Expert Advice

Ten-Year-Old Can't Fall Asleep

Pediatrics Expert Advice from Shari Nethersole, M.D.

Q
My 10-year-old boy can't fall asleep at night. He is up till 11, sometimes 12 o'clock. He is not real active when he gets home after school due to lack of playmates around, but he does play hockey as a sport. He is very intelligent, so do you think he just can't shut down his "brainwaves" at night? I watch what he consumes as far as caffeine, sugar, etc., but I am beginning to worry about it. He says he can't go to sleep -- he tries but is not tired. Should I have him checked out? Could there be a food allergy?
A
Sleep patterns can vary quite a bit from child to child. At 10 years of age the average child needs about 10 hours of sleep at night, but the range is from 8 to 12 hours of sleep. It is sometimes difficult to figure out what is "normal" for you own child. It is possible that he only needs 8 hours of sleep.

If he has difficulty getting out of bed in the morning on a regular basis, or if he seems irritable or tired during the day, it is likely that he is not getting enough sleep. There are a few rules you should enforce: No television in the hour before bedtime. TV is a stimulant for most children, and watching it just before bedtime can "jazz them up," and make it more difficult to fall asleep. The same goes for listening to loud or harsh music. Some soft, quiet music is probably okay. Reading for 20 to 30 minutes is a good way to settle down for a good night's sleep. The last rule is that he should not get into bed until he is truly tired. It is very frustrating to be limited to a bed for one or two hours when you are not ready to fall asleep.

It is very unlikely that the sleep problem is caused by a food allergy. The biggest food issue, caffeine, you have already addressed. Chocolate can also serve as a stimulant, and I would avoid large amounts of it in the hours before bedtime.

Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.

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