Sleep and Your Child

• Make sure your child or young person is getting enough exercise throughout the day and eating well.
• The circadian rhythm is a 24-hour body clock so what we do during the day, impacts us at night.
• Provide a comfortable, uncluttered sleeping place and a relaxing bedroom environment.
• Use calming and relaxing approaches such as a bath, puzzles and reading
• Support your child to self-settle.
• Establish a regular bedtime routine and be consistent every day of the week.
• It can take several weeks or even months to establish a new routine so keep at it and persevere, you will get there.

Bedtime routine 

Bedtime routine is important in getting a good night’s sleep helping to support children’s body clocks and aid relaxation.

Consistency is key, sometimes sleep patterns may get worse before they get better. It is not uncommon to think that a new routine isn’t working but it is important to stick to it for at least two weeks to see results.

Visit the The Sleep Charity website and Sleep Action for more information.

Golden Hour

The golden hour is the hour before bedtime for relaxing and winding down. If your child is excited or anxious, their bodies will produce extra cortisol, a hormone that wakes us up and stops us falling asleep.

This will then suppress the production of the hormone melatonin, a hormone that encourages us to become sleepy. For children, there are lots of activities which stimulate cortisol production such as exercise, watching TV and dancing.

Focus on quiet time and relaxing, and offer quiet, relaxing activities for your child. This could include spending one-to-one time with your child. You may want to give deep pressure hugs which can have a calming effect. Listen to relaxing music or audio books, read a story or poems using a quiet tone. Do calming crafts or tasks, puzzles, colour block sorting, counting objects or a jigsaw.

Remember to turn screens off at least an hour before bedtime as they will stimulate your child.

Visit the Sleep Action and The Sleep Charity website for further information

Bedroom environment

Temperature

• Hot, cold and drafty rooms can seriously impact on sleep.
• Your body’s heat peaks in the evening and then drops to its lowest levels when you are asleep so between 16 and 20 degrees is an ideal temperature.
• Temperatures over 24 degrees are likely to cause restlessness while a cold room of 12 degrees will make it difficult to fall asleep.
• Young children may require a slightly warmer environment, so think about getting a thermometer to keep track of temperatures.
• An extra layer of sheets or blankets will make you more comfortable when it’s cold and a pair of bed socks can also help.
• If it is safe to do so, have windows open to maximize cool air circulation in hot months.

Lighting

• When we see light our bodies tell us it’s time to wake up and when it’s dark, we release melatonin (the sleep hormone) which relaxes the body and helps us to drift off to sleep.
• Remember all screens and devices should be off, and not showing any light, so keep these out of the bedroom.

Comfort

• Your child’s bed and being comfortable is so important for a good night’s rest. Think about their mattress, pillows, duvet and positioning.
• Sound: loud, sudden or repetitive noises can interrupt sleep. However, some people find background noise and familiar sounds can be helpful and ‘white noise’ soothing.

 Relaxation

• The final step in creating the perfect sleeping environment is to ensure your child’s bedroom is relaxing. Making sure the bedroom is calm, tranquil and uncluttered.
• Some children may need additional sensory considerations and strategies in place to support and promote good sleep.

For children with additional needs and learning disabilities, please speak to a specialist school nurse or school nurse for more guidance and support.

Visit The Sleep Charity website and Sleep Action for more information.

The relationships in your child’s life help shape their emotional health and wellbeing.

Finding time to think about your own feelings, your child’s development, behavior and communication will support your understanding of them and how they are feeling. This can help you understand how to support your child with change and sleep difficulties.

Visit the Free guides: understanding your baby, child or teenager page to find out more.

Gradual Retreat

This strategy is a way of helping your child get used to going to sleep without their parent/carer in the room. It can be useful for children who need to be cuddled to sleep.

It is a gentle technique which is unlikely to cause distress to your child or you. However, it may take some weeks to be effective.

It is useful for toddlers and children who do not need to feed at night and who are old enough to understand that their parent is still in the room when they are not touching.

• Have a consistent, positive bedtime routine.
• Say goodnight and sit on a chair or cushion next to the bed.
• If they cry, gently put your hand on them. Avoid eye contact.
• When your child stops crying, go back and sit on the chair or cushion.
• Repeat every time they cry and stay in the room until they are asleep.
• Return and repeat whenever your child wakes up during the night.
• Each night, move the chair or cushion slightly further away from the bed. If your child is upset by this, bring it back to the previous night’s position.
• Once the chair is outside the room, your child is ready to go to sleep by themselves.
• Do move the chair or cushion back several times during one bedtime if it is going well.
• Do go at your child’s pace.
• It may take several weeks until your child goes to sleep happily on their own using this technique.

The Kissing game technique

This is a strategy for a gentle sleep training technique for helping your toddler or older child to get used to going to sleep without you in the room with them. It is similar to the gradual retreat strategy. This strategy is for children aged one years and older.

• Have a consistent, positive bedtime routine.
• Put your child to bed when they are drowsy but awake and kiss them goodnight.
• Promise to return in a few moments to give them another kiss.
• Return almost immediately to give a kiss.
• Take a few steps to the door, then return immediately to give a kiss.
• Promise to return in a few moments to give them another kiss.
• Put something away or do something in the room then give them a kiss.
• If your child stays in bed, keep returning to give more kisses.
• Do something outside their room and return to give kisses.
• If your child gets out of bed or stands up say “back into bed and I’ll give you a kiss”.
• Keep returning frequently to give kisses until they are asleep.
• Repeat this every time your child wakes during the night.
• Do be prepared for this to take a long time when you first start – it may take three hours and 300 kisses until your child falls asleep.
• Do substitute strokes and pats for kisses if your child sleeps in a cot and you can’t reach in to kiss them.

Rapid return

• After putting your child to bed and kissing them goodnight, the last thing your should say to them is ‘sleep time’ and leave the room.
• Wait outside the bedroom and as soon as your child gets out of bed or stands up, you return immediately with no eye contact or conversation except saying ‘sleep time’. Put your child back into bed/lay them down and leave the room again.
• Repeat this until your child is asleep.
• At first you may have to repeat this many times, but gradually if you consistently follow this approach, your child will learn to self-settle and go to sleep quickly.
• If your child wakes up in the night, repeat the same approach.
• Remember consistency is key.

Body clock shift back

The body clock shift back strategy is for when a child is falling asleep too late at night and their bedtime needs to be moved to a more appropriate time.

• Use a sleep diary to find the average time your child falls asleep.
• Start your child’s evening routine 1 hour before this time. They will then be getting into bed an hour later at the time they are usually falling asleep.
• Once your child has fallen asleep within 15 minutes of going to bed for 3 nights, start the routine 15 minutes earlier so that they get into bed 15 minutes earlier.
• Once your child falls asleep again within 15 minutes, move everything back again by 15 minutes.
• Continue doing this until your child is falling asleep at an appropriate time and not feeling sleepy in the day.

Talk to your child to try and understand their anxiety or worries. With older children, try talking to them without any pressure, perhaps during mealtimes, whilst walking or during an activity like arts and crafts. It can be easier for them to talk when there is another focus.

Provide a calm and consistent bedtime routine for reassurance and predictability. Create a comfortable sleeping space and peaceful environment. Support them to learn how to self soothe by trying muscle relaxation, mindfulness, or something like worry bags, worry boxes or worry dolls.

Visit the Mindworks website and Beacon House website for further information.

Sleep walking

Sleep walking can happen in up to a third of children at some point. They usually grow out of it by adolescence. It is safe to wake a child when they are sleep walking. If you have a child who sleepwalks, safety is really important so think about safety gates and locks on windows. Visit The Sleep Charity website for more information.

Nightmares 

About three quarters of children have nightmares, with 40% having them on a regular basis. They often start in early childhood with a frightening event or experience.

Anxiety can also increase nightmares due to higher levels of cortisol in the body when going to sleep. Children experiencing nightmares often need comforting and reassurance during the night. Talking about any worries or anxieties during the day, but not too close to bedtime, may bring cortisol levels down and avoid nightmares occurring.

A calm and consistent bedtime routine may also help. Nightmares are different from night terrors. Visit The Sleep Charity website for more information.

Night terrors 

Night terrors are less common than nightmares and only affect about 3% of the whole population. They don’t have any long-term effects and aren’t remembered the following morning.

Night terrors can be very distressing to see. If your child has a night terror, they may appear terrified, confused, shaky, they may be thrashing around, sweaty and have an increased heart rate.

If your child is having a night terror, make sure they are safe in their surroundings and support them back into bed. Although there isn’t a way to prevent night terrors from happening, simple strategies can be put in place to help.

These include:

• having a good bedtime routine
• talking about worries or anxieties during the day but not too close to bedtime
• avoiding any caffeine or sugar in the evening.

Visit the Sleep Action for further information.

If your child or young person is experiencing sleep difficulties, we would recommend using a sleep diary for at least 2 weeks.

Visit The Sleep Charity website for further information.

• Changes that occur during puberty can disrupt a teenager’s body clock and cause it to shift.
• During adolescence the body clock can shift around 2 hours later, and this can last until their early 20s.
• This means that adolescents are likely to be more active in the evening and go to bed later.
• Because of this, teenagers may find it hard to settle at night and get up in the morning.
• Some teenagers find this shift to their body clock can be very disrupted.
• This is going to sleep very late at night or in the early hours of the morning and getting up in the late afternoon.
• A good evening routine will help to prevent disruption to a teenager’s body clock.

Visit the Teen Sleep Hub website for further information including advice about:

• anxiety
• routine
• going to sleep and waking up
• social media, screen time and peer pressure
• exercise
• remixes to relax.

Sleep difficulties in children and young people with additional health needs and learning disabilities can be more common and complex.

This can range from finding it hard to get to sleep and waking up a lot at night to irregular sleep patterns and waking early in the morning.

What are the reasons?

There can be several reasons for sleep issues such as:

• physical reasons such as night-time wetting
• reduced mobility meaning your child may not able to turn and reposition themselves without support
• skin conditions causing itching and discomfort at night
• epilepsy and night-time seizures or seizures on waking
• autism or communication issues that can make changes to bedtime routines difficult (it is ok to change bedtime routines for autistic children, it just may take additional time and require extra support)
• hyperactive or attention conditions that may make it difficult to settle or move between daytime and night-time routines
• poor memory skills could mean a child has not learnt to sleep in their own bed
• those who have had a lot of hospital stays may have disrupted sleep patterns.

Visit the Specialist School Nursing page, Mindworks website, Cerebra website or National Autistic Society website for further information.

Visual timetables are suitable for all children including those with additional needs and learning disabilities.

These timetables offer a series of pictures or symbols that can help children to understand the sequence of events in their sleep routine.

Visit the Autism Speaks website for further information.

Helplines

• Mindworks
• National Sleep Helpline

Websites

• NHS 
• The Sleep Charity
• The Teen Sleep Hub
• Sleep Action
• Mindworks
• Cerebra