As children grow, they naturally become more aware of how their peers see them. Suddenly there are “right” and “wrong” things to wear, say, or do. A certain level of self-consciousness is normal, but for some kids, worries about peer judgment become so intense that everyday situations feel overwhelming.

Social anxiety can trigger racing heartbeats, sweaty palms, trouble sleeping, nausea, or even school refusal. “When children constantly feel the need to be vigilant about how people perceive them — even just taking a seat in class — they may be experiencing a social anxiety disorder,” says Lauren Chorney, PhD, clinical child psychologist at the Renaissance School of Medicine.

Social anxiety often increases in middle and high school, when social hierarchies become more defined. “A kid who got through elementary school with an anxiety level of 5 (on a scale from 1 to 10) might now be at an 8,” Chorney explains.

For younger kids, the signs may be harder to decipher. They may struggle to explain what’s worrying them. To pinpoint fears, Chorney uses a “magic wand” exercise, asking kids to imagine school without academic work — more like camp. If they feel better, academics may be driving the anxiety. She repeats the exercise by removing different elements (peers, teachers, separation from parents) to uncover the real source of discomfort.

Once parents understand the root, they can support kids more effectively. Some children need social-skills practice; others know what to do but feel too anxious to try. “Depending on the child, they may need help with the anxiety, the skills, or both,” says Chorney.

Role-playing with parents or a therapist is a good way to practice interacting. Then, a one-on-one get together — ideally with a structured activity like baking or a board game — can reinforce confidence. If a child lacks friends, ask teachers to recommend a classmate who might be a good match.

Starting middle or high school can heighten anxiety: “Everybody is older, bigger, and further along in their development,” says Chorney. One early sign that intervention may help is lunchtime isolation. “If your child is sitting by themselves for more than a week, it may be time to step in,” she says. Parents can encourage after-school activities or contact the school for help connecting their child with peers who may be a good fit.

If teens feel uncomfortable discussing these issues with parents, a therapist can teach strategies that feel realistic and age-appropriate. Many kids Chorney sees don’t have a diagnosable disorder — they simply need someone neutral to talk to.

With support, kids can learn coping skills such as positive self-talk and breathing techniques. Above all, parents should remember: occasional social anxiety is normal. But when worries consistently interfere with comfort or connection, support can make a meaningful difference.

Children and adolescents who don’t get enough sleep don’t always appear tired. Instead, they may show irritability, mood changes, trouble concentrating, or behavior that resembles ADHD, says Rayan Kteish, MD, pediatrician and sleep medicine specialist at Stony Brook Children’s Hospital. Lack of sleep can also contribute to anxiety, depression, aggression, headaches, fatigue, and school performance problems.

A key concern is missing out on deep sleep, the stage believed to support physical restoration, learning, memory, and healthy brain development.

The National Sleep Foundation recommends:

These are guidelines, Dr. Kteish emphasizes. Some teens feel fully rested with eight hours of sleep, while others may need more. “If you get eight hours and wake up refreshed, that’s enough,” she says.

Occasional snoring is normal, but snoring three or more nights a week — especially with daytime tiredness, behavior concerns, or gasping — may signal sleep apnea. Children with sleep apnea often sleep enough hours but get poor-quality sleep because their breathing repeatedly stops and starts.

In younger kids, large tonsils, are a common cause; in teens, snoring may relate to weight, anatomy or family history. A sleep study can clarify what’s going on. Treatment ranges from tonsil and adenoid removal to allergy management, CPAP therapy or orthodontic devices such as a palate expander that can help open the airway.

There are no FDA-approved sleep medications for children or teens. Supplements like magnesium or melatonin should only be used if a clinician recommends them for a specific medical reason. Melatonin has some demonstrated efficacy in improving sleep in children and adolescents with autism or ADHD, but evidence for broader use is limited.

Sleepwalking is common in pre-pubertal children and often goes away on its own. Safety should be a top priority in homes with a sleepwalker : secure doors, monitor stairs, and avoid bunk beds. Medication is rarely needed unless episodes cause repeated injury or major disruption.

Electronic devices are one of the biggest obstacles to good sleep. Devices should be turned off at least an hour before bed and kept out of the bedroom. A consistent sleep schedule — even on weekends — helps regulate the body’s internal clock. Younger children benefit from a calming, predictable bedtime routine. Positive reinforcement, bedtime passes, and small rewards can help ease bedtime resistance.

Keep bedrooms cool, dark and quiet. Adolescents should avoid caffeine and heavy meals at night. Parents should know that ADHD medications given late in the day can interfere with falling asleep.

Healthy sleep supports learning, mood, behavior, and development. And restorative rest is essential for growing bodies and minds.

As parents, we spend so much time focusing on our children’s well-being that it’s easy to overlook our own. Regular health screenings are an important way to catch potential issues early — often before symptoms appear — so you can stay strong, healthy and fully present for your family.

Stony Brook offers a wide range of routine screenings, including diabetes, blood pressure, cholesterol, skin cancer, colorectal cancer, prostate and breast cancer, and more. These quick, preventive checks can make a meaningful difference in long-term health.

Make your well-being a priority. Scan the QR code — or visit stonybrook.info/care-screening — to schedule your routine screenings today. It's an important step toward a healthier future for you and your family.