Definition

• Young children who try to postpone bedtime
• They refuse to get into bed or stay in their bedroom. They may visit you during the middle of the night.
• They delay bedtime with ongoing questions, requests, crying or even tantrums
• Some children suddenly complain of a stomach ache
• A common problem that occurs in up to 30% of young children who no longer sleep in a crib

Health Information

Cause

• Fighting bedtime is your child’s attempt to test your limits and stay up later.
• Your child would like to go to bed when you do and have you present until he falls asleep.
• This is not about fears.

Care Advice

1. Establish a New Rule About Being a Good Sleeper:
   • Tell your child the rule: "I want you to be a Good Sleeper". Then define it.
   • At bedtime, a Good Sleeper stays in his bedroom and doesn’t fuss.
   • During the night, a Good Sleeper doesn’t leave his bedroom or wake up his parents, unless it’s an emergency.
   • You decide bedtime and lights out time. Try to keep it the same time each night.
2. Reward Good Bedtime Behavior:
   • Give your child an incentive for changing his bedtime behavior.
   • If he stays in his bedroom without a fuss, give him a reward in the morning.
   • Put a sticker on his Good Sleeper chart.
   • Give him a special treat with breakfast, such as a serving of ice cream or a special cartoon show.
   • The average child will change his behavior for something he really wants. You just need to be creative.
3. Leave Your Child’s Bedroom Before He Falls Asleep:
   • Start the night with a pleasant bedtime routine, doing things your child likes. Keep it to 30 minutes or less.
   • Before you give your last hug and kiss, ask, "Do you need anything else?"
   • Then leave and don’t return. It’s very important that you are not with your child at the moment of falling asleep. Otherwise, he will need you to be present following normal wakings in the night.
4. Offer to Check on Your Child:
   • If your child says he is afraid, tell him you will check on him every 15 minutes (instead of him checking on you). For some children, you may need to start with checking in every 5 minutes. As behavior improves, gradually extend the time.
   • When you come in, tell him he’s doing a good job of being quiet. Leave within 15 seconds.
   • On one of your visits, you will find him asleep.
5. Ignore Verbal Requests or Questions:
   • Ignore ongoing questions or demands from the bedroom.
   • Don’t talk with your child during this time.
   • At the most, say: "It’s time to be quiet". For older kids say: "It’s time to turn off your brain".
6. If Your Child Leaves the Bedroom, Return Him Quickly:
   • If your child comes out of the bedroom, return him immediately to his bed. Offer to tuck him in.
   • Give him a choice of sleeping on the floor. That helps some children cooperate with your rule.
   • Avoid any lectures. Be firm but loving.
   • Warn him that if he comes out again you will need to close the door.
   • For younger children, warn them you may need to put them back in the crib. If you do, still start each night in their "big bed".
7. Close the Door if Your Child Won’t Stay in His Bedroom:
   • If he comes out again, close the bedroom door.
   • You have no choice.
   • Tell him you can open it as soon as he’s in bed. Or he’s lying down somewhere in his bedroom. It’s called helping children "win".
   • Every 10 minutes or so, open the door. Ask your child in a loving way if he’s ready to stay in his bedroom now. If not, close it again.
   • Some parents consider closing the bedroom door too extreme. But, it’s needed for teaching some children that parents mean what they say. You usually only have to close it 2 or 3 nights.
8. Wake Him at the Normal Time Each Morning:
   • Don’t let him sleep in. If you do, he won’t be tired the next night.
9. What to Expect:
   • Be consistent and you will see improvement within a week.
   • Expect some crying and protest during the sleep training.
   • Young children normally cry when they don’t get their way.

Call Your Doctor If

• Your child is not sleeping well after you try this program for 2 weeks
• Your child becomes frightened
• You have other questions or concerns

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

#AAP