Parents aren't the only ones who miss the problem, says Dr. Owens. She believes that many pediatricians tend not to encourage conversations about sleep problems with their patients' parents because they may not know how to help solve them. A recent survey she conducted backs this up: Of more than 600 pediatricians interviewed, only 25% said they felt comfortable diagnosing and treating sleep problems.
It's also difficult to identify kids as problem sleepers because they act differently during the day than do adults, says Dr. Griebel. "While adults with sleep problems may appear exhausted, no self-respecting child wants to go to sleep during the day," she says, adding that once they're past the napping age, only those kids with serious disorders, such as narcolepsy, tend to sleep then. Rather than give in to tiredness, the child will fight it, resulting in fidgeting, aggression, and an inability to concentrate or pay attention.
Experts agree that while there are different approaches to resolving sleep problems, one factor rises above the rest as a predictor of success: family dynamics. "A child's temperament is certainly key, but in the end it's really the family's commitment that can change his behavior," says Dr. Mindell. "If the parents follow through with their doctor's advice, consistently put it into practice, and place importance on it, things can definitely improve."