep deprivation like a new parent with an infant who wakes every two to three hours to be fed or changed. I recall five hours of sleep being my personal threshold for feeling human in the early days of parenthood. Less than five hours of sleep and I was nearly non-functional.

That’s because sleep is the great regulator. Without it, we struggle to maintain our attention, regulate our emotions, and manage our energy.

This is why the first thing I ask parents before we dive into figuring out why a child might be struggling, well, with anything, is “How are they sleeping?” Everyone has their own threshold for sleep, kids included. In case you’re wondering, here are the daily sleep amounts for kids and teens recommended by the American Academy of Pediatrics.

Many autistic children and teens are even more sensitive to the emotional and sensory impacts of not getting enough sleep. Children and teens with ADHD can struggle to wind down and fall asleep which often impacts family dynamics at bedtime. And, children who are anxious may experience their most intense worries when the lights go out. You might even have a child who struggles to sleep then gets the grand idea to sneak screen time in the middle of the night, which of course keeps them more awake.

Screen boundary tips at bedtime:

All family members charge all devices in the hallway or kitchen/no devices in bedrooms
Screens are plugged into charge at the beginning of the bedtime routine
Use parental controls like “downtime” on apple devices to block access during sleep timeframes
If needed, block the wifi at the router between certain times of day

We've all read about the negative impact of not enough sleep for kids and teens. And, we all know that when children are well-rested, they are better able to remain emotionally regulated when things don't go their way, they are able to access learning by remaining engaged in the classroom, and they are generally happier. When I talk to parents in my therapy practice, here are the top three most common issues interfering with kids getting good sleep and my tips for getting back on track.

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Anxiety About Separating

From the beginning, parents rely on co-regulation to help babies and young children fall asleep. We instinctively rock and bounce and hum and sing, whatever it takes, to lull a child to sleep. As children grow, they may transition to a safety object that replaces a parent at bedtime such as a lovey, stuffed animal, or even a toy. These items serve as a "security blanket," helping a child feel secure when they are by themselves. For some children, they may not have ever attached to an item of comfort other than their parent, or their “security item” may not make them feel secure enough to fall asleep without their caregiver present.

As children get older, and more skilled at negotiating, they may engage in any number of "tactics" to prolong separating from their caregiver at bedtime, especially if they are feeling alone or scared. You may get requests for one more drink of water, one more story, or one more song to get a parent to stay just a little longer. Sometimes kids begin to talk about fears that happen when they are alone, like the dark or an unexpected noise (see #2). Your child is seeking your connection, which is a good thing in general, but if your goal is to help them feel safe falling asleep on their own so that everyone gets their best sleep, read on.

What to do: During the daytime, engage your child in a discussion of a plan to make their bed the most comfy place to get sleep at night. Allow them to rearrange their space, choose items that help them feel safe, and tighten up the bedtime routine to be as predictable as possible. When the bedtime routine is simple and consistent, over time kids will learn that having a snack after brushing teeth isn’t part of the plan. Children will also begin to feel safe within the consistency of their routine because it's predictable.

Remember that the routine belongs to the child, not to the parent. While each parent might have a special thing that they do to connect with their child, the step-by-step of the bedtime routine needs to remain consistent so that parents can go in and out of the routine when one parent wants to meet up with friends or the other has to work late. Otherwise, as a parent you will feel chained to the routine and that's exhausting and not sustainable.

Once you have the routine down, some children need an additional strategy to stay in their bed after that last goodnight kiss. Many kids benefit from knowing that their caregiver will come back and check on them in one minute, five minutes, ten minutes, and so on. Encourage your child to stay in their bed until you come check on them. This strategy allows their body to settle without getting up to find you and over time they will get used to falling asleep in their bed while waiting for you to check in.

2. Anxiety About Their Environment

If children are scared to be alone in their bed, you have likely heard them say they are afraid of the dark, perhaps they heard a noise they cannot explain, or they just can't get comfortable. When our children voice these complaints, it's really hard to tell sometimes what is a true fear and what is a stalling tactic to avoid separation from us. If it’s hard to figure out, just target both concerns by helping them feel as comfortable as possible and also checking back on them to build independence while falling asleep (strategy mentioned in #1).

What to do: Most of the time, making sure kids have ownership over the set up of their sleeping space can help with any worries about not being able to get comfortable. If they have declared their space comfortable during the day, this should boost their confidence with being comfortable at bedtime. However, the unseen fears of the night (e.g., the dark and mysterious noises) are sometimes more challenging to support).

First, we want to start with explaining to children that their room and home remain safe whether the lights are on or off. For example, talk through how you’ve never seen monsters when the lights are on and use nightlights to help prove your point.

This is often a good time to introduce the idea of a REAL worry versus a TRICK worry to a young child. TRICK worries are things that can't really happen like monsters and aliens in our closet. REAL worries are things like a thunderstorm that are a real danger if we were climbing trees during a storm (and something kids will say for sure they know is not a good idea because it's dangerous). We can then let our kids know, even if they hear a storm or a siren outside, they are safe inside and can trust that we will keep them safe.

Next, it can be helpful to add play to a dark room to give your child more positive associations with the dark. Play with a flashlight in your child's room making shadow puppets and they will begin associating a fun memory with the dark. Another strategy is to lie down in the dark with your child at bedtime and play a guessing game about all the noises you hear. Most noises can be explained by appliances, HVAC systems, plumbing, and the neighbors' dog. Helping your child connect noises to people or things they are familiar with during the day will help ease their mind at night.

3. Anxiety About Their Thoughts

Once kids know they are safe to sleep alone, they can still be kept awake by an endless list of thoughts. Children who are anxious during the day may experience more intense worries at bedtime. The most common reason for this is that during the day they are distracted by school, family, friends, and entertaining things that keep their worries in the back of their mind. At night, their anxious thoughts take center stage and seem much more significant in the dark and quiet. This is true for adults, too. How many times have you worried about something at night just to wake up and it seems like no big deal in the light of day?

I often ask kids to think of their anxious thoughts like a character in a musical (or a player on a sports team, whatever makes the most sense to them). During the day, our anxious thought is just one actor blending in with the chorus. At night, our anxious thought gets a solo performance while everyone else is waiting backstage. We might feel more anxious because we notice our thought more, but it's not necessarily scarier, it just seems that way because it's in the spotlight.

What to do: Many kids I've worked with have benefitted from writing down their nighttime worries on a notepad by their bed or by dictating them to a parent. This doesn't have to be in the form of journaling paragraphs, but can just be bullet points on a notepad that serves as a "brain dump" before climbing into bed. Have your child say, "good-night" to those thoughts or trick worries and tell them they will deal with them in the morning. When your child wakes up in the morning, have them look over the list and cross out the trick worries and make a plan together for problems that need to be solved.

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Anxiety About Their Anxiety

Some kids have anxiety about not being able to fall asleep and then get anxious that they will be tired the next day. Always remind a child that their body is a machine and will always eventually get the rest that it needs. If your child is struggling to settle beyond these strategies, check in with your pediatrician or a mental health provider to talk through strategies specific to your child and family so that you can all get the rest you need to feel your best tomorrow.

Let’s stay connected!

~Dr. Emily

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