Twas’ the night before… anything (Christmas, Halloween, going to DisneyWorld, birthday, or for me, Great America for the first time). I remember how hard it was for me to fall asleep when I got to do something super fun the next day or stay asleep at night. With holiday season here, we may see increased sleep issues in our kiddos. However, many kiddos (and adults) have a difficult time with sleep, not just at the holidays, but every night.   This will detail sleep for both the holidays and every night sleep.

Let’s start with the basics…

What does a sleep deprived child look like?

• Babies sleeping less than 14-16 hours in a 24 hour period

• Toddlers sleeping less than 13 hours

• Preschoolers sleeping less than 12 hours

• School age kids sleeping less than 10 hours

• Teenagers sleeping less than 9.25 hours

What do a sleep deprived child’s behaviors say?

• Difficulties controlling their body and impulses

• Difficulties getting a long with others

• Hard time managing emotions

• Inability to stay focused and perform well

• “Wired” at bedtime: The need to stay awake is so strong in some children that instead of getting drowsy many get ‘wired’. They appear to have ‘wild’ behavior as long as they have stimulation levels high enough to keep them awake. Once the stimulation decreases they create their own commotion to keep themselves awake.

What do kids need to sleep?

• In order to sleep a child must feel SAFE. If a child does not feel safe they will have more anxious emotions and a rise in stress hormones which will make falling  asleep even more difficult.

  • What can make a child feel unsafe? – Sleeping in a new environment, changes to their nighlty routine, new or unfamiliar people in the house, unfamiliar lights or sounds.

• Children need CALM to sleep.  Anything that upsets your child’s sense of well-being will raise their arousal and pull her system in the opposite direction of sleep.

  • What impact’s children’s well being? Parental stress, separation, major life changes, upsetting events, lack of sleep, overstimulation, overscheduled days, anticipation, growth spurts, pressures to perform.

• Children need to DROP THEIR BODY TEMPERATURE to sleep.

  • Humans need to drop their core body temperature 2-3 degrees in order to initiate sleep. When kids are physically active after 6pm it raises their body temperature, making it harder to initiate sleep.

• Children need consistent ROUTINE to sleep

  • They need a transition to indicate it’s time to get ready to sleep. This is something that happens every night. (ie: snack, dimming lights, picking up toys)

  • They need a connecting and calming activity. This can be reading together, drawing together, giving your child a massage.

  • They need a cue activity..something that happens every night before bed while the child is in bed. This can be a song, a prayer, turning off the light, or turning on the fan which signals it’s time to sleep.

How do we unintentionally disrupt sleep in our kids?

• Irregular schedules: If there is more than a 30-60 minute difference between when a child woke up/went to sleep it can throw our kids into jet lag. Even changes in meal time can affect their circadian rhythms.

• Light: Strong morning light is very important to a child’s body clock keeping a consistent rhythm. If a child is exposed to too much light at the wrong time of the day it sends the wrong signals to the brain about when to sleep. Too many lights on in the house and too much LED screen time before bed is incredibly stimulating to child’s brain and reduces signals for the body to prepare for sleep.

• Exercise: Not enough or exercise at the wrong time of the day. Children need at least 60 minutes of physical activity during the day. Too much exercise too late at night overheats the body when body temperature should be dropping.

• Stimulants: One can of soda is the equivalent of an adult drinking 4 cups of coffee. It takes a long time for caffeine to leave a child’s body.

Are there certain times we should expect more difficulties sleeping?:

• 2 to 3 days before and after holidays

• Time surrounding growth spurts

  • Growth spurts happen every 6 months in 2+ year olds, much more frequently from birth to 2

• Troubling events

  • Sometimes it can take up to 6 months for a child whom you otherwise thought was able to cope with a difficult situation to show their stress. Big life changes due to COVID are a perfect example!

• Vacations

  • The anticipation of, disruption of routine, new environment can all cause difficulties sleeping.

When you know what to expect you can better respond to and care for your child when they are having difficulties sleeping.

How can you help your child sleep?

It starts during the day!

• A rushed or stressful wake up in the morning (well all know how short tempered we can be when running late!)can leave your child feeling stressed and disorganized throughout the day.

• Keep a consistent wake up time in the morning, and predictable timing for naps

• Schedule meals an hour or two before bedtime and keep consistent meal times during the day. Research shows it’s best to not have a heavy meal right before bed.

  • In your child’s diet include complex carbs; this includes fruit, vegetables, whole grains

  • Reduce simple carbs like candy, cakes, cookies, soda and fruit juices.

• Provide exposure to morning and daytime light.

• Make sure your child gets exercise during the day! During the cold long winter months there are many indoors activities you can do with your child to meet their need for movement. Our Occupational Therapists have some great ideas including;

  • Heavy work; this includes pushing, pulling, lifting, carrying, anything that puts those muscles to use.

  • Playing hide and seek.

  • Creating an indoor obstacle course.

  • Pretending the floor is ‘lava’ and your child has to jump on pillows/couch cushions to get from one side to another.

  • Jumping on a small trampoline.

Night time tips to promote sweet slumber:

• Eliminate screen time at least after dinner- blue light shuts down sleep and suppresses natural melatonin production. If a night light is needed make sure the light is indirect and use a pink light, or warm yellow colors. Turn off the light when the child is asleep.

• Dim lights around your home after 6pm to signal to your child’s brain that the time to sleep is approaching.

• Keep a consistent bedtime. Cortisol (stress hormone) increases when a child goes to bed past the appropriate time. This impacts sleep due to increased stress of fight or flight phenomenon.

  • Give your kiddo a hot bath before bed then have child in bed no more than 30 minutes after bath, right after bath is most beneficial. The warm water from the bath helps to draw heat away from your child’s core, lowering their body temperature and signaling to their brain’s it’s time to sleep.

• Towel dry with firm pressure to give your child sensory input.

• Provide comfy pj’s and the coldest room possible. Listen to your child, if they tell you a tag is bothering them or their PJ’s feel scratchy find something that will make them feel comfortable. We all know how annoying a scratchy tag can be!

• Ideal placement of bed is in a corner or against wall looking towards the door. Think about how your child’s bed can become a safe ‘nest’. A bed that sits on the floor with no distinction between the floor can feel to open and vulnerable to a child.

• Try lavender or vanilla essential oils (therapeutic grade) to assist with sleep.

• Use a white noise machine to block out distracting noises.

• Keep the bed away from window so your child isn’t exposed to lights or noises from outside.

• Use blanket rolls to make  canoe or nest for increased input in the bed. Most of the time when a child crawls into bed with mom or dad they are seeking the pressure they feel from mom and dad’s body against theirs.

• Consider a weighted blanket or bean bag on child to increase the pressure and sensory input on your child during the night.

• A massage before bed can help your child feel connection to you their parent and helps their body to calm and meet needs for touch and sensory input.

• Use a visual schedule. This helps to set expectations for your child and reduces the stress than can occur when your child does not know what will happen next.

We have learned a lot through education, clinical experience, and through reading! A great book full of resources for childhood sleeping strategies that we found invaluable in learning about sleep for this blog is “Sleepless in America” by Mary Sheedy Kurcinka ; “Sleepless in America” by Mary Sheedy Kurcinka.  If you would like more information or need help with implementing these strategies, please schedule a free screening with one of our skilled pediatric Occupational Therapists.

Written by Jessica Frederick COTA/L and Amy Stumpf, M.S., CCC-SLP/L, CLEC