Why Won't My Toddler Sleep? Sleep Resistance in Kids

I don't want to sleep!

My daughter is two years and six months old, and for the past week, she has been refusing to sleep at night! Even though she is yawning frequently and her eyes are heavy with sleep, she insists that she needs to use the bathroom, either to urinate or have a bowel movement, or even claims she feels like vomiting! Whatever she tells me, she insists on doing it.
She just went to the bathroom, but she keeps asking to go again, and she simply won't go to sleep! Last year, she made herself vomit by poking her finger down her throat, and now she can make herself vomit without using her finger.
Is she sick? What should I do?

Mimi, 30~39 year old female. Ask Date: 2004/10/25

Dr. Cai Zhengxian reply Pediatrics

Dear Mimi,
Your child seems to have a "bedtime struggle" every time it's time to sleep, which can have many possible causes.
We suggest the following:
1.
Your child or your family may not have a regular sleep routine.
Sometimes, she may feel physically tired but mentally excited, making her reluctant to go to sleep.
We recommend discussing a fixed schedule with your husband for the whole family.
For example, you could set a bedtime of 9:00 PM for your child and 11:00 PM for adults.
2.
Conversely, it may be that you are forcing her to go to bed even when she doesn't feel tired.
It's important to note that young children do not necessarily need more sleep than adults, as they often have longer periods of deep sleep and recover quickly.
It's possible that her sleep duration is sufficient for her to feel refreshed.
3.
She may be experiencing too many restrictions on her behavior during the day.
If there is inconsistency in behavior expectations between parents or grandparents, she may feel confused about whom to listen to.
This could lead her to intentionally ignore one parent's instructions when it's time for bed.
In such cases, we recommend that both parents communicate and coordinate their disciplinary approaches for consistency.
4.
Your child may not be independent enough yet and could be afraid of the dark or sleeping alone, fearing that her parents won't stay with her.
This is easily resolved by having you or your husband consistently accompany her to bed at a set time, reading stories or listening to music until she falls asleep before leaving.
5.
There may be significant changes occurring in the family.
Although young children may not understand concepts like divorce or major conflicts between parents, they can be sensitive to the possibility of family separation.
If they witness loud arguments during the day, they may exhibit emotional behaviors at night.
This is a serious warning sign indicating that your family may be undergoing significant changes.
If this is the case, we recommend seeking assistance from family, friends, or mental health professionals, such as marriage counseling.
Wishing you good health and all the best!
Tainan Hospital

Reply Date: 2004/10/25

More Info

Sleep resistance in toddlers is a common issue that many parents face, and it can be particularly challenging when your child exhibits behaviors that seem contradictory to their obvious tiredness. In your case, your two-and-a-half-year-old daughter is showing signs of sleep resistance, such as frequent yawning and sleepiness, yet she insists on engaging in various activities to avoid going to bed. This behavior can be perplexing and concerning, especially when it escalates to self-induced vomiting.

First, it’s important to understand that sleep resistance can stem from a variety of factors. Here are some potential reasons for your daughter's behavior:
1. Developmental Stage: At around two years old, children are developing their autonomy and may resist sleep as a way to assert their independence. They may feel that by refusing to sleep, they are exercising control over their environment.

2. Routine and Structure: Children thrive on routine. If there is inconsistency in bedtime rituals or if the family does not have a set sleep schedule, this can lead to confusion and resistance. Establishing a consistent bedtime routine can help signal to your child that it is time to wind down and prepare for sleep.

3. Separation Anxiety: Many toddlers experience separation anxiety, which can manifest at bedtime. Your daughter may be afraid of being alone in her room or may fear that you will not be there when she wakes up. Providing comfort through a bedtime story, a nightlight, or even staying with her until she falls asleep can help alleviate these fears.

4. Physical Discomfort: If your daughter is experiencing any physical discomfort, such as needing to use the bathroom frequently, it may be a way for her to delay sleep. It’s essential to ensure that she is comfortable and that any physical needs are addressed before bedtime.

5. Emotional Factors: Changes in the family environment, such as parental stress or conflict, can affect a child's emotional state and lead to sleep disturbances. Children are sensitive to their surroundings, and any tension can manifest as anxiety at bedtime.

6. Behavioral Patterns: If your daughter has previously engaged in behaviors that led to attention (even negative attention), she may continue to do so as a way to elicit a response from you. This can include behaviors like insisting on using the bathroom repeatedly or claiming to feel sick.

To address your daughter's sleep resistance, consider the following strategies:
- Establish a Consistent Bedtime Routine: Create a calming pre-sleep routine that includes activities such as reading a book, dimming the lights, and engaging in quiet play. This routine should be consistent every night to help signal to her that it is time to sleep.

- Set Clear Boundaries: While it’s important to be responsive to her needs, setting clear boundaries about bedtime can help. Explain that after a certain time, it is time to sleep, and that bathroom trips should be limited to before bedtime.

- Provide Comfort: If she is anxious about being alone, consider staying with her until she falls asleep or providing a comfort object, such as a stuffed animal, to help her feel secure.

- Monitor Daytime Activities: Ensure that she has plenty of physical activity during the day to help her expend energy, which can promote better sleep at night.

- Consult a Pediatrician: If her behavior continues or escalates, it may be beneficial to consult a pediatrician or a child psychologist. They can help rule out any underlying medical issues or provide strategies tailored to her specific needs.

In conclusion, sleep resistance in toddlers can be attributed to a combination of developmental, emotional, and environmental factors. By establishing a consistent routine, providing comfort, and setting clear boundaries, you can help your daughter navigate this challenging phase and promote healthier sleep habits. If concerns persist, seeking professional advice can provide additional support and reassurance.

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