A Child’s Difficulties with Sleep: Tips from an Occupational Therapist

Occupational therapists are known for working with individuals to improve and address occupations. Occupations are described as things that an individual needs to do, wants to do, and are expected to do in their every day life. Therefore, occupations include things like: social participation, education, activities of daily living (dressing, grooming, etc.), caring for others, meal preparation, and of course, SLEEP. The focus of this blog is on the sleep issues a child may experience, importance of bed time routines, and sensory based strategies regarding sleep for children.

Sleep Issues in Children 

There are many different issues regarding sleep that any child may experience. They may have difficulty with bedtime, falling asleep (sleep latency), awakenings throughout the night, regularity or duration of sleep, snoring, or excessive movement in their sleep. If a child is having difficulty with bedtime or falling asleep each night, it may mean that the child needs more routine within their day, it is too early or too late for them to go to bed, or could even mean that they are experiencing social or emotional issues. If the child often wakes up each night, this could be a result of sleep terrors/nightmares, being overstimulated or an environment that is too loud, lack of exercise during the day, or they ate too close to bedtime. If a child snores or sounds as if they are gasping or choking in their sleep, it could mean that they have sleep apnea. If snoring is the case for your child, you should discuss this with their pediatrician and consider getting your child a sleep study. If your child is experiencing any of these difficulties, you may want to log your child’s sleep for a few days, get into a more structured bed time routine, keep a consistent bedtime, and assess your child’s sleep environment for anything that may be bothering them or keeping them awake. 

Bed Time Routine 

Children often thrive with implemented routine and bedtime may be one of the most important routines. Firstly, it is important not to allow your child to eat or exercise too close to bedtime as these may be alerting activities for them rather than calming activities. It is also important to limit screen time prior to bed, because this also can be an alerting activity and increase arousal level rather than promote calming. It is best to allow your child to have sedentary time or passive play time before going to bed so that they may begin to calm their minds and their bodies. For example, a child may participate in quiet coloring at the table, play with play doh, or read books. If bath time appears calming for your child, then this may be implemented into their bedtime routine. But if bath and/or grooming tasks (i.e., brushing teeth) cause any type of distress or discomfort for your child, these tasks may be better completed right before or after dinner time or when the family gets back home for the day. Make sure that the child's bedtime routine is, for the most part, remaining consistent and that bed time is also rather consistent for the best results. 

Sensory Strategies 

            Overall, sleep is a sensory experience. This is why we must look at all aspects of the child's environment in order to promote the best possible sleep experience for the child. First, we must think about noise and the auditory system. Many children and individuals in general sleep better with some type of white noise or calming, soft music in the background. Next, we can think about deep pressure and body position.  Other strategies to try include having your child sleep inside a sleeping bag on top of their bed, providing heavy blankets, utilizing a weighted blanket, or have body pillows on either side of your child. These strategies can help the child that seems to need a parent sleeping right next to them and help children to have a better sense of their position in space during their sleep. The visual system is another concern. It is best to ensure a mostly dark room for your child, but to provide a night light or glow stick. The temperature of the child's room should also be monitored for an ideal sleep environment. In conclusion, sleep is so important for a child's development and as issues arise they must be addressed in order to improve the child's overall quality of life.


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