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Improving sleep for children and young people

Children and young people need adequate amounts of consistent, quality sleep to properly rest and develop their minds and bodies. Well-rested children are more attentive, have a more positive mood, and learn more quickly. Persistent sleep disturbances result in higher levels of stress hormones, irregular biorhythms, decreased attention and cognitive skills, and heightened arousal level (as the body compensates to combat sleepiness).

Often your child will display some typical behaviour at bedtime or during the night, for example your child may seem to be angry, upset, distressed, anxious, avoidant, disruptive or hungry. It may not always be obvious what the problem is so it is helpful to think about why your child might be having problems sleeping.

  • Not recognising that they are tired
  • Outside distractions
  • Sensory needs and room distraction: for example any bright lights or background noises. Not staying warm through the night.
  • Fear of falling asleep or of what sleep is: for example not knowing what other people do when they are asleep, or whether they will ever wake up again- perhaps even what sleep is.
  • Separation: being away from the rest of the family
  • Over/ under tired
  • Dreaming or night terrors: : previous dreams or nightmares have created a fear of falling asleep
  • Seasonal changes: For example summer has more daylight and your child may struggle to fall asleep- the extra daylight hours may make it hard for your child to go to sleep
  • Sharing rooms with another individual: the distraction of another person and their routine may upset their sleep pattern.

Children with sensory issues often lack adequate sleep:

  • They may have trouble filtering out sounds inside and outside the house, whether it's traffic outside or even the sound of their sibling breathing in the next bed.
  • They may find it difficult to cope with the sensation of sleepwear, sheets, pillows, blankets and the mattress itself.
  • They may be unable to lower their arousal level enough to reach the state of cam needed to drift off to sleep, or they may have difficulty waking from daytime naps, causing them to oversleep and then be unable to fall asleep again until very late at night.
  • Emotional factors such as anxiety can also interfere with getting a good night's sleep.

Strategies for Improving Sleep

  • Make sure your child goes to sleep and wakes up at the same time each day.
  • Avoid caffeine, also found in fizzy drinks, chocolate etc.
  • Try not to let your child drink or eat heavily before bed.
  • Don't allow your child to sleep with the television on as it interferes with the quality of sleep.
  • Encourage your child to exercise regularly, which can help regulate the sleep cycle. Exercise may need to be done earlier in the day, since late-night activity can make it hard to wind down and fall asleep.
  • If your child is not sleepy by bedtime, help induce drowsiness by having them listen to calming music, sit in a dark or dim room, or take a bath.
  • Avoid late naps if your child still requires one, try and keep them awake until an early bed.
  • Make sure the child's sleeping environment has low light and is quiet and comfortable for him.
  • A warm bath before bed often helps. A bath can be very relaxing, and essential oils added to the bath may be calming and relaxing. For some children a shower or even a bath can be over stimulating just before bedtime. If this is the case, move the bath time to the afternoon or earlier in the evening.
  • Vibration can help some children sleep better. For example you could try a vibrating pillow, or vibrating teddy.
  • Routine. For some children, a calming and reassuring bedtime routine means not just pyjamas, tooth brushing, story and lights out, but having each of those activities take place in exactly that order every night at the same time: with the same toothbrush and same story, etc. A picture to-do list (www.do2learn.com), transition warnings, and consistent bedtime can all help a child who resists bedtime. The child will then be able to see what bedtime 'looks' like.
  • Try spending a few minutes lying or sitting down next to your child, discussing the day, and what will happen tomorrow. Often, children resist going to sleep because they don't want to miss out on exciting activities. Reassurance that in the morning they can play with their favourite toy may help them get over their reluctance to go to sleep.
  • Try giving your child a backrub or massage, or squeeze their feet, legs, hands, and arms gently but firmly before they fall asleep.
  • TV, music or use of electronic devises before bed is far too stimulating for some children, but the right music or video may be soothing.
  • For deep pressure input, wrap your child tightly in a quilt or hug them, or press pillows against them for some deep pressure. Smaller children could always burrow under heavy beanbags and cushions, you could make this into an obstacle course so they have to climb under and over objects, and making sure this isn't too over stimulating.
  • Try extra snug pyjamas, or extra loose ones. Respect your child's sense of temperature: let them decide whether he needs layers of clothing and blankets to be warm enough, or just a T-shirt on a winter's night. Try warming their pyjamas in the dryer before bed.
  • Encourage your child to sleep with a comfort object such as a favourite blanket, doll or stuffed animal. You could also give them an item of your clothing such as a T-shirt that you've worn that day if they are having difficulty separating from you.
  • If your child has trouble staying asleep, you may want to avoid having them fall asleep in one place (e.g. the couch or your bed) and moving him to another place while he's asleep (e.g. his own bed). Some children can become disorientated by the realisation that they're suddenly in unfamiliar surroundings, making it difficult for them to relax and fall back to sleep.
  • Using social stories to explain what others do when asleep and why sleep is important; you could use pictures of people sleeping etc.

Reducing sensory stimuli

Your child might find being in bed uncomfortable. Some children are very sensitive to light, sounds, smells and touch. Distractions in the room are a big issue in preventing sleep. Here are some ideas that could help:

  • Block out light using dark curtains or black-out blinds.
  • Reduce noise using thick carpet, turning off appliances, and moving your child's bed away from a wall with activity going on the other side.
  • Block out noises by letting your child use ear plugs or listen to music through headphones.
  • Remove labels from bedding and night clothes, or try bedding and nightclothes made from other materials.
  • Reduce smells coming into the room by closing the door fully, or by using scented oils that you child finds relaxing.
  • Remove distractions, such as toys on the bed and pictures on the wall (unless your child finds these relaxing), and consider a different colour on the walls.
  • Use a small night light with a warm glow (not bright enough to cast shadows) if he/ she is afraid of the dark. Try to avoid blue light which has been proven to be the source of light that blocks melatonin production.
  • Remove labels and tags on clothes if your child is hypersensitive to touch. However, some children find it soothing to play with a label on a teddy or bedding so tailor it to meet your child’s needs.
  • Consider the type of wash powder or conditioner that you've used and whether your child could be over-sensitive to the smell.
  • Use a heavy/ weighted blanket or flannel sheets to provide deep-pressure and a calming environment.
  • Use older fashioned layers of blankets rather than duvets.
  • Try using a tight sleeping bag.
  • Check visually all bed spreads for too much detail or colour which may be too stimulating.

Eliminate computer / electronic screen / smartphone and TV time before bed

Melatonin is a hormone secreted by the pineal gland. It has been shown to regulate sleep patterns in animals. Light screens (e.g. computers, TV, smart-phones etc.) reduce the production of melatonin thus making it more difficult for the body to prepare itself for sleep.

Consider changes to food and drink

Changing bedtime routines can be stressful and if your child is used to having certain drinks or snacks near bedtime, suddenly switching to something different may be counterproductive. However, you could try changing to decaffeinated drinks, or reducing the amount of the food which could be causing wind or constipation.
Alternatively, you could try gently phasing certain foods out over a period of days or weeks so that less and less is consumed overall without anything suddenly being taken away. For example, you could offer one biscuit instead of two, or mix decaffeinated and caffeinated drinks together.

Some people advocate making radical changes to a child's diet like completely eliminating caffeine. We suggest that this is only worth doing if you have already tried a more moderate approach. We also suggest that you visit a dietician before introducing any major changes just to check that you're continuing to offer your child a balanced diet.

Cut out sugary foods before bedtime and to avoid drinks like blackcurrant which can irritate the bladder. Milk or water are healthy bedtime drinks.

It is also important for the child not to go to bed hungry so a healthy snack before they clean their teeth might be helpful.

Sleep Inducing Foods

There are a variety of food groups which, it has been suggested, can assist with improving sleep and mood. All the foods contain an essential amino acid called tryptophan which can only be produced through diet. This then converts in to the neurotransmitter serotonin, which is then converted to the neurohormone Melatonin.

Food Group Specific Foods
Milk/Milk Products Traditional milk products (warm), yogurt and soya milk
Meat Chicken and turkey
Fish Cod, tuna, mackerel, salmon,
Cheese Cheddar processed cheese, cottage cheese, tofu,
Fruits Apples, bananas, blueberries, strawberries, avocados, pineapple, peaches
Vegetables Spinach, asparagus, green peas, broccoli, tomatoes, cabbage, cauliflower, mushrooms, cucumbers, potatoes
Nuts Walnuts, peanuts, cashews, pistachios, chestnuts, almonds
Seeds Ground flax, sesame, pumpkin, sunflower seeds
Legumes Mung bean, soybeans, kidney beans, lima beans, chickpeas
Grains Wheat, brown rice, red rice, barley, corn, oats
Bread Wholewheat bread

Use relaxation techniques

Relaxation techniques can helpful for children to unwind. Here are some examples:

  • A few drops of lavender oil to your child's bath.
  • A gentle foot, hand or scalp massage.
  • An hour's quiet time before bedtime. Doing a quiet activity could help your child to unwind. It also provides a social cue: if everyone in the house is quiet and relaxed then it is time to get ready to sleep. You could mark the quiet time on a daily timetable so the child knows what to expect and becomes familiar with this routine.
  • Music.
  • Gentle exercise, such as yoga.
  • Gentle lighting in the bedroom.
  • Time each evening when your child can talk about their day. It may help to have a "worry book" so your child can write down or draw any concerns before they go to bed.
  • Rough and tumble play. Although this is the opposite of quiet time, it might be more effective for your child.

MohDoh

MohDoh Sleep mouldable aromatherapy putty is an aid which can help with sleep. The effects of touch and smell may help your child calm and relax as part of their bedtime routine. The squidgy, putty like, tactile nature of the dough has in itself a soothing, calming effect. It is suggestive that your child uses the putty at least 30 minutes before settling for bed.

Other Calming Sensory Strategies

When the person is over-stimulated and feeling anxious these activities / strategies may help them to feel calmer:

  • Sitting under a heavy blanket.
  • Hands on head and pressing down
  • Tucking legs up and squeezing
  • Deep pressure massage
  • Slow rocking e.g. rocking chair
  • Giving themselves a hug
  • Lavender scents
  • Squeezing and relaxing a small fidget toy
  • Squeezing and relaxing face and / or hands
  • Snuggling into a small space
  • Sucking yoghurt / thick milkshake through a straw
  • Bear hug

Useful websites and resources:

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Useful websites

Useful websites:
www.sleepcouncil.org.uk
www.cerebra.org.uk (sleep service) 08003281159. Can offer advice and support through sleep
practitioners.
www.scope.org.uk/sleep
www.bearhugblankets.co.uk
www.cornwallfisdirectory.org.uk

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