Sleep Problems in Children: Bedtime, Night Waking, and Nightmares

An independent educational resource prepared by Mark M. Simonian, MD, FAAP

Sources checked: August 6, 2026     |     Medical review completed: August 6, 2026

This page is for general education only and does not replace individualized medical advice. This resource does not establish a doctor-patient relationship. For questions about your own child, contact your child's current healthcare professional.

Magnolia Pediatrics, Valley Children's Healthcare

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Sleep needs and sleep patterns change with age. Many bedtime struggles and night wakings improve with a predictable routine. Get help when sleep is disrupted by breathing problems, safety concerns, pain, daytime impairment, or distress that persists.

Urgent Warning Signs - Check This First

Sleep difficulties do not usually require emergency care. Breathing pauses, color changes, inability to wake, and a child who cannot be kept safe require immediate attention.

CALL 911 NOW

  • A child has stopped breathing for more than 20 seconds, is blue or gray, limp, unresponsive, having a seizure, or has severe trouble breathing

  • A child has a dangerous mental-health crisis, is attempting to harm themselves or another person, or cannot be kept safe

GET URGENT MEDICAL OR MENTAL-HEALTH HELP NOW

  • A child has new confusion, extreme sleepiness, hallucinations, severe headache, neck stiffness, fever with serious illness, or a sudden major behavior change

  • Your child or teen talks about suicide, self-harm, or wanting to harm others. Call or text 988 in the United States for urgent crisis support

  • A child has persistent breathing difficulty during sleep, repeated gasping or choking, or a sleep problem accompanied by significant daytime illness

CONTACT YOUR CHILD'S HEALTHCARE PROFESSIONAL TODAY

  • Frequent loud snoring, mouth breathing, observed pauses in breathing, restless sleep, daytime sleepiness, attention problems, or behavior concerns

  • Sleep problems affect school, child care, family functioning, mood, growth, or safety; or persist despite a consistent routine

  • Nightmares, night terrors, sleepwalking, or nighttime fears are frequent, cause injury risk, or are associated with trauma, anxiety, medicine changes, or a new medical concern

Build a Predictable Sleep Routine

  • Set a regular wake-up time and bedtime most days, including weekends when practical

  • Use a calming, repeatable sequence: bathroom, teeth, pajamas, book, brief connection, lights out. Keep the routine simple and realistic

  • Dim lights and turn off phones, television, gaming, and other electronics at least 30 minutes before bedtime. Keep the bedroom quiet, cool, and relaxing

  • Give children age-appropriate choices within the limit: which pajamas, which book, or which quiet activity. Avoid turning bedtime into a long negotiation

Night Waking and Bedtime Resistance

  • Respond calmly and briefly. Reassure, return the child to the planned sleep space, and repeat the same approach consistently

  • Avoid adding new habits that you cannot sustain, such as long screen use, extended bargaining, or a parent sleeping in the child’s bed every night unless this is part of a deliberate plan

  • Check for common contributors: illness, pain, constipation, hunger, caffeine, stressful events, daytime naps, schedule changes, or medication effects

  • For babies, continue to follow the separate Safe Sleep guidance. Do not use this page to change an infant’s safe-sleep plan

Nightmares, Night Terrors, and Sleepwalking

  • Nightmares usually wake a child, who may remember the dream. Comfort, reassure, and help the child return to sleep

  • Night terrors occur early in the night; the child may appear frightened but is not fully awake and usually will not remember. Stay calm and protect the child from injury

  • For sleepwalking, secure doors and stairways, clear hazards, and gently guide the child back to bed. Do not try to force the child fully awake

  • Keep a sleep log if episodes are frequent, prolonged, or risky and share it with the healthcare professional

Sleep and Breathing

  • Frequent snoring, mouth breathing, gasping, pauses in breathing, restless sleep, daytime sleepiness, difficulty paying attention, or behavior problems may indicate sleep-disordered breathing

  • Record a short video only if it can be done safely and without disturbing the child, and share it with the healthcare professional. Do not delay emergency care for breathing or color changes

Call Preparation

  • Bedtime, wake time, naps, night wakings, snoring or breathing symptoms, daytime sleepiness, and a one- to two-week sleep log

  • Illness, pain, medicines, caffeine, stressors, nightmares, screen use, and what has helped or worsened the problem

  • Teacher or child-care observations about alertness, behavior, learning, or falling asleep during the day

Related Guides

  • Safe Sleep for Babies: What Families Need to Know

  • Bedwetting in Children: What Is Normal and When to Seek Help

  • Temper Tantrums, Aggression, and Big Feelings: When to Seek Help

  • Coughs, Colds and Breathing: When to Seek Care

Sources and Medical Review

  • HealthyChildren.org (American Academy of Pediatrics), Healthy Sleep Habits: How Many Hours Does Your Child Need?: Read source

  • HealthyChildren.org (American Academy of Pediatrics), Nightmares, Night Terrors and Sleepwalking in Children: Read source

  • HealthyChildren.org (American Academy of Pediatrics), Sleep Apnea in Children: Detection and Treatment: Read source

  • Centers for Disease Control and Prevention, Sleep and Health: Read source

  • Centers for Disease Control and Prevention, About Sleep: Read source