Sweet Dreams

One of the best ways to help your child is to make sure he or she gets a good night’s sleep. Well-rested children are more attentive, have a more positive mood, and learn more quickly. Most experts agree that children between ages 3 and 5 need 10-12 hours of sleep while kids between ages 7 to 12 need 9-10 hours.

Unfortunately many children with sensory processing difficulties (and their parents!) do not sleep well. Exhausted children do not think, behave, and learn at their best, and being tired makes it even harder to deal with sensory challenges. Persistent sleep disturbances result in higher levels of stress hormones, irregular biorhythms, decreased attention and cognitive skills, and heightened overall arousal because the body compensates to combat sleepiness. Children with sensory problems may lack adequate rest for many reasons such as because they:

are unable to lower the arousal level of the central nervous system in order to reach the state of calm required to drift off to sleep.
have trouble filtering out sounds inside and outside the house, whether it’s traffic or crickets outside or even the sound of a sibling breathing in the next bed or the next room!
can’t tolerate the sensation of sleepwear, sheets, pillows, blankets, and sometimes even the firmness/softness mattress itself.
have difficulty waking up from daytime naps which causes them to oversleep and then be unable to fall sleep again until very late at night.
emotional factors such as anxiety or anger, fear of bad dreams, or feeling left out of family activities, especially if there are older siblings who stay up later.

There are many theories and books on fostering sleep in children. I usually recommend Marc Weissbluth’s Healthy Sleep Habits, Happy Child. Sometimes parents need some extra help from a sleep specialist, especially if the child snores to rule out sleep apnea or other physical conditions that may be interfering with sleep.

For children with sensory processing issues, usually some fairly simple changes make a big difference in the quality and quantity of their sleep. Here are a few ideas:

Help set your child’s internal time clock. Have your child go to bed and wake up at the same time every morning, 7 days a week.  It’s tempting to let kids stay up late and sleep late on weekends and vacations, but this confuses the body’s internal clock and can cause difficulty falling asleep well beyond the weekend or holiday.
Establish a bedtime routine. To enhance your child’s sense of security, stick to a predictable routine for getting ready for bed every night such as brushing teeth and washing face, cuddling up in bed, and then reading a book together.  While it is standard advice to engage only in such relaxing, soothing activities at bedtime, it is possible that your child may actually require some intense vestibular and proprioceptive input before bed. This will take some trial and error. You may find that your child falls asleep more easily if, for example, he jumps on his mini-trampoline as part of his bedtime routine. For some kids, a bath is overstimulating just before bedtime. If this is the case, move bath time to the afternoon or earlier in the evening.
Don’t let your child go to bed hungry or thirsty. If needed, give her a light, nutritious snack before bed (and before brushing teeth). Milk and turkey contain L-tryptophan which helps induce sleep. Give just enough to satisfy but not so much that your child will definitely need the bathroom or a diaper change during the night. If your child insists on having a bottle to go to sleep, give him water only to avoid teeth problems.
Consider bedding and clothing. Use unscented laundry detergent and in general, avoid fabric softener because it leaves a residue. Make sure the mattress is not lumpy, too hard, or too soft. Most kids prefer all-cotton bedding and cotton or polar fleece pajamas with tags and labels removed and without elastic waistbands and cuffs. Speak with your occupational therapist about using a weighted blanket at bedtime (I wrote at length about using weighted materials in the expanded edition of Raising a Sensory Smart Child
Make the bedroom conducive for sleep. Use a night light if your child prefers one, but consider whether your child needs the room to be completely dark. Minimize environmental noise by keeping the house relatively quiet, using a white noise machine, or soundproofing the room. Make sure the room isn’t too hot or too cold. Consider what you can do to fix any distressing vibrations from an air conditioner or clanging from a radiator.
Avoid or reduce naps if possible because daytime naps often interfere with nighttime sleep. If your toddler is outgrowing his need for naps, limit nap length or eliminate them and get him to bed earlier at night.
Use the bedroom for sleeping only. By using the bedroom for playing and watching TV, the child may associate the bedroom with activities he can do when awake.

Certain medications and foods may interfere with sleep. Consult your pediatrician if your child is taking medicine (antihistamines, mood stabilizers, etc.) and his or her sleeping habits have changed. In general, avoid giving your child caffeine (chocolate, hot cocoa, ice tea, Coke/Pepsi/Mountain Dew) because it interferes with sleep.  You may also want to consult with your doctor about using a melatonin supplement, which is hormone that helps regulate sleep and wake cycles.