16 Tips to Help Your Child Get Better and More Effective Sleep
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16 Tips to Help Your Child Get Better and More Effective Sleep

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Sleep Hygiene

Sleep is vital for our health and wellbeing. This is especially true for children, who are experiencing exponential growth in terms of their bodies, brains and emotional lives. During this time of change and growth, children are especially vulnerable to the harmful effects of sleep deprivation.

Fortunately, there are ways to help your child sleep better. As a licensed therapist who has spent a lot of time working within South African state hospitals, I have spent many hours collaborating with parents to create better sleep routines for the whole family.

As such, I have had the privilege of witnessing the gains – emotional, physical, mental and social – that come about when a child regains a healthy sleep schedule. In this article, I take you through the “do’s and don’ts” of good sleep habits.

Read on to learn more about sleep hygiene and how you can use it to improve your child’s life.

What is sleep hygiene?

Sleep hygiene refers to the habits, rituals and behaviours that we can perform to ensure a good night’s rest. There are many lifestyle changes that we can make in order to improve not just the quantity, but also the quality of our sleep. But what does the science say – does sleep hygiene really work?

Does it work?

The evidence for the effectiveness of sleep hygiene interventions is mixed; and some studies show that alone, sleep hygiene has only a modest positive impact on people with insomnia [1]. Does that mean that it doesn’t work?

Not quite. Sleep hygiene is recommended by organizations such as the National Sleep Foundation and Harvard’s Division of Sleep Medicine as a great way to improve the quality and quantity of your sleep. The “do’s and don’ts” of sleep hygiene that we discuss here are based on sound scientific principles.

However, if your child is suffering from insomnia or another sleep disorder, sleep hygiene strategies should not be used instead of formal treatment. Rather, they should be combined with other behavioural or medical interventions provided by an expert (more on this later).

Why is sleep so important for kids?

It’s safe to assume that you know sleep is important, given that you’re reading this article. What many people underestimate, however, is just how important sleep is for our children’s brain development and overall wellbeing. What is it that makes sleep so important for our young ones?

As a parent, you know all too well that your child is growing fast. Brain science [2] shows that children’s physical development is paralleled by exponential brain growth.

This brain growth happens predominantly during sleep: millions of neural connections are forming each night. The development is most pronounced during the first three years of life, but the growth continues into early adulthood.

These brain connections serve as the foundation for a child’s social, physical, intellectual and emotional health [3]. Research also shows that it’s during sleep that long term memories are formed [4]. It’s not surprising, then, that research has linked sleep problems to poor health in children.

For example, sleep issues in kids may lead to learning problems, language difficulties, hyperactivity, poor concentration and lower all-round cognitive performance [5].

Furthermore, sleep is vital for physical growth and healing in the body, as well as heart health, immune functioning and the capacity to feel happiness [6]!

How much sleep does my child need?

Before you start thinking about how optimize your child’s sleep health, it’s important to consider how much sleep your child really needs.

As rule of thumb, a person’s need for sleep decreases as they age. For example, new-borns need up to 17 hours of sleep per day. Teenagers, on the other hand, need between 8 and 10 hours – which is more than the 7-9 hours that is recommended for adults.

If you’d like to read up on the latest sleep-age recommendations published by the National Sleep Foundation, take a look here. If you’ve already done your research, then continue reading these practical pointers for sleep hygiene amongst youngsters.

Sleep hygiene 101: The “do’s”

Below, we discuss the “do’s and don’ts” for ensuring that your child – whether an infant, toddler, child or adolescent – is getting enough good quality sleep. Let’s start with the “do’s” – those things we want to encourage:

1. Encourage a calming bedtime ritual

A bedtime ritual can be incredibly helpful in signalling to your child’s brain and body that it’s time to rest. Of course, this should be tailored according to your child’s age – as should all the sleep hygiene strategies that we discuss here today.

For example, infants and toddlers might appreciate a nightly bed-time story, a soothing bath or a lullaby. Try to perform the same routine consistently each night. For adolescents, you may find it more helpful to encourage them to set aside an hour of quiet time before bed.

During this time, your teen could practice whichever calming activities they find useful. They might, for example, want to listen to some soft music, read a book or draw. Another useful approach is to help your teen (or child) to practice deep breathing and meditation.

You might also encourage them to visualize themselves in a safe and peaceful place – real or imaginary.

2. Encourage consistent sleep-wake times

Did you know that our bodies are regulated by a biological clock? This internal clock lives in a part of the brain called the suprachiasmatic nucleus (SCN) [7].

This is responsible for regulating many of our basic functions: from moods, hormones and appetite to sex drive, cardiac function and concentration.

Of course, our sleep-wake cycle is also governed by this biological clock. If you don’t believe me, think back to the last time you visited a country in a different time zone. Jetlag is what happens when our internal clocks are thrown out of sync.

When it comes to sleep hygiene for our children, we can guide them to behave in a way that coordinates their natural sleep cycles.

The idea is simple: encourage your child to go to sleep at the same time each evening; and ensure that they wake up at the same time each morning. This sort of consistency can go a long way toward ensuring a good night’s rest.

3. Use a transitional (comfort) object

Transitional objects are items that help your child to feel safe and calm, even when you’re not around. You might use a special blankie or a stuffed toy, for example. This can be especially helpful in supporting younger children to self-settle.

A transitional object will help your child to develop an internal sense of peace and safety. Around the age of 4 -5 your child will most likely start to grow out of the phase where they need the comfort object.

But don’t worry, it’s not a problem if your child enjoys their toy or blankie well into adolescence.

4. Get your child in the sunlight each morning

Sleep Hygiene - Go outdoorsIf possible, ensure that your child is getting some time in the sun shortly after waking up. Why? We’ve already spoken about our brain’s biological clock. Research shows that sunlight helps to reset and reinforce this internal mechanism [8].

Furthermore, sunlight triggers an increase in cortisol – a natural hormone which is linked to mental alertness. At the same time, sunlight causes your brain to stop producing melatonin – a hormone that’s linked to sleepiness [9].

How can you use this knowledge to your child’s advantage? Soon after they wake up, take them on a short stroll outdoors; or get them to spend some time sitting or playing in the sunlight. Alternatively, your child could always eat breakfast in a room that’s filled with sunlight.

If, due to climatic restraints, this is not a realistic option for you, exposing your child to bright lights might be the next best option. Sunlight, however, truly is first prize!

5. Encourage exercise

A regular exercise schedule can be used to combat insomnia and improve your child’s sleep quality more generally. Why? Research suggests that exercise lowers arousal levels while also combatting depressive and anxious thoughts [10].

Exercise is also thought to act directly on the internal body clock, ensuring a more regular sleep-wake schedule [10]. How much exercise is enough? The NHS recommends at least 60 minutes of physical activity per day for children over the age of 5.

Top tip: help your child or adolescent find a form of exercise that they enjoy. This might be anything from a cycle to school to a walk in the park, team sports or martial arts, dance or rollerblading to an extended game of tag in the playground.

What about infants and toddlers? If you’re parenting a child of this age, you’ll know that they are naturally very busy. You don’t usually need to encourage exercise – they’ll get this from climbing, crawling, playing and jumping.

Finally, exercise shouldn’t be performed right before going to bed – especially high energy training. Remember that the period leading up to bed time should be reserved for calming activities, so your child should rather exercise earlier in the day.

6. Encourage your child to use the bedroom only for sleeping

Sleep science tells us that the very cells of our brains are primed to learn by association [11]. When it comes to healthy sleep, therefore, we want our children to associate their bedroom with feelings of drowsiness.

This means that we should encourage our kids to use the bedroom for one thing and one thing alone: sleep!

I’ve worked with many adolescents who perform a remarkable range of activities while in bed. This varies from guitar rock-concert rehearsals and video game marathons to study sessions, dinner consumption and extended phone calls with their friends. And their parents wonder why the teen is having trouble sleeping!

All this activity in the bed and bedroom is a big no-no, because your child’s brain is associating the room with mental alertness and excitement. This brings me onto another point which is especially pertinent for teens as well as younger children: limiting screen time. We’ll discuss thus below, under our sleep hygiene ‘don’ts’.

7. Keep the bedroom dark and quiet

To promote healthy sleep, you want your child’s bedroom to be a sleep sanctuary. This means an absence of noise and light. Thick curtains are certainly your friend in this regard. Ideally, you would want to avoid any devices in the room that might unexpectedly buzz, chime or emit flashing lights.

Furthermore, when it comes to keeping your child’s room quiet, you may find that environmental sounds – such as dogs barking or passing traffic – are unavoidable. In such instances, you could consider children’s’ range earplugs or earmuffs.

What if your child needs a nightlight? We discuss this further down. The presence of light and noise can disrupt the quality of your child’s sleep. Even if they are not conscious of being awoken, these stimuli can stop the brain from passing into the deeper phases of sleep [12].

8. Encourage your child to drink enough water – but not too much!

This pointer isn’t based on rocket science. If your child is not properly hydrated before going to sleep, they’re probably going to wake up thirsty during the night. On the other hand, if they’re overhydrated, their sleep is going to be disrupted by frequent toilet visits.

As a parent you want to aid your child in balancing their fluid consumption. Often, this is a matter of trial and error – take some time to find the sweet spot. Keep in mind that one or two pee breaks during the night is not going to disrupt your child’s sleep cycle too badly.

Sleep hygiene 101: The “don’ts”

Now, let’s cover some of the “don’ts” of sleep hygiene for kids. Here are some things to discourage:

1. Discourage tech use at night

An important rule for promoting sleep hygiene is that technology use should be limited in the hours preceding bed time. This includes phones, laptops and television.

Why? Screen time causes mental alertness and stimulation during the period in which we want our children’s brains to be slowing down and getting ready for slumber [13].

Furthermore, the UV light emitted by these devices may trick your child’s brain into thinking that it is day time. Dare I say it: many parents are guilty of tech use after dark as well.

Keep in mind that kids imitate what they see and it’s going to be hard to stop them from abstaining if you’re not leading by example!

2. Discourage caffeine consumption

Again, this isn’t rocket science. Caffeine keeps you awake – that’s why us adults love it, right? While research has shown that caffeine consumption can be harmful to children, “moderate” usage is generally considered acceptable [14].

However, caffeine can disturb your child’s sleep quality, stopping them from getting enough deep restorative sleep. To promote sleep hygiene, help your child or teen to eliminate or reduce their caffeine consumption.

If they do consume some caffeine, this should happen earlier rather than later during the day. Keep in mind that caffeine is found not just in coffee and energy drinks, but also in tea, sodas and certain chocolates and medications.

3. Discourage tossing and turning

We’ve all been there: a sleepless night where hours go by as you toss and turn the night away. This is not a helpful practice, as it encourages an association between being in bed and feeling restless.

If your child has been sleepless for 30 minutes or more, encourage them to get up and leave the bed. Ideally, they should do something restful until they feel sleepy again. Consider trying soft music, breathing exercises or simply sitting in a chair until the sleepiness descends.

Initially, you may need to guide your child through this; but aim for them to be able to take this sort of action on their own when they’re able to.

4. Don’t make a big dinner

Eating a large meal before bed can make it hard to get a good night’s sleep. Try to give your child smaller meals at night; and rather encourage them to eat earlier during the day.

On the other hand, you don’t want your child to go to bed if they’re hungry. If they express this, consider giving them a light snack. Alternatively, a warm cup of milk can reduce hunger and promote relaxation.

5. Discourage clock watching

It’s a trap that’s easy to fall into. You can’t sleep. You glance at the clock out of curiosity and feel a surge of anxiety when you realize that your alarm is due to chime in just a few hours.

The anxiety caused by clock-watching makes you less likely to be able to sleep soundly. Therefore, it’s important to discourage your child or teen from watching the clock. If possible, remove any light-emitting clocks from the bedroom, for reasons which we discuss below.

6. Don’t use a nightlight unless necessary

Even a dim nightlight may penetrate through your sleeping child’s closed eyelids. This can trick the brain into thinking that it’s day time, potentially resulting in disturbances in your child’s melatonin production.

But nightlights are not always bad. For example, they may be imperative for children who are prone to anxiety and/or night terrors. Nightlights can also be helpful if you’re trying to potty-train your child.

If your child requires check-ups, a dim nightlight is better than switching on the overheads. So, don’t rush to eliminate the nightlight if this is going to do more harm than good!

Nonetheless, keep in mind that darkness is the best recipe for healthy sleep. If you do need a nightlight, try to find one that emits a soft red hue. Research shows that the wavelengths associated with red or amber light are least likely to interfere with the brain’s melatonin production [15].

7. Discourage late night interactions

Many children wake up during the night and seek out their parents. This may be a matter of sleeplessness, anxiety, nightmares or simply wanting to say hi! While we instinctively want to comfort our children, late night interactions can reinforce your child’s sleep disruptions.

Don’t engage in long conversations; and don’t invite your child into your bed. If your child comes to you during the night, gently guide them back to their own bed and encourage them to settle down as quickly as possible.

If your child still needs reassurance, you can sit by their bed until they fall asleep. When your child sleeps the whole night through, praise them for their achievement!

8. Don’t get carried away with check-ups.

If you’re checking up on your child during the night, try to do so with as little fuss and excitement as possible. For an anxious child, your presence alone should be enough to reassure them. Your goal is simply to let them know that you’re there and everything is ok. Don’t chat; and try to keep the check-up as brief as possible.

Additional Principles for Working with Your Child

Here are some extra tips for promoting sleep hygiene as a parent:

Set Boundaries

Father ChildAs I’ve discussed above, consistent and predictable boundaries are important. At times, this may be challenging for you, the parent. You may find that being firm develops into “tough love”. However, it’s important to stick to your guns if you wish to improve the quality and quantity of your child’s sleep.

Why? Research has shown that when parents implemented firm household rules – limiting caffeine consumption and setting bedtimes – their children were more likely to sleep well. The researchers also found bigger sleep deficiencies in kids whose households allowed bedroom tech use [15].

Furthermore, setting healthy boundaries for your children can go a long way toward creating an environment that feels safe and predictable. A lack of consistent boundaries can be anxiety provoking; and this can negatively affect your child’s sleep quality.

Take it easy

In line with the notion of boundaries, your approach should be firm but gentle. You don’t want to end up fighting with your child about their sleep hygiene.

If your child becomes angry and upset because of the boundaries that you’re setting, this itself is likely to disturb their sleep. Try to focus on working collaboratively with your child. In this regard, communication is key.

Communicate

In promoting sleep hygiene for your child, you’re not just helping them to achieve a better quality of life in the present moment. You’re also helping to instill a set of healthy behaviors and attitudes that will set them in good stead for the rest of their lives.

It’s important, therefore, that you communicate with them. Help your child to understand why sleep is so important. Explain what sleep hygiene is about and help them to understand why you’re guiding them in this direction.

Think Carefully About Day Time Naps

This is a contentious topic among sleep specialists. Should your child or teen nap during the day? Research on children over 2 years of age suggests that long day-time naps, or naps that are too close to bedtime, can disturb the quality of your child’s nighttime sleep [16].

Ultimately, however, different children have different needs; and younger children need a huge amount of sleep time for proper brain development to occur.

Be flexible; and allow yourself to be guided by your child’s needs. If they really want to nap, then let them. But if you notice that their nighttime sleep is suffering, consider limiting the amount of time spent napping during the day.

What about teens? The same rules apply. But keep in mind that teens very often experience a “sleep debt” if they’re not getting the recommended 8-10 hours per night. In such cases, a 20-minute nap during the day can help to promote alertness without necessarily affecting their night sleep.

Tailor Your Approach

The sleep hygiene recommendations that we have discussed today do not need to be adhered to dogmatically. What works wonders for one person may prove ineffective for another.

There’s nothing wrong with using a bit of trial and error – see what works for your child and feel free to abandon any sleep hygiene strategies that seem to be causing more harm than good.

Offer Praise and Encouragement

This is a big one. Don’t forget to congratulate your child or teen! Encourage them when they’ve had a good night’s rest, but don’t stop there. Validate any efforts that your child is making to implement a healthier sleep routine in their own lives.

In doing so, you’ll help them to develop a great level of self-confidence and a healthier approach to sleep in general.

When to Seek Support from a Sleep Specialist

Sleep hygiene can benefit anyone. In people with sleep disorders, however, sleep hygiene should be used to complement more formal treatment strategies. Here are some signs that might indicate the presence of a sleep disorder.

  • Your child often struggles to fall asleep.
  • Your child experiences frequent night-time awakenings.
  • Your child appears drowsy, cranky, irritable or unfocussed during the day (even if they seem to be sleeping a lot).
  • Your child is worried and/or upset about their sleep issue.
  • Your child’s sleep disruptions are negatively affecting their (and/or your) quality of life.
  • Your child’s sleep issues persist even though they’re practicing good sleep hygiene.

If you tick any of the above boxes and find that you’re struggling to help your child get the sleep that they need, consider speaking to your nearest GP or paediatrician. Additionally, you can click here for a more comprehensive guide to sleep disorders in children.

Better Sleep for a Better Life

Sleep: we spend about a third of our lives doing it. It makes sense that we try to do it right, especially given that healthy sleep is a precondition for physical, emotional and mental health! For children in particular, getting enough good quality sleep is absolutely vital.

Sleep hygiene means taking practical steps to ensure that you and your family are getting the sleep that you need. For best effects, encourage your child to adopt sleep hygiene as a state of mind and way of thinking rather than just a set of behaviours.

In this way, you can instil in your child the sort of mindset that will ensure healthier sleep habits going forward.

References

1. Irish, L. A., Kline, C. E., Gunn, H. E., Buysse, D. J., & Hall, M. H. (2015). The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep medicine reviews22, 23-36.

2. Johnson, M. H. (2000). Functional brain development in infants: Elements of an interactive specialization framework. Child development71(1), 75-81.

3. Bergland, C. (2013).  Sleep strengthens Healthy Brain Connectivity. [online] Psychology Today.  Available at:  http://www.psychologytoday.com/blog.the-athletes-way/201311/sleep-strengthens-healthy-brain-connectivity [Accessed 1 Nov. 2018].

4. Clemens, Z., Fabo, D., & Halasz, P. (2005). Overnight verbal memory retention correlates with the number of sleep spindles. Neuroscience132(2), 529-535.

5. Dahl, R. E. (2007). Sleep and the developing brain. Sleep30(9), 1079-1080.

6. Dement, W. C., & Vaughan, C. (1999). The promise of sleep: A pioneer in sleep medicine explores the vital connection between health, happiness, and a good night’s sleep. New York: Dell Publishing Co.

7. Wang, T. A., Yanxun, V. Y., Govindaiah, G., Ye, X., Artinian, L., Coleman, T. P., … & Gillette, M. U. (2012). Circadian rhythm of redox state regulates excitability in suprachiasmatic nucleus neurons. Science337(6096), 839-842.

8. Duffy, J. F., & Czeisler, C. A. (2009). Effect of light on human circadian physiology. Sleep medicine clinics4(2), 165-177.

9. Hadlow, N. C., Brown, S., Wardrop, R., & Henley, D. (2014). The effects of season, daylight saving and time of sunrise on serum cortisol in a large populationChronobiology international31(2), 243-251.

10. Passos, G. S., Poyares, D. L. R., Santana, M. G., Tufik, S., & Mello, M. T. D. (2012). Is exercise an alternative treatment for chronic insomnia? Clinics67(6), 653-660.

11. Suzuki, W. A. (2008). Associative learning signals in the brain. Progress in brain research169, 305-320.

12. Chepesiuk, R. (2009). Missing the dark: health effects of light pollution. Environmental Health Perspectives117(1), A20.

13. Wood, B., Rea, M. S., Plitnick, B., & Figueiro, M. G. (2013). Light level and duration of exposure determine the impact of self-luminous tablets on melatonin suppression. Applied ergonomics44(2), 237-240.

14. Temple, J. L., Bernard, C., Lipshultz, S. E., Czachor, J. D., Westphal, J. A., & Mestre, M. A. (2017). The safety of ingested caffeine: a comprehensive reviewFrontiers in psychiatry8, 80.

15. Wright, H. R., & Lack, L. C. (2001). Effect of light wavelength on suppression and phase delay of the melatonin rhythm. Chronobiology international18(5), 801-808.

16. Thorpe, K., Staton, S., Sawyer, E., Pattinson, C., Haden, C., & Smith, S. (2015). Napping, development and health from 0 to 5 years: a systematic review. Archives of Disease in Childhood100(7), 615-622.

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16 Tips to Help Your Child Get the Best Sleep Possible
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About the Author Daniel Sher, M.A. Clinical Psychologist

Daniel Sher is a clinical psychologist at a private practice and a locum therapist at the Western Cape Health Department.

Sher completed his Masters in Clinical Psychology at the University of Cape Town (UCT). During this time, he was trained in various modalities of psychotherapy as well as psychological assessment at the UCT Child Guidance Clinic. Furthermore, he completed his master's thesis, titled, Cultural Discourse Among South African Clinical Psychologists, and presented his findings at the European Congress of Psychology in Stockholm, 2013.

In 2015 he worked at Valkenberg Psychiatric Hospital. More specifically, he worked at the Male Admissions Unit (acute psychosis), as well as Alexandra Hospital (Inpatient Unit and Outpatient Service for adults with comorbid Intellectual Disability and Mental Illness), J2 Psychiatry Unit at Groote Schuur Hospital and Hanover Park Community Health Clinic.

Under supervision of clinical psychologists and in collaboration with multi-disciplinary teams, he worked intersubjectively with clients suffering from psychiatric disorders using individual psychotherapy, psychoeducational groups and family interventions. He also completed psychometric and neuropsychological interventions, the latter of which involved case presentations to the Division of Neuropsychiatry at Groote Schuur Hospital.

As a Community Service Clinical Psychologist (2016), he was employed by the Western Cape Department of Health. he worked at a district level general hospital: Khayelitsha District Hospital, where he engaged in psychological interventions with clients dealing with various psychiatric disorders and comorbid medical conditions. He also provided outreach therapy services at two community health clinics and worked closely with a multi-disciplinary team consisting of psychiatrists, nurses, and family physicians.

His professional interests as a therapist include long-term psychodynamically informed therapeutic models, in addition to cognitive-behavioral and other short term solution-focused interventions.

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