Dear Michelle,

Your daughter is certainly having a very hard time going to sleep on her own. Why won't she go to sleep in her bed if you are in the room?

You have quite a challenge to change the pattern of sleep you describe since your daughter has been accustomed to a routine that is not age appropriate for a very long time. First off, you must realize that because this pattern has been established for ten years, getting your daughter to sleep in her own bed will take time. Your daughter seems to have anxiety or fears that keep her overly attached to you at bedtime. Even though you may think you know what her worries are, talk to her again about what may make her nervous or even scared at bedtime if she is in her own bed. I once found out that a 10 year old girl, who also was unable to fall asleep on her own at night, heard scratching noises from her bed. We eventually discovered that there were actually bats in the attic! Her parents immediately took steps to get rid of them. While this situation is rare in my experience, you need to know everything you can about what is frightening your daughter at bedtime. What are her worries? Does she see scary things in her room? Is it too dark? Does she hear any scary noises? These worries may be founded in reality or may be subjective and more a reflection of what is termed "separation anxiety." Does your daughter have trouble separating from you and her Dad in other situations? Can she have a sleepover at a friend's house? Has she been able to stay overnight at a relative's house or even go to sleep away camp? If your daughter has trouble in general with leaving you and /or her Dad, then she may be more prone to anxiety than other girls her age.

A gradual approach to easing your daughter back into her bed in her room is my preference. You are trying to change very ingrained habits. So, patience on your part will be necessary. On the other hand, your daughter may be experiencing anxiety attacks, which may be beyond her control. Spontaneous anxiety attacks are the body's reaction to fear in the absence of real danger. Your daughter may experience real fear at being left alone. She may feel her heart racing, have stomachaches, sweaty palms, very scary thoughts, headaches, nausea or other physical discomfort that can be very frightening to her.

As mentioned above, if your daughter is otherwise comfortable separating from you and her Dad, you may try to reassure her that she is safe and be able to coax her back into her room, with your staying with her for shorter periods of time. If, however, there is a pattern of difficulty separating, you should seek help from your child's pediatrician and/or a qualified mental health professional, who has expertise in dealing with children and adolescents. Anxiety in children and adolescents is quite common and treatable. Your goal is to reduce anxiety symptoms so that your daughter is able to go to sleep on her own and be more comfortable overall separating from you and her Dad. This will take time. Be patient. Professional help should also give you and her Dad some practical guidance so you can best help your daughter overcome her fears.