Anxiety, Anger, and Major Sleep Issues in 2.5 Year Old Following Long Holiday – Is This Normal?

Question

We went to Australia from Canada for two months to visit (and stay with) family when our son was 2.25 years old. He is now 2.5 years old.

Now he is terrified to go to sleep, screams if we leave him (even if we keep the door open) and wakes in the night screaming for mama (me). I have taken to sleeping on a mattress next to his crib when he wakes in the night because he becomes so hysterical and seems confused – screaming, crying, banging the wall, jumping up and down, demanding things that seem to make him even more upset – that I cannot leave the room because it’s so distressing to everyone and only makes him worse. We have never seen him so angry – he almost seems possessed. He also wakes up very angry in the morning and after nap, throwing his stuffies and drink.

Some background: He was successfully potty trained a month before we left. At six months old we sleep trained him using controlled crying/CIO and then again when we night weaned him at 14 months. Both occasions worked effectively and quickly and he slept like a dream from 7:30pm–6:30am every night, happily putting himself to sleep in his crib with the door closed, and very rarely waking at night. He would also go down for nap in the same manner and sleep for up to three hours, usually waking up happy.

During our trip he had a few experiences that we think may have caused some prolonged anxiety:

1. Our flight to Australia was awful, he barely slept the entire time and vomited all over himself. It was his first real vomit.
2. He then vomited in his sleep one night when we were at his grandparents’ house (a month after we arrived). I brought him into bed with me that night and from then on, for the rest of our holiday, had to sleep with him from some point in the middle of the night because he would wake up crying and we couldn’t let him disrupt the people we were staying with. He still talks about when he vomited at his grandparents’ house.
3. The day following the vomit in his sleep, he fell and hit his head on the concrete and vomited twice right afterwards. After monitoring him for signs of concussion (of which there weren’t any that stood out) we decided to take him to a doctor, but the doctor didn’t think he had suffered a concussion.
4. There was an occasion after the night-vomiting episode when I went out for dinner with a friend and his dad put him to bed. He was hysterical and nothing his dad did helped him, so dad left him to cry himself to sleep. This took over an hour.
5. Behaviourally, he seemed to change in Australia. We stayed with various family and friends and in a few hotels, and travelled a bit but still tried to keep our routine as close as possible to our regular one. Tantrums and mood swings started and he seemed quite unsettled. He also started biting his nails (which he saw his cousin do) and still does.
6. We have been home six weeks now and we were making progress where we could leave the door open and he’d fall asleep without me, but he got a terrible flu two weeks ago which has set us further back and added this night time anger to the mix.

Prior to our trip he was a very happy, kind, well-behaved child who never had sleep issues or displayed any separation anxiety. I am his primary caregiver; he does not attend daycare; his dad works away for weeks at a time; and we have no family close by to help.

Our bedtime routine is solid: book and milk, brush teeth, pee pee, bath, PJs, white noise, night light, goodnight song, kisses and down.

We thought things would return to normal when we got home to his familiar surroundings. We are at a loss as to how to handle this. I am exhausted and worried he will never return to the great sleeper he used to be.

Questions: How can we help him get back to sleeping well again (going to bed and sleeping through the night without me)? And how should I be handling these distressing nighttime wake-ups? I want to be firm/not give in all the time, but I also don't want to exacerbate any fears/anxiety he's experiencing.

Answer 1

What a difficult situation, hang in there, I'm sure it will get better in time. I want to preface this by saying I'm not an expert, but I'm hoping to provide an objective external perspective from the parent of a boy around the same age as yours.

It sounds like your lengthy trip has affected your child's sense of stability and control. Although most adults enjoy travel it is also a very stressful experience, even for those of us who are old enough to rationalise it. Young children thrive on the comfort of stability and routine, so it's not completely surprising that a long trip, combined with some traumatic experiences (the vomiting, injury, and trouble sleeping), could leave your child feeling insecure. He may not be completely confident in the permanence of his home anymore.

It sounds like your child is waking in the night in a state of terror, this is probably linked to a fear of being left alone or being separated from his parents.

I would suggest that you should forgo any notion of "giving in" or "tough love" at this point and continue with a routine that keeps you close at hand during sleep time. When we wakes in the night get to him quickly and comfort him. He needs to regain that trust and confidence that allowed him to rest comfortably before.

I also suggest you talk this out with your child. Just like adults, children can gain a lot from discussing and thinking things through. You mentioned how he still talks about throwing up at his grand parents, and that is something you should encourage and makes a good starting point, clearly that event had a big emotional impact.

Discuss topics with your son like the nature of travelling vs home, talk about home being a safe and permanent place, and how you are all staying there. Ask how he feels about the trip, how he feels about home, and how he feels when he wakes up in the night. Bring these topics up at neutral times during the day, well separated from sleep time and certainly not when he wakes in a terror at night. It is often easiest to get children to talk when they are engaged in another activity, like drawing or playing with legos, etc.

Ask simple questions and let him answer, don't suggest or supply answers and don't draw the conversation out when he quickly moves on to other topics, as children do. You can also talk about your experiences and feelings about the trip. It might also help to talk about the nature of long and short trips. We take trips all the time, trips to the park, the library, the zoo or the grocery store, and sometimes we take longer trips. Going on trips is fun, and after our trips we come home again, and it's nice to be home.

When your child wakes in the night, I suggest ignoring any demands he makes and instead just offering comfort. Hold him close, rock him, sing to him, or comfort him in whichever way would be most familiar to him and natural to you. Consider it as him having taken a step back and treat him as if he were a younger baby during these times. Any request he is making is likely stemming from a need for comfort, which ultimately is best provided by closeness and love.

Your doctor may have additional suggestions, and if you all feel it is warranted they may be able to refer you to a behavioural specialist who could help further.