DEAR DOCTOR K >> My 6-year-old son just can't seem to fall asleep at night. He doesn't fuss — he just doesn't get enough sleep. Is there anything I can do?
DEAR READER >> Kids can have many different kinds of sleep problems. Like your son, they can have trouble falling asleep. Other kids may fall asleep promptly, but awaken repeatedly. Others may snore or have breathing problems during sleep. Still others may have abnormal movements during sleep.
Fortunately, your son's problem is one of the easier of these sleep problems to fix. The pediatricians at Harvard Medical School who specialize in sleep problems tell me that correcting a handful of things can cure the problem in most kids:
• Stop your son's caffeine intake at least eight hours prior to bedtime. Not a lot of 8-year-olds drink coffee or tea, but there's plenty of caffeine in cola beverages or in chocolate, for example.
• Reduce your son's exposure to bright light starting two hours before bedtime. Dimmer light helps the brain prepare for sleep.
• Keep your son's bedroom dark, quiet, and at a comfortable temperature.
• If your son still uses a night-light, choose one with a low-intensity bulb.
• Reduce the intensity of your son's reading lamp to 40 watts or less.
• Some parents play classical music in the background, hoping it will lull a child to sleep. Bad idea. Music — particularly great music — is not "white noise." The ingenious melodies and rhythms are compelling; your son will be (pleasantly) distracted by them. Even generally soft music can have sudden loud moments. And if you play it, but let it stop when the piece ends, your son may notice the sudden absence of music and have trouble falling back to sleep without it.
• Remove video games, media players, cellphones, computers and TVs from your son's bedroom. Pretty obvious advice, I know, but you'd be surprised how often it's not followed.
• Position your son's alarm clock so that it faces away from the bed. This can be helpful if your son stresses out each time he sees that five more minutes have passed and he's still awake.
• Keep pets out of your son's bedroom (and out of his bed!).
• Insist that your son do his homework at a desk (or better yet, outside the bedroom), not in bed.
Really, it's the same advice I give adults with problems sleeping: Use the bed for sleeping, not for reading, watching TV or playing games.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.