Answered by Patricia L. Foster, M.D. – Board Certified Child & Adolescent Psychiatrist, in private practice in Greenwich, CT.
My 6 1/2 yr. old has a hard time going to bed at night. We always have a "routine" so she is very familiar with it. She also doesn't like to get up and go to the bathroom at night – I think she is afraid of the dark. We've tried giving her a flashlight plus use the hall light if it's dark. She sometimes has a small "accident" in her panties – I think because she is "holding" instead of getting up to use the bathroom...any suggestions? Thanks. – Gina
Dear Gina,
Going to sleep for young children is very often a trigger for anxiety. You seem already tuned in to one of your daughter's fears that commonly surface at bedtime, but also may flare up at times of separation from you or other important adults in her life. Since anxiety has a biological and genetic factor, you may, as a child, have had similar worries as your daughter. I would encourage you to talk with your daughter about how you coped with them and that they eventually went away. You will be giving your daughter the positive message that her fears will pass. She will get through this. Fear of thunderstorms, snakes, "monsters", bugs, are examples of common fear worries that surface in young children who are dealing with separation issues and transitions.
Make sure that your daughter is not accidentally seeing scary movies on television or elsewhere.
Are there any other stresses or major changes going on in your daughter's life? Such changes might be: changing schools, moving, illness in a family member, loss of a pet, loss of a close friend (who moved away) or significant person, such as a baby-sitter, a new teacher, a new sibling, divorce, re-marriage and so forth. Any such changes will heighten your daughter's anxiety. She may need more take time to adjust if she has experienced any of the above stresses.
You are really describing two tasks that your daughter is trying to master:
- Falling asleep by herself
- Getting up in the middle of the night to go to the bathroom by herself
I would suggest focusing first on helping your daughter her get comfortable with falling asleep by herself. Try to be patient if she has accidents and can't yet get to the bathroom. Talk to her about the option of using pull-ups, if she feels too embarrassed by the "accidents" or if you feel too frustrated when she has an accident. Every child masters going to sleep independently somewhat differently. The child who is more prone to anxiety will take longer, but will learn to fall asleep by herself if you are patient and know this will not be forever.
In general, talk to your daughter about any worries she may have. Let her know that many children have similar worries and that she will outgrow them. Try to accept the fact that your daughter will take longer at going to sleep by herself, but that one day, when she is older, she will push you away and may not even want to be seen with you!!
Try not to focus so much on your daughter getting herself to the bathroom. She obviously is not yet ready to get up and to the bathroom consistently yet. By reassuring her that she is doing fine every time she acts more independently, you are lowering her anxiety & bolstering her confidence. Some books that might be relaxing and reassuring to read with your daughter at bedtime are:
- The Berenstain Bears In the Dark, First Time Book, Random House, 1982
- The Berenstain Bears Say Goodnight, Random House, 1991
- Sometimes I Worry Too Much But Now I Know How to Stop, Dawn Huebner, Ph.D.
In general, the more relaxed you are, the more relaxed your daughter will be. Be flexible with her and know that some days bedtime will be easier than other days. After all, your daughter didn't learn to walk right away. She will get there. Meantime, try to do some simple things on her bed to relax & distract her. Listening to soft music, cuddling with her favorite teddy bear or blanket are ok at night time. She can flip through any fun books also. These are soothing, relaxing ways to unwind that will help her feel more secure and make the whole transition easier for your daughter to master.
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