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Insomnia

What is insomnia?

Insomnia is a sleep disorder that can make it hard to fall asleep, stay asleep, or sleep well. 

Short-term insomnia may last for a few days or weeks. It is often linked to stress. Chronic insomnia lasts longer. Sleep problems are chronic when they happen at least 3 nights a week for 3 months or more.

Good sleep supports brain function, growth, and overall health. When your child does not get enough sleep, it can affect their physical, mental, and emotional well-being. It can also affect focus, learning, and behavior. Your child may also have trouble coping with illness.

Insomnia is common during serious illness. Talk to your care team if your child has trouble sleeping. They can help identify possible causes of insomnia and suggest ways to improve sleep. 

Symptoms of insomnia

Signs and symptoms of insomnia may include:

  • Trouble falling asleep
  • Waking up during the night
  • Trouble going back to sleep 
  • Waking up too early 
  • Poor sleep quality
  • Trouble keeping a regular sleep schedule
  • Feeling tired during the day
  • Mood changes or irritability
  • Hyperactivity or poor impulse control
  • Trouble with focus, thinking, or memory
  • Worrying about sleep
  • Trouble at school or with friends

Causes of insomnia

Insomnia can happen for many reasons. Sometimes, there is no clear cause for insomnia. 

Causes of insomnia may include: 

  • Stress or worry 
  • Pain or discomfort 
  • Side effects of medicines or treatments 
  • Stomach problems, such as acid reflux 
  • Asthma or other breathing problems  
  • Mental health concerns, such as anxiety or depression 
  • Diet or caffeine, including tea, coffee, and energy drinks 
  • Use of alcohol, tobacco, or drugs 
  • Other sleep disorders or health conditions 
  • Changes in routine   
  • Poor sleep habits, like not having a regular bedtime or using screens too much before bed, especially activities that are exciting or stimulating 
  • Environmental factors, such as noise or light 

Insomnia in children with illness 

Changes in sleep habits and routines during illness can also lead to sleep problems. Stress, pain, noise, and worry can also make it hard to fall asleep or stay asleep.  

When a child has a serious illness, families often change their usual habits and sleep routines. Children may wake up during the night for medicine, fever checks, or other care. Parents or caregivers may sleep with their child to make care easier.  

Over time, children can get used to these changes and have trouble going back to their usual sleep routine. Some children may not want to sleep alone. 

Insomnia in teens

Teens are known to stay up late. Around puberty, the circadian rhythm (the body’s internal clock) shifts to a later time. Many teens do not feel sleepy until late at night. 

Early school start times can make this harder. When teens stay up late but still need to wake up early, sleep loss can build up over time.  

Screen time can also affect sleep. Texting, gaming, social media, homework, and streaming shows may keep the brain alert and make it harder to settle down at night. 

Talk to your care team if your teen has ongoing sleep problems.  

Diagnosis of insomnia

Your care team will try to find the cause of your child’s insomnia. Sleep problems may be linked to illness, stress, medicine, or something else. 

To diagnose insomnia, your child’s health care provider may: 

  • Review your child’s health history and do a physical exam 
  • Ask questions or use a questionnaire to learn more about sleep habits and symptoms  
  • Review medicines that may affect sleep 
  • Ask you to keep a sleep diary to track sleep and daily habits 
  • Use an activity monitor (actigraphy) to track sleep and wake patterns over several days 

Treatment for insomnia

Treatment often starts with healthy sleep habits and changes to bedtime routines. Small changes over time can make a big difference. 

To help improve sleep: 

  • Create a quiet, dark, and comfortable sleep space. 
  • Keep a calm, regular bedtime routine. 
  • Limit bright light and screen time before bed, especially games and apps that are engaging or stimulating.  
  • Address stress or worry that may be affecting sleep. 
  • Encourage and praise healthy sleep habits.  
  • Wake up at the same time each morning. 
  • Get sunlight during the day, especially in the morning.  
  • Encourage daily exercise and physical activity. 

In some cases, your care team may recommend other strategies to manage insomnia, such as cognitive behavioral therapy, light therapy, melatonin, and sleep medicines.

  1. Cognitive behavior therapy

    Some children and families may benefit from cognitive behavioral therapy for insomnia (CBT-I) and other behavioral interventions. This type of therapy can help families build healthy sleep habits and manage thoughts or behaviors that may affect sleep. Therapy may include:

    • Relaxation skills 
    • Self-soothing skills 
    • Changes to bedtime habits and routines  
    • Ways to manage worry about sleep

  2. Light therapy

    Light therapy uses bright light to help reset the body’s internal clock and support a healthy sleep-wake cycle. Exposure to sunlight, especially in the morning, may help improve sleep and energy levels during the day.  

    Natural sunlight can help, but getting sunlight may be hard during long hospital stays or at certain times of the year. In some cases, your care team may suggest light therapy. During this therapy, your child is exposed to a controlled light source for a set amount of time.  

  3. Melatonin

    Melatonin is a hormone that helps regulate sleep. It is made by the pineal gland in the brain. Normally, melatonin levels increase at bedtime and continue through the night, telling the body that it is time to sleep.  

    Some children with insomnia or sleep disorders may benefit from taking a melatonin supplement. Dose and timing are important. If melatonin is not used properly, it can make sleep problems worse. Talk to your doctor or pharmacist before using melatonin. It can cause side effects and may affect how other medicines work.  

  4. Sleep medicines

    In some cases, a health care provider may prescribe medicine to help with sleep. There are no medicines approved specifically for insomnia in children.  

    Always talk to your care team before giving your child any medicine, supplement, or sleep aid, including over-the-counter products. 

Tips for healthy sleep

  • Know how much sleep your child needs. Children and teens often need more sleep than adults. Those with a serious illness may need even more sleep. 
  • Keep the bedroom quiet, dark, and cool. Set up a comfortable space just for sleep for your child. Limit light and noise during the night.
  • Make sure your child avoids caffeine and nicotine, especially after 4 p.m. or within 6 hours of bedtime.
  • Encourage physical activity during the day. Exercise can help improve sleep at night. Your child should avoid heavy exercise near bedtime.
  • Spend time outside. Sunlight and bright light during the day help keep your child’s sleep-wake cycle on track.
  • Limit screen time and engaging activities before bed. Work with your child to practice calming, self-soothing strategies.

Learn more about Healthy Sleep Habits

Questions to ask your care team

  • What is causing my child’s insomnia? 
  • Is my child’s insomnia related to their illness, treatment, or medicines?  
  • What changes can we try at home to help improve my child’s sleep? 
  • Could anxiety or stress affect my child’s sleep?  
  • Would therapies, such as light therapy or melatonin, be helpful for my child?
  • Can a psychologist help my child sleep better?  
  • When should we seek more help if my child’s sleep does not improve?

Key points about insomnia

  • Insomnia is a sleep disorder that can make it hard to fall asleep, stay asleep, or sleep well. 
  • Poor sleep can affect your child’s physical, mental, and emotional well-being, as well as focus, learning, and behavior. 
  • Insomnia can have different causes, including stress, illness, pain, medicines, screen use, or changes in routines. 
  • Sleep problems are common during serious illness because daily routines, sleep habits, and care needs often change. 
  • The first steps to improve sleep usually involve small changes to routines and the sleep environment. 
  • Some children may need other treatments for insomnia, such as behavior interventions, CBT, light therapy, melatonin, or sleep medicines with guidance from the care team.
  • Talk to your care team if your child has trouble sleeping. They can help find possible causes and suggest ways to improve sleep.

Find more information

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The Together by St. Jude™ online resource does not endorse any branded product or organization

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Reviewed: July 2026

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