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

Anxiety can cause difficulty falling asleep, frequent waking, and overall reduced sleep quality, impacting a child's daily functioning and well-being. According to the American Academy of Pediatrics (AAP), 15 to 25 percent of kids and teens struggle to fall asleep or stay asleep. 

Tailored bedtime routines and using healthy strategies to manage nighttime anxiety, however, can help a child foster better sleep and cope effectively with anxiety-related sleep issues. 

What Causes Anxiety in Children to Intensify Before Bedtime?

The connection between anxiety and sleep is deeply intertwined, particularly in children. Wondering “why do I get anxiety at night?” may be a nightly ritual for your child that actually increases stress around sleeping habits. Many factors may contribute to worries around sleep including separation fears, fear of the dark, routine changes, overstimulation, academic or social stress, as well as parental stress. 

Even if shielded from direct adult hardships like job loss or relationship troubles, children are perceptive and often sense parental stress. Heightened stress triggers increased cortisol levels and disrupts natural sleep-wake cycles. 

Nighttime anxiety varies by age, with babies and younger children often seeking comfort and closeness to their parents during sleep time due to fear or unease, while 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. 

As we’ll see, consistent bedtime and wake times, however, can play a crucial role in maintaining optimal sleep and help contribute to a happier and healthier life.

How Does Anxiety in Children Impact Sleep, and What Can I Do About It?v

The amount of nightly sleep required depends on age—and the American Academy of Sleep Medicine recommends children aged 6 to 12 years regularly sleep 9 to 12 hours per 24 hours, while teenagers aged 13 to 18 years should get between 8 to 10 hours of sleep per 24 hours.

Anxiety in children can significantly impact their sleep in some of the following ways:

Difficulty falling asleep

Anxious thoughts can make it hard for children to relax and fall asleep, and they may experience racing thoughts or worries that interfere with their ability to initiate sleep.

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, leading to fragmented sleep patterns, reduced time in restorative sleep stages like REM, and lower sleep quality overall.

Sleep-related disorders

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

Daytime fatigue

Children with anxiety may experience disrupted sleep, which leads to daytime fatigue, irritability, difficulties concentrating, and mood changes affecting overall daytime functioning.
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Addressing the underlying causes of anxiety in children and finding tailored strategies to manage anxiety effectively can significantly improve a child’s sleep quality and overall well-being.

How Can I Manage Anxiety at Night in Children for Better Sleep?

Managing nighttime anxiety in children—by establishing a consistent, calming bedtime routine, creating a relaxing sleep environment, and addressing your child’s worries—is crucial for ensuring better sleep quality. Encouraging relaxation techniques, limiting screen time, promoting physical activity, and using positive reinforcement can also help alleviate anxiety. 

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Other helpful bedtime strategies may include:

Establishing a calm bedtime routine: Create a consistent, calming bedtime routine that includes activities such as reading a book, taking a warm bath, or practicing deep breathing exercises. 

‍Creating a relaxing sleep environment: Ensure the 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 concerns can help alleviate anxiety. 

‍Limiting 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.

‍Encouraging relaxation techniques: Teach and practice relaxation techniques with your child, such as deep breathing, progressive muscle relaxation, or guided imagery. 

‍Promoting physical activity: Engage your child in physical activities during the day. Exercise can help reduce anxiety and improve sleep quality.

‍Using positive reinforcement: Praise your child for their efforts in managing anxiety and achieving better sleep. 

‍Creating a safe space: Offer reassurance by letting your child know they are safe. One way to do this is by using a comfort object or creating a "worry box" where a child can write or draw their worries in order to leave them there safely before bedtime.

‍Seeking professional help if necessary: If anxiety persists or significantly affects your child's 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, but keep in mind that every child is unique. It may take time to find what works best for your child. Tailor strategies to suit your child's preferences and needs while aiming to create a supportive and calming bedtime routine. 

Are There Bedtime Routines for Children to Promote Relaxation and Reduce Anxiety?

Anyone who’s spent time with a sleep deprived child knows the critical role of sufficient sleep in their overall health and happiness. Developing a consistent bedtime routine can help alleviate anxiety, stress, and worry in children, but, rather than following a rigid template, get to know your child's unique needs by involving them in crafting their bedtime routine. 

Two important aspects of promoting relaxation at bedtime include:

Establish a Regular Bedtime

When determining a feasible bedtime, consider your child's daily schedule, including school activities, meals, homework, and the need for relaxation and fun, as well as connection with you. Highlight the significance of sleep as an equally important part of their schedule as any other activity.

Bedtime Stories

Reading bedtime stories or listening to audiobooks with younger children can foster connection and a peaceful atmosphere before sleep. The practice encourages not only peace and serenity, but also offers a time for bonding and connection. 

Are There Specific Strategies for Overcoming Nighttime Panic Attacks in Children?

An abrupt onset of overwhelming fear leading to an intense physical response, a panic attack often manifests without any actual threat or necessarily discernible trigger. A panic attack can be highly distressing, including the sensation of losing control, undergoing a heart attack, and even the feeling of imminent death.

Nocturnal panic attacks in children—extreme and acute instances of anxiety—can be especially upsetting for both child and caregivers. And, if you’ve ever witnessed a child suffering a nocturnal panic attack, you’ve inevitably asked yourself how to calm an anxiety attack at night. 

Though there are several helpful strategies to support children as they manage their nighttime panic attacks effectively, one way to help alleviate a panic attack is to create a safe space for your child and seek professional help if needed. 

Other helpful bedtime techniques to alleviate panic attacks 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
• Calmly 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 and overcome the distress of nighttime panic attacks.

Disruptions in a child’s daily schedule and increased screen time can impact a child's sleep quality, but emphasizing the importance of establishing a regular sleep routine can build a lifetime of good habits. 

Creating a secure and comfortable sleeping space, transitioning gradually to their own bed, and ensuring their room feels like a safe place are important aspects of a creating calming bedtime routine. And remember, if you need further support or assistance in helping a child deal with anxiety at night, don’t hesitate to reach out for a free consultation from a licensed Handspring Health therapist today. 

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