A Contact-a-Family survey found that disabled children are more than twice as likely to have problems with sleep as others.
Without specialist support, sleep problems can continue for years. Sleep deprivation not only affects a child’s learning, behaviour, mood and health but also the physical and mental well-being of the whole family.
Some sleep problems are common with certain impairments, so you need to take account of your child’s diagnosis. But the large majority of sleep problems are behavioural, so there’s a lot you can do. Have a look at the following list and see if you can identify why your child may be having sleep difficulties.
Environment is one of the common reasons children have difficulties sleeping.
Is your child too hot or too cold? Ideally the temperature in the bedroom should be between 16–18 C.
An over-stimulating bedroom
Does your child get out of bed to play with toys? If so, your child may be over-stimulated by the bedroom environment. Bright colours are often stimulating to children. You will need to consider creating a restful bedroom environment. It’s important that your child’s bedroom is a calm and suitable environment for them to get to sleep in.
Is your child playing computer games or watching TV before they go to bed? Light from screens (such as tablet computers, mobile phones and TVs) blocks melatonin production. We recommend no screens the hour before bed. Use the settings control to automatically set night time settings to your phones and tablets. This ensures that a lower level of light is emitted during the evening.
Is their bed comfortable? Try lying on it and seeing how it feels. Is your child wet or soiled? This will cause discomfort which could impact on their ability to sleep.
Is your child kicking the bedding off during the night and waking because they are cold? If so, you can consider using a double duvet tucked under the mattress of a single bed. Or are they too hot or too cold, think about what you are experiencing at night time. If you are sleeping with just a sheet on, and your child has a heavy duvet, they could be getting too hot.
Is there any noise inside or outside the home that may be disturbing your child? Some children with sensory issues, such as autistic spectrum disorders, can be particularly sensitive to noise. What may seem like a quiet sound to you can seem very loud to them. The noise of an electric fan can mask other noises in your home and may be worth considering if noise is an issue.
Is the room dark enough? Melatonin is produced when the room is dark. You might consider buying black-out blinds to make the room darker.
Could your child be hungry? What time are they having their tea-time meal? Does their meal-time need to be later? Giving your child a snack mid-afternoon can help if you want to try moving their meal-time to later in the day. There are also foods that can help at bedtime.
Is your child using ‘I’m thirsty’ as a distraction technique, or are they genuinely thirsty? Monitor what they are drinking during the day and give them a drink with their bedtime snack. Try offering water at night time, instead of juice or milk. If they are thirsty, they will drink water.
Lack of understanding about day and night
Does your child understand the difference between day and night? Sometimes children with additional needs require help to learn when it’s daytime and when it’s time to sleep, particularly if they have a visual difficulty. Tried and tested strategies can help with this. The same sequence of events should happen every night. Visual or other timetables can help a child understand the order of events and what is going to happen next. Gro Clocks can help too. Search for them online.
Bedtime routine Does your child’s bedtime routine encourage sleep? Has their routine become unsettled lately because of an event like a family holiday or Christmas?
Getting up too early
If your child wakes in the night do you treat it as a night awakening, or as the start of the day? You should consider what a reasonable time to begin the day is. If your child wakes before that time, return them back to their bed. This will help to strengthen their body clock.
Is your child in pain? Could they be teething? Some disabled children cannot reposition themselves at night which can disrupt their sleep. If you think that your child may be in pain you should seek advice from medical professionals.
Is your child on any medication that may affect their sleep? Or do they have to be given medication during their sleep which may be disturbing them? Check with a medical practitioner if you are unsure.
An hour before bed, turn off the TV and all other screens (such as iPad, games consoles and phones), dim the lights and close the curtains to begin the visual clues it’s coming up to bedtime.
Drinks Avoid drinks of cola and chocolate at bed time. Have a sleep food snack to help your child with their sleep.
Half an hour before bed, it’s bath time. If your child finds a bath too stimulating, bath earlier in the evening. On a non-bath night, a cuddle in a warm towel will help.
After the bath it’s time to brush teeth and get ready for bed (put on pyjamas).
Quiet time before sleep
· Sit with your child and spend half an hour of quieter fine finger games (such as playing with jigsaws, colouring, drawing, threading, hammer beads).
· Then it’s bathtime; don’t go back downstairs after you have gone to the bathroom.
· If your child finds a bedtime story calming, spend the next 5 minutes sharing a book, no stimulating storylines as this could have an adverse affect.
· Then it’s a kiss and cuddle goodnight, and leave the room. Remember you want to leave them awake, so they fall asleep in the same conditions that will remain all night (alone).
· Wake your child every morning at a set time so they can learn the routine and you can help strengthen their body clocks.
Keeping a sleep diary
When we are sleep deprived, we can become forgetful and stressed so don’t always recognise what’s happening at night.
Every night merges into one, so you need to be able to take night time and look at it in segments. Using a sleep diary can help you identify areas of inconsistency, areas to praise or perhaps you might notice your child is getting more sleep than you thought! Download a sleep diary
Tips for using a sleep diary
· You need to complete your sleep diary honestly to use it effectively. Use extra sheets if you need to.
· If your child sleeps elsewhere, such as a respite centre or another family member’s house, ask them to fill in the sleep diary. You might notice your child sleeps better there and using the diary will be able to identify why.
· Check with your school to see if your child naps in the day, or with the escort if they travel home by bus. This will affect night time sleep if the nap is too late in the day or if they are at an age where naps are not appropriate.
· Keep the diary by the bed with a pencil so that you can fill it in immediately rather than trying to remember what happened later.
· Share the diary with professionals who work in sleep to see if they can help you find a cause for your child’s sleeping difficulties.
· Keep the diary for at least two weeks and then see if you can identify a pattern to your child’s sleeping habits. You can then identify an area that you can start to address.
Experiment with your child’s food intake to find the right amount of food to have in the evening. It takes around one hour for the tryptophan in foods to reach the brain, so don’t wait until right before bedtime to have your snack.
A slice of toast with your tea and honey will release insulin, which helps tryptophan get to your brain. Once there, tryptophan turns into serotonin – which murmurs: “time to sleep”.
They’re practically a sleeping pill in a peel! Bananas contain a bit of soothing melatonin and serotonin, as well as magnesium, a muscle relaxant.
Drizzle a little in your warm milk or herb tea. Lots of sugar is stimulating. But a little glucose tells your brain to turn off orexin, a recently discovered neurotransmitter linked to alertness.
It’s not a myth. Milk has some tryptophan – an amino acid that has a sedative-like effect – and calcium, which helps the brain use tryptophan. Plus there’s the psychological throw-back to infancy, when a warm bottle meant “relax, everything’s fine”.
Oats are a rich source of sleep-inviting melatonin. A small bowl of warm cereal with a splash of maple syrup is cosy – and if you’ve got the munchies, it’s filling too.
Almonds and peanut butter
A handful of these heart-healthy nuts can be snooze-inducing, as they contain both tryptophan and a nice dose of muscle-relaxing magnesium.
A small baked spud won’t overwhelm your digestion, and it clears away acids that can interfere with yawn-inducing tryptophan. To increase the soothing effects, mash it with warm milk.
It’s the most famous source of tryptophan, always credited for all those Christmas naps. But that’s modern folklore. Tryptophan works when your stomach’s empty, not overstuffed, and when there are some carbs around, not tons of protein. So put a lean slice or two on some whole-wheat bread mid-evening, and you’ve got one o