I’m often asked by parents who are getting very little sleep what advice I can give them, to make nighttime a little less stressful for everyone involved.
When experts get involved the standard advice is to have a settled bedtime routine, with all electronic devices turned off for an hour before bed.
Whilst that is undoubtedly good advice, it rarely gets to the route of the problem. In many case it is about as useless as telling parents to get their children to count sheep. And ultimately it leaves parents feeling as if no-one really understands what is actually happening. The reality is it is rarely that simple.
In my experience there are three main causes of children and young people struggling to sleep. This post aims to address each and suggest strategies that may help some children. It isn’t a magic wand, but I hope if nothing else it will make you feel a little less alone.
Lack of Melatonin
Many children with autism struggle to drift off to sleep at night. For some this is because their bodies aren’t producing Melatonin naturally.
Melatonin can be prescribed via a doctor (via GP) or psychiatrist (via CAMHs) and is given before bed as part of the bedtime routine.
A small dose is usually prescribed initially, which is then upped if needed. It is extremely weight dependent so don’t be surprised if it stops working when your child has a growth spurt. You may need to go back to be reassessed.
Anxiety About Being Alone
Some children and young people find it very difficult to sleep because they are worried about being alone. Because of difficulties with theory of mind, not being able to physically see the person caring for them can provoke high levels of anxiety.
The state of hyperarousal caused by the feelings of anxiety can not only make it difficult for children and young people to fall asleep at night but can also mean they struggle to get back to sleep if they wake during the night.
So what can you try:
Social Stories about sleeping and where everyone is during the night. This should be read at least once a day over an extended period of time, with some children it will continue to be read each night before bed. Incorporating the child’s special interest will help maintain their interest in the story and enhance the likelihood of them retaining the message.
Try putting a photograph on your bedside table of them and a photo of you on your bedside table. Ideally within the photographs you should both be in your own beds sleeping. The photograph will act as a visual reminder that you are still where you should be. But knowing you are also looking at them as they sleep will also help them to feel reassured.
A calm pack, containing their favourite calming items. The pack should be easily accessible on their bedroom table and contain things like photographs of you having a nice time as a family. A stuffed toy and something that is non-stimulating yet special interest related is also helpful. Each night write a new note to your child and put it in the calm pack, that way if they wake they are able to have contact with you and feel your presence without physically waking you
Using a baby monitor in reverse. Put the baby monitor in your room so that your child can see you if they wake briefly in the night. The sight of you sleeping in your bed may be enough to help them settle and go back to sleep.
For older children (or if you don’t fancy the invasion of a baby monitor watching your every move) walkie talkies may do the trick… Though of course the beeping of you will still wake you, the fact that your child isn’t waiting until their anxiety levels have risen then coming into your room, should make it easier for them to fall back asleep more quickly.
Anxiety About The Following Day
Many children and young people on the spectrum have very high anxiety levels. It is very common for them to lie awake at night worrying about what will happen the next day, especially if the following day involves change.
So what can you try:
Allocate some time before bed to allocate worries, leaving less pressure on your child when they are trying to sleep.
Use a visual timetable (either written or pictorial) as part of your evening routine. Knowing what will happen the following day will help to reduce anxiety about the unknown.
Make sure you are as ready as possible for the following day. Ensuring school bags are packed, uniform is ready and lunches (as far as possible prepared) will all help to reduce the number of things to be worried about.
Give them a notebook and pen to write down any worries they have during the night, with the reassurance that you will go through them the following morning. The act of writing them down is almost like passing them on to someone else.
Work on understanding those worries which regularly occur and work with others involved in the child or young person’s life to reduce them. The less anxiety there is during the day, the less there will be at night.
I end this by reminding you that I am a teacher and a mum.
I am not expert in sleep… if I was I would be getting significantly more of it than I do. But I know from experience that these are things that can help. I hope they help some of you get a little more sleep.
And if not then I remind you that you are not alone, and that one step at a time you will get there.
If you do want to learn more you might find our autism section a useful place to start. It’s full of different strategies to try out.
Why not join our private Facebook Group, which brings parents and teachers of children on the spectrum together to discuss strategies to help at home and at school.
Or if you’re looking for more personal support, why not check out our Consultancy Services.
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And of course if I can be of any help then please just shout (or drop me an email).