Is your little sleepyhead tired all the time? About 25% of children and teens don’t sleep well. This may be caused by your child’s sleep habits or bedtime routine. They may have a medical condition that your pediatrician can diagnose and treat to help them sleep better at night.
Staying Up Late
One common reason for a child being tired often is that they stay up too late. Kids younger than 12 need 9-12 hours of sleep per night, while teens need 8-10 hours.
Here are some tips to help your child get the right amount of sleep:
- Set a regular bedtime schedule and stick to it. Set a time when you turn off the lights, phone, and computer screen.
- Keep your child’s bedroom cool and quiet to help them doze off.
- Try not to let your child have caffeinated drinks like soda pop, energy drinks, or tea in the afternoons or evenings.
Insomnia
Some children may be light sleepers or just can’t fall asleep at night. Try to help your child relax at bedtime with a warm bath or reading a book.
Bedtime fading may help them deal with insomnia too. Ask your child to go to bed about 15 minutes before the time when they naturally fall asleep. Gradually, move their bedtime a little earlier, but keep the morning wake time the same. Soon, they should be going to sleep at the right time to wake up refreshed.
Don’t encourage school-aged children to take daytime naps when they’re tired. Make sure they wake up at the same time each day before school, so they learn good sleep habits.
Sleep Apnea
Being tired all the time is a common sign of obstructive sleep apnea in children or teens. It’s a condition where you stop breathing during sleep because something blocks the throat and air passages. Children who are overweight or obese, or who have enlarged tonsils or adenoid glands, jaw or mouth problems, or a large tongue are at risk for obstructive sleep apnea.
Your child may stop breathing and wake up multiple times during the night. They may struggle to wake up in the mornings or focus during the school day because they don’t get a good night’s sleep.
If you notice that your child snores, gasps for breath, breathes heavily, tosses and turns, wets the bed, sleepwalks, or has frequent nightmares, they may have sleep apnea. See your pediatrician for a diagnosis and possible treatments.
Narcolepsy
Narcolepsy can cause kids to be very sleepy in the daytime. They can’t stay awake and may drop off to sleep often. It’s a chronic sleep disorder that may affect kids, although it usually first appears in adolescence. Narcolepsy may be caused by low amounts of hypocretin, a brain chemical that helps control when your child sleeps and stays awake.
Narcolepsy may also cause your child to lose muscle tone and control (also called cataplexy), not be able to move or speak when they wake up or right as they fall asleep, or have scary hallucinations.
Kids with narcolepsy may nod off in class. They may not concentrate well in school or remember things because they’re so tired. Your child may wake up often during the night and struggle to get back to sleep.
About 70% of children with narcolepsy have cataplexy. They may show signs like drooping eyes, slack jaw, slurred speech, buckling knees, or falling over.
See your pediatrician to confirm that your child has narcolepsy. They can prescribe medications, therapy, or sleep habit changes to help your child stay awake and alert during the day.
Medications
Some medications that your child is taking may cause sleep problems. Stimulants prescribed for ADHD (attention deficit hyperactivity disorder), such as amphetamine (Adderall) and methylphenidate (Ritalin), may cause kids to take longer to fall asleep and keep them from staying asleep.
If your child has allergies, the antihistamine drug diphenhydramine (Benadryl) may make them drowsy. Newer antihistamines like cetirizine (Zyrtec), fexofenadine (Allegra), and loratadine (Claritin) don’t cause sleepiness, so these are other options.
Epstein-Barr Virus
Children infected with the Epstein-Barr virus (EBV) that causes mononucleosis may be extremely tired. Other symptoms of this infection include sore throat with white patches, fever, swollen lymph nodes, and achy, stiff muscles. Teens with EBV may be even more tired than younger children.
Your pediatrician can diagnose EBV. Kids with this infection will need plenty of bed rest and fluids, acetaminophen for aches, and avoiding sports or active play for about a month.
Asthma and Other Chronic Illnesses
Children with chronic illness that isn’t well controlled may have fatigue. Asthma may make children short of breath, causing them to tire out during activity.
Children with hypothyroidism, or an underactive thyroid gland, may be very tired because of low hormones that regulate metabolism. Anemia, or low levels of red blood cells that carry oxygen to your organs, makes kids feel extremely tired.
Juvenile arthritis often causes fatigue in children. They may make them even more tired when their disease flares up with high inflammation. Kids with juvenile arthritis may also have severe joint pain that disrupts their sleep or wears them out.
Mental Health Conditions
Mental health conditions like depression may cause severe tiredness, lack of interest in activities, and trouble concentrating during the day, especially in teens. Some depressed kids want to sleep all the time. Others may cycle between times when they’re always active and always worn out. Kids with anxiety may also have fatigue.
It may help to set a sleep schedule for your child or see a mental health professional for cognitive behavioral therapy (CBT) to help them deal with their sleep problems.
Heart Disease or Cancer
It’s rare, but extreme tiredness in children may be caused by serious illnesses. Heart conditions like heart failure, cardiomyopathy, congenital heart disease, or heart valve disorders like aortic stenosis may have severe fatigue as a symptom.
Very rarely, severe fatigue can be a symptom of cancer in kids and teens, including blood cancers like leukemia and lymphoma, or bone cancers like Ewing sarcoma.
What should you do if your child is tired all the time or can’t sleep? If your child seems very tired for a week or two, see your pediatrician to try to diagnose a cause. Most of the time, fatigue can be treated, so your child can get back to an active, normal lifestyle.