In this blog post, occupational therapist Anne Buckley Reen, OTR/L offers tips of what to do if your child is not sleeping well.

Most of us take a good night’s sleep for granted. For many children and adults however, lack of sleep severely inhibits their ability to function and experience positive emotional states and good health. The SANE approach facilitates change through restorative Sleep, Activities to reduce stress, balanced Nutrition, and nurturing Environments for a child not sleeping well.

Sleep

Sleep is essential. A biologically restorative state of consciousness, sleep replenishes the body on all levels: cellular, endocrine, immune, metabolic, physical and emotional. It repairs and restores major organs and brain chemicals needed for coping, memory and attention.

In the absence of a good night’s sleep, the body and brain begin a slow deterioration impacting on all areas of health and function. Although the body can survive for a month or more without food, death can occur in a week without sleep. Three nights without restorative sleep can produce a state known as “sleep deprived psychosis,” in which rational thinking is impossible. Epilepsy can occur after 24 hours without sleep.

A child not sleeping well is often cranky and irritable. Some have trouble falling asleep, others staying asleep. Both problems could be caused by poor self-regulatory abilities which result in them seeking something (a thumb or blankie) or someone (a sibling or parent) to help. After a restless night, they are easily stressed, moody, labile and difficult to calm.

Poor sleepers are not happy kids. The reason for this is simple. During restorative sleep, the brain and body produce serotonin, a chemical necessary for mood stabilization, coping, attention and memory. The less serotonin available, the less able one is to deal even with the most mundane day-to-day task. Picky kids get pickier, cranky kids get crankier and spacey kids get further detached.   With insufficient production of brain chemicals necessary for memory and attention, poor sleepers tend to be poor students as well.

Activity

Stress depletes our coping chemistry, throwing the entire nervous system out of balance, and thus disrupting sleep. Children who are stressed require strategies and consistent routines to help calm mind and body. Physical and breathing exercises both balance brain chemistry. A 10-minute walk or slow jog, and deep breathing, especially in the morning and mid-day, are powerful regulators and reduce arousal.

A sleep hygiene program, including routines and a set schedule, beginning sleep 30 minutes before lights out, are essential for all children, but especially for children with issues. Following this routine at the same time every night, most parents report significant changes in 1-2 weeks.

• Establish a set bedtime:  7:30 pm for preschoolers and 8:30 pm for school-age.
• Banish TV, computer or video games for at least one hour before bedtime:  These tend to rev up, rather than calm down, young minds.
• Provide a calming and soothing warm bath for about 15 minutes, followed by a deep towel massage to arms, legs, back, hands and feet:  Add Epsom salts for detox and calming. Speak quietly and soothingly. Put on pajamas and get straight into bed. (This is important because the body temperature drops after coming out of the bath, just as it does in the first stage of sleep- so the body is already “gearing down.”)
• Read one short story and turn the lights out:  Accept no excuses for more.

Nutrition

In order to fall asleep, stay asleep and sleep restoratively, the body requires certain nutrients. According to Sidney Baker, MD, protein and B vitamins, especially at breakfast and lunch, are key to influencing the brain’s ability to achieve a deep restorative sleep 12 hours later. Diets high in sugar and other stimulants (chocolate, caffeine) will inhibit sleep. Save these treats for special occasions; never eat them after 4 pm. Check also for side effects of medications which very often interfere with sleep cycles.

If necessary, you can use supplements to calm the body and ready it for sleep.

Environments

Environmental factors including space, structure, sounds and light can both positively and negatively affect sleep. Adjusting the energy flow in children’s bedrooms according to feng shui principles can help. For children who need lights on to fall asleep, get a dimmer switch and turn lights all the way out, once they are asleep. Any light on in the night will stimulate the pineal gland and inhibit production of sleep hormone.

Music with a 60-beat-per-minute tempo can help to calm to body and mind and regulate the child who is out of balance. Try two great CDs: “Baby Go To Sleep” (birth to 7) and “The Surf” (all ages). Played throughout the night on repeat mode the music enhances regulation of the sleep cycles.

Absence of sleep can produce a variety of disorders and influence behavioral and attention problems. A foundation for all function, sleep is a necessary starting point for getting our children “in balance.”

Good night!

Anne Buckley Reen is a pediatric occupational therapist and President of OT For Kids. She can be reached at 718-318-1180. She lectures nationally with Debra Dickson, PT.

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