Question: I can tell that my daughter Kayla experiences nights of not getting a full night's rest. On school nights, she is in bed by 8:30 p.m.; however, she'll be tired in school and/or after school, and her mood or temperament is less than desirable. There are nights she will be up at 3:00 am and turn on the television. We've told her she can do anything but watch television. Any suggestions?

Answer: Sleep problems are one of the most common parental concerns. Researchers believe that perhaps ten percent of American children are sleep deprived. Sleepiness and inattention is also a frequent complaint of teachers.

Sleep disorders in children can include such symptoms as difficulty falling asleep, frequent waking, sleep walking, sleep terrors and nightmares, bed wetting and difficulty sleeping alone.

Various symptoms can be organic or behavioral in origin, or some combination of both. It is important that you take your child to her pediatrician to determine if there are any medical concerns. She may refer you to an ear, nose and throat specialist for further assessment. Some medical causes are enlarged tonsils or adenoids, sleep apnea (the repeated cessation of breathing during sleep) and chronic ear infections. Children with sleep apnea may awaken frequently and feel as if they are gasping for breath.

Other causes of frequent awakening might be due to medication, chronic illness, anxiety or depression. Many medical researchers are now beginning to wonder if some of the behavioral problems we see in children are actually caused by poor sleep. Doctors believe that 6-year-olds should be sleeping ten ½ to 12 hours per night.

Ways to improve sleep habits are to have no active stimulation, such as computer or television, for a half hour or longer before bed. A consistent routine that includes a specific bedtime and quiet soothing rituals, such as a warm bath, soft music and reading, can also help. Restrict her access or disconnect the TV so that she can't get over-stimulated in the middle of the night. Teach her visualization (imagining herself in a quiet favorite place) and relaxation techniques (tightening and releasing each muscle, deep breathing, holding her fingers or favorite stuffed toy) as an alternative to help soothe herself back to sleep.

For more information:

• The Sleep Book for Tired Parents, by Becky Huntley (Parenting Press)
• Sleep Disorders and Sleep Problems in Childhood

Debra Collins is a licensed marriage and family therapist. Debra has worked in both primary and middle schools as a school counselor. She gives workshops to teachers and students, and offers parenting classes in the San Francisco Bay Area. Debra is also a clinical supervisor for a mental health clinic serving schools in the area. To learn more, visit her Web site.

Advice from our experts is not a substitute for medical or other professional advice and services from a qualified health-care provider familiar with your unique situation. We recommend consulting a qualified professional if you have concerns about your child's medical or emotional condition.

Updated July 2008