This week’s question is from Adrienne,
“My 10-year-old son is virtually impossible to wake up and get going in the mornings. He is struggling to get out of bed and can’t seem to wake up easily no matter what we do. This turns into a big argument, struggle, and stress for me and my husband every day. My husband tries to threaten and punish, which I don’t think is helpful, and then he and I get into an argument about it. I just want my son to do what he needs to do with getting up and going without all of the morning drama. I’m not sure if there’s something physically wrong or another issue we need to look at, but I’m worried about what’s going to happen to him in the future if he doesn’t learn to wake up on his own.”
In this episode, I will address how to get your groggy or resistant child going in the morning. Trying to get everyone out the door in the morning can be stressful, especially when you have a child that struggles to get up. It can cause a lot of problems not just for the child but also between parents and siblings. Sure, some people are just biological early birds but for others not so much. There could also be some other things going on that are interrupting sleep which would make it difficult for your child to wake up early. I’ll give you some tips on what to investigate to see if perhaps it’s a sleep issue. If you have a child who is groggy, resistant, or slow to start in the mornings, this is the episode to listen to for tips to get “up and at’em” without the struggle or drama! (Hint: these tips aren’t just for sleepy kids either!)
Sleep Cycles & Morning Grogginess … 00:01:33
Parenting Approaches Between Parents … 00:04:14
Is Sleep Quality a Potential Root Cause? … 00:06:30
Evaluating Bedtime & Sleep Hygiene … 00:08:50
Nutrition, Supplements, Medication & Sleep … 00:10:12
Talk with Your Child About Their Observations … 00:14:25
Strategies for Difficult Mornings … 00:17:42
Dr. Nicole Beurkens
Hi everyone, welcome to the show. I’m Dr. Nicole, and today I’m answering a question from one of you. We are going to be talking about how to help kids who really struggle to wake up and get going in the mornings. This specific question today comes from Adrienne who writes: “My 10-year-old son is virtually impossible to wake up and get going in the mornings. He can’t seem to wake up easily no matter what we do, and it turns into a big argument and struggle and stress for me and my husband every day. My husband tries to threaten and punish, which I don’t think is helpful, and then he and I get into an argument about it. I just want my son to do what he needs to do with getting up and going without all of the morning drama. I’m not sure if there’s something physically wrong or another issue we need to look at, but I’m worried about what’s going to happen to him in the future if he doesn’t learn to wake up on his own.” Well, Adrienne, this is a great question, and I know that many parents are listening and can relate to this. So let’s talk about some big picture issues first, and then we will break it down into some specific strategies.
So first of all, it’s important to realize that kids at different ages and developmental stages can go through different challenges with this as they grow. There can be more struggles with the front end of the sleep cycle, getting to sleep, there can be more challenges with getting up in the morning, depending on their age and developmental stage. Certainly, we know that for our teenagers, this is a common issue or a more common issue, because developmentally, they are in a stage with rapid brain and body changes where their circadian rhythms — that’s their sleep and wake cycles, get pushed forwards more, and so they are more biologically driven to go to bed later and then wake up later. So earlier mornings, especially early school mornings can be a real challenge for them. So that’s an example where we would look at something like that and say, “Okay, there’s a developmental stage issue going on here.” And that can happen at various phases of development. Certainly, this can also be more of an issue in kids with neurodevelopmental conditions, things like autism spectrum disorder, ADHD, those types of issues, any type of executive function difficulty, as well as kids who have mental health issues like depression, like a history of trauma. We know that all of those types of issues can make sleep, which includes waking up in the morning, more difficult. So I think that’s just helpful as some context if your child is struggling with this, to just think about if one or more of those factors is perhaps an issue here because those things do predispose kids to more of those challenges. I want to touch on the parenting approach issue here because I think Adrienne raises an important point, and I appreciate her honesty about it, that the struggle and the stress in this household in the morning is not just related to their son not getting up and going quickly, but it also is related to then the tension and the difference of opinion between parents around how to handle this, and that’s common. What happens between parenting partners, especially when you live together when you have things like this going on with a child, whether it’s with waking up in the morning or going to bed at night, or anything else that we deal with kids. And certainly, that brings more stress, more difficulty to the situation. And that’s tough, especially when it’s an every morning kind of thing.
So let’s talk about parenting approach here because it does make a difference. Punishments in a situation like this, focusing on consequences and punishments just really isn’t going to be helpful. It takes a punitive approach, it assumes that the child absolutely could be easily getting up and out of bed and going and is choosing not to and therefore tries to leverage punishments or negative impacts or outcomes as a way to motivate the child to just get up and get going. In my experience, I’ve yet to meet a child who is able to just quickly and easily get up and go in the morning and is choosing not to. If they’re not getting up and going, there’s a reason for that. Punishments taking that punitive sort of approach and looking at it through that typical behavioral lens of “My kid could do this. They’re choosing not to”, that tend to add to the emotional burden of this entire situation. It creates more shame, more anxiety, more distress for the child, but also for the parents, and it’s likely to create more challenges than in the parent-child relationship that will not only impact this issue every morning, but it’s going to bleed over into other things that you deal with your child throughout the day. So I would really encourage parents to not approach this issue in a punitive or a shaming or a behavioral way, but instead, to focus on it from a problem-solving lens or through a problem-solving lens. “We are going to figure this out together. We are having this issue every morning. I know this doesn’t feel good to you. It’s not feeling good to us. This isn’t working for any of us. So we are going to get this figured out, we are going to try to do some detective work to figure out what’s really going on here, and how can we help so that we can make this better for all of us.” That’s really the approach we want to take, it’s one of problem-solving, as opposed to punishment. So those are some big-picture things to think about.
Now, as we get into strategies, there are some proactive, or kind of big picture ideas, strategy-wise that we want to get at, and then I’ll share some specifics that I think are helpful in the morning when you are actually in the moment. So in the big picture, when a child is struggling to get up and going in the morning, there are lots of things that we need to think about there in terms of why that might be going on. Again, I talk about this a lot on these podcast episodes. We need to kind of dig deeper and look at what might be the root of what’s happening here. Is my child feeling anxious about the school day? Is my child not getting good restful, restorative sleep, and so they’re literally exhausted in the morning? Now there can be lots of reasons for this. So we want to look at what might really be going on and make sure that we have ruled out a sleep issue or a sleep disorder that needs to be treated. That’s really first and foremost. If a child is just dragging in the mornings, and you as the parent are like, “Man, it almost doesn’t matter what I do to this kid, he or she just cannot get into a state of alertness, where the brain is awake and functioning and doing what it needs to do”, you really do need to talk with the primary care provider about that and probably get a referral to a sleep medicine specialist to look at: Is there something bigger going on there? Is your child getting enough good quality sleep? Because if they’re not, if they’re either getting too little sleep, or the quality of it is poor, that’s really going to impact this issue in the mornings. And while you can implement other types of strategies, you really aren’t going to resolve it if you don’t resolve whatever the sleep issue is. So that’s something to really consider, especially if you notice that this is a problem for your child, no matter how much sleep they get, this is a problem for your child, not just on school days or on days when they have to get up earlier or it’s more hectic, it’s a problem even on days when maybe they’re looking forward to something. So you sort of look for those clues that say that this maybe be a more physiologically-driven issue, and then you need to get a consult to look at that. So that’s something in the big picture to consider there.
The other thing is to make sure that you have got good sleep hygiene routines and nighttime routines. Now, you might think “Well, wait, we are talking about the morning and getting up and getting going.” Yes, but being able to have enough energy to be up and revitalized and have our brain alert and functioning in the morning is dependent on the night before. Are we getting our kids to bed at a consistent time? Are they sleeping restfully? Do we have the room set up so that the temperature, the blankets, the level of darkness all of those things are conducive to good sleep? Are we setting the stage for a good sleep in the earlier evening hours with having some winding downtime, getting those screens turned off at least 45 minutes to an hour before bed, making sure that they’re not having caffeine later in the day, avoiding sugary snacks, having consistent routines that allow kids to feel more calm and relaxed so that they can go to bed, fall asleep more easily and then get a good night’s sleep? So those are things that we want to think about. Often when parents come into the clinic and they are concerned about the waking up issue, I have this conversation of backing up and talking about what’s happening in the evenings because that’s really critical.
Now you also want to consider that there could be some nutritionally-focused issues going on here. Children with sub-optimal or deficient iron levels can have real problems with sleep, not getting restful sleep, and not having enough energy to be able to wake and get going well in the morning. B vitamin levels are another thing we think about here with kids who just are really dragging, who cannot kind of get it in gear, who are really struggling with their energy levels, particularly in the morning. And bearing in mind, these may be kids who seem very hyperactive and overactive during the day, but when it comes to getting up and going in the morning may be very lethargic. That can be an indication, again, of things like B vitamin levels, iron levels. You also want to think about if you are using sleep aids with your child. Even something like melatonin. Are you giving them too much? Are they getting more than they need, and therefore, when they have to get up early, they’re still really groggy and can’t wake up. So you want to look at that, whether it’s an over-the-counter nutritional supplement like melatonin, or GABA, or Valerian, or one of the sleep support formulas, or certainly if you are giving some sort of over-the-counter medication or a prescription medication sleep aid. You really want to look at that. They may be over-medicated, and that’s why they can’t get up. I see that sometimes with medication for kids who are diagnosed with ADHD and are given stimulants during the day to manage their attention and their impulsivity and hyperactivity, but then they struggle to wind down and sleep at night. And so sometimes those kids are given a prescription for a medication that helps them sleep. Usually, it’s a blood pressure medication or something that kind of slows them down and helps with sleep. Well, if they’re getting too much of that medication or it’s not the right medication for them, they can be super groggy and overtired in the morning. So you want to talk with your prescriber about that and make sure they’re aware of that so that you can tweak that.
Okay, so the next piece is really talking with your child about their observations and feelings about mornings, about waking up. How are they perceiving this? What’s their experience? Do they see it as a problem? Do they recognize that they’re having trouble with this? Do they recognize that maybe this is creating some issues for them with stress in the morning or getting to school or whatever it might be? So figure out what their awareness is and how they’re feeling about it. Is it stressful for them? Do they think that it would be helpful for this to change? And then see if they have ideas about what works or doesn’t work for them. It’s amazing to me, sometimes we go through all of these mental gymnastics in our head about how to help kids with things and what we are going to do and how we are going to fix this, and we fail to ask them what they think. Do they have ideas? “Hey, are there things that we are doing now that you just know are not helpful to you?” Or “Are there things that you think we could do that would be better?” Now, certainly, kids don’t always have something to offer when we ask that question, but it’s very worth asking because I find that more often than not, kids do have some ideas about what works or doesn’t work or might help. And then you want to make a plan.
You want to come up with some ideas, too. They might have some ideas. You have some ideas, and you say, “Okay, we are going to make a plan”, because remember, we are approaching this through a problem-solving lens. “This is a problem. You are not bad, we are not bad. It’s just that this isn’t working, and so we are going to come up with a new plan.” And so you come up with a plan of, “Hey, let’s come up with some new ideas. Let’s try this for a week, maybe two weeks”, however long you want to try it for, and then let’s see how it goes. Talk about how you will know if the plan is or isn’t working. “Well, gosh, we will know if the plan is working because mornings will be less stressful. I’ll be able to just go in a couple of times to remind you to get up, you will be able to get up, you will be feeling more rested, and we will be on time for school. That’s how we will know this is working. If this plan isn’t working, then we will know because you will keep having trouble getting out of bed, you will be super tired, we will be late to school, I’ll be really stressed out.” So you want to talk about that. And then it offers you the opportunity to revisit. So you say “Okay, we said we were going to try these ideas for a week. We tried them”, and we come back together and we say “Let’s look at our plan. Is it working? Is it not working? Is part of it working? What’s helping, what’s not helping? Do we need to revise the entire thing? Do we just need to maybe add or tweak something?” And so you are using this problem-solving model which actually is a lovely model to use with kids around so many things that come up. We are talking about this right now for addressing this getting up in the morning issue, but you can utilize this type of problem-solving approach with them for all kinds of challenges that you might encounter. And it’s a great process to teach them and walk them through, that they then can use as they get older and certainly in their life as adults. So those are some of the overarching ideas and strategies and things that I think that you need to be looking at if this is an issue that you are dealing with.
Now, let’s talk about some specifics for the mornings. Alarm clocks. Now, there’s a variety of alarm clocks available, all types of them, and these can be helpful for some kids. Sometimes they are not, but there are ways to use them and different types that you may not have tried that could be beneficial. I am a very big fan of the slow wake alarm clocks. These are clocks that have lights and sounds that mimic dawn, that mimic the sun starting to come up in the morning. So let’s say your child needs to be up at 7, you would set the alarm for 7 am, meaning they need to be out of bed at 7. But actually, the clock would start to come on around 6:15, and it slowly starts to have the light come on. Most of them have a pretty large light. It’s definitely visible. The light starts to come on, and it gets gradually brighter over that 45-minute time period or 30-minute time period until the child needs to actually get up. Same thing with the sound. Some of them make nature sounds, some make music, whatever. But it starts out very quiet, and then gets louder over the course of that. Now, why can this be helpful? Well, it’s mimicking the natural rhythm of the sun coming up, which supports our brain then, in as the light starts to get brighter, that light comes into the brain, into the pineal gland, and starts to turn off the melatonin faucet in the brain, and that’s important for waking up because we need less melatonin when we need to get up.
So that sort of progressively brightening light helps send that message to the brain to turn off melatonin, which allows us then to wake. It also is helpful because it’s a gradual approach to bring kids out of a deeper sleep cycle. You have probably had this experience as an adult: If you are in the middle of a deep phase of your sleep cycle and the alarm goes off, oh my goodness, it’s so startling, you feel exhausted. But when we wake up at the end of our sleep cycle, when we are naturally in a lighter phase of sleep, it’s much easier. And so what we are doing with the slow wake alarm clock is giving the brain a little bit more of that warning, a little bit more of that time to come out of that deep phase into that later phase and make it easier to get up.
So there are lots of options for that. I have one on my website under my favorites section that you can look at, but really, there are so many available. So that could be an option, and I think to let kids pick one out. There is a variety of them available. I’ve used them with my own personal kids as well as many kids at the clinic, and for some kids, it’s just the ticket. The other thing is with an alarm clock, especially if you are using more of a traditional alarm clock, to have it across the room from their bed, so they actually have to get up to turn it off. Now some of you may be laughing right now going, “Oh, my kid is so dead asleep, it doesn’t matter. I can have six alarms blaring and they wouldn’t get up.” And yes, that’s true. For some people, this is not effective. But for some kids who are struggling with this, especially just hitting the snooze or whatever, but the alarm clock across the room so they have to get up to turn it off. There are also alarm clocks, as I mentioned, with different sounds. Experiment with what works well for your child. I’ve had kids and teens tell me that what they need is to have an alarm that goes off with blaring certain type of music that is activating for them, helps them wake up and get out of bed. So experiment with different types of music, sounds, even things like vibration.
There are alarm clocks and things that you can put like under the pillow or under the mattress to help with that. So you want to experiment with some things to see what works for them. Practically speaking for your role as the parent in this, you can sort of start to do this gradual approach by starting to get them up at least 30 minutes before they actually need to get up out of bed. That’s key. Do not try to just get them up when they need to be up, that’s not going to go well. So you start by turning on the light outside their room, maybe in the hallway. Then you might go in a few minutes later, turn on a lamp. Then a little while later, maybe you open the shade. You get the idea. You are gradually increasing the amount of light the amount of sound, the amount of stimulation each time you go in, you are maybe talking more, maybe having some music, leaving the door open to the room so they’re hearing what’s going on out in the house, and you are gradually acclimating them.
For some kids, it’s helpful in this process to give them some physical contact when you actually go into the room then for the first time, turn on a lamp, maybe you go over and just sort of rub their back for a minute, maybe you sit down next to them and just talk for a moment, “Hey it’s going to be time to get up soon. We are going to have a great day”, whatever, just to start to rouse them a little bit. And then as you get closer to the time when they actually need to wake up, giving them some prompts of things like, “Okay, we are going to sit up now”, or “Okay, I’m going to pull the blanket back from you now”, handing them a glass of cold water is setting them up and saying, “Here’s some cold water to drink”. That can be activating and helpful.
Okay, now we are going to put our feet on the floor, so sort of guiding them through this process, and you are staying calm and emotionally neutral, that’s really important. You are not letting your own emotions get into all of this. You are realizing this isn’t something that they’re intentionally doing to cause a problem, this is something that they’re struggling with, and we are working on problem-solving this. So you stay calm and emotionally neutral, but you do keep the process moving. So you pull off the covers, you hand them the cup of water, or you hand them their shirt, or you put the shirt over their head for them to put their arms through, you go ahead and assist and physically help them to sit up. You say, “Okay, we are going to head to the bathroom”, and you kind of put your hand behind them and guide them to get up and you walk them to the bathroom to get them moving. So you are staying calm and neutral, but you are keeping the process moving, and you are physically facilitating keeping that moving. Now, if a child is extremely resistant to this, physically resistant, like refusing to get out of bed, this is now a different problem. This helps you know that actually, the issue here is probably one of avoidance because they’re anxious about something or they’re not wanting to start the day for some reason, and that’s important to know, too.
If your kid has no problem hopping out of bed early right away when they don’t have to go to school, for example, but on the days for school, they are extremely resistive, won’t get up and moving no matter what you do, that’s not so much a physiological problem of sleep and wake cycles and energy levels and those kinds of things. This is an issue of delving into why it is that they’re having such a hard time facing the day when they have to do this stuff. And then we need to obviously dig into that and figure out what’s going on there and work with the school or put other supports in place so that they feel like they can face the day. So being mindful and observant of, is this happening on some days versus others? What might be going on there? Are there some bigger conversations that we need to have emotionally about what’s going on, and why it is that they are not getting up out of bed? So that’s another thing to think about there.
So that gives you lots of ideas of what you need to be thinking about if this is an issue that you are dealing with, with your child, and then some specifics that you can try. Remember to keep it focused on a problem-solving mode, and this is something we are going to figure out together. And I do encourage you to figure it out. It’s not something to just avoid. Kids who truly have this issue, don’t just grow out of it. This then becomes an issue for them as they get into their high school years, I’ve even seen it into the college years, and that just creates a lot of stress and struggle. So the sooner you can delve into what’s going on with this, get things ruled out, and put good strategies in place, the better off you are going to be, and certainly the better off they are going to be now and as they grow older. So I hope this is helpful for Adrienne and for any of the rest of you with kids who are struggling to get up and move in the mornings. Remember, if you have a question you would like to hear answered on a future show, email it to firstname.lastname@example.org. Thank you, as always, for listening, and I’ll catch you back here next time.