Can't Sleep, Won't Sleep!

tiredparent.jpgUp to 40% of children aged 1 to 5 have some form of sleep problem.  It’s not uncommon to see sleep-deprived parents literally on the verge of pulling their own hair out!  All have the same complaints: ‘won’t go to bed’, ‘can’t fall asleep’ and ‘keeps waking up at night’.

If you're one of those folk, here's some sleep information that you may find useful (based on original article by Galland & Mitchell)…

 

HOW LONG SHOULD MY CHILD SLEEP FOR?

There are no set rules as every child is different.  However, children do sleep less as they get older.  As a rough guide: toddlers (age 1-3) sleep for 12-14 hours, pre-schoolers (3-5 years) for 11-12 hours, and school-aged kids (6-12 years) for 10-11 hours.

 

WHY IS SLEEP IMPORTANT FOR KIDS?

Sleep is important for children's brain development.  Children that sleep poorly tend to have more behavioural problems, poorer school performance and can have problems with weight.  They can also grow up to develop behavioural and emotional problems in later life.

A child's disturbed sleep can also affect the rest of the family, particularly the parents – maternal depression and marital problems are often seen in these cases.

 

HOW CAN I HELP MY CHILD SLEEP?

Tackling sleep problems in children involves 3 main approaches:

  1. Good 'sleep hygiene' practices to help your child get to sleep.
  2. Specific sleep programmes that aim to keep your child asleep.
  3. Sleep medication (when all else fails).

 

WHAT IS GOOD 'SLEEP HYGIENE'?

  • Make sure your kid has plenty of exercise and activity during the day – this will make them feel more tired at bedtime.
  • Avoid food and drinks that contain caffeine and try not to eat too close to bedtime.  If a snack is essential then go for ‘snooze foods’ that are rich in carbohydrates, calcium and tryptophan, e.g. peanut butter sandwiches, biscuits and milk, dairy products, beans and rice.
  • Have a regular bed routine every night starting about 30 minutes before they go to bed.
  • A warm bath before bed will help them feel sleepy.
  • A good sleep environment is quiet, warm and dark.  Sleep time should be associated with ‘lights out’ and ‘lights on’ when they wake.  If your child won’t sleep with the lights off then try a night light or having a light on outside the room.
  • Bedtime stories are really important especially when children are scared to go to bed - go for ones that deal positively with the dark.
  • Have a consistent wake time every morning – it’s not a good idea to let them lie-in to catch up!

 

WHAT SLEEP PROGRAMMES ARE THERE?

  • 'Non-blissful ignorance' - a technique called unmodified extinction is used when children wake during the night and aims to remove parental attention that reinforces the problem.  It sounds horrible but extinction is just another word for ignoring.  The child is allowed to cry themselves back to sleep when they wake, but it isn't easy and not everyone is keen on it!
  • 'Controlled crying' (or graduated extinction) - probably a better alternative and involves progressively increasing the time you allow them to cry, e.g. start at 5 minutes and check on them briefly, then 10 minutes next time etc.  It’s important that the parent only checks on the child briefly and just to reassure.
  • 'Floating camp-bed' – this starts with the parent camping out in the child’s room just for reassurance and then gradually moving further out of the bedroom with each night until they are outside.  Be prepared to camp out for a week or so!
  • 'Wild card' – this is used in children over 3 years and involves giving them a ‘pass’ to allow one ‘free’ trip out of the bedroom or visit by the parent to satisfy an acceptable request.  After that the extinction technique is used.

 

Obviously these techniques don't suit everybody and can be quite tough, but some people find them effective - it depends on what you are comfortable with and what works for you and your child.

 

SHOULD I USE SLEEP MEDICATION?

  • There are medicines which can help your child sleep and may be necessary in a small number of cases.  If you think you have reached this stage then it is worth talking to your GP or Health Visitor to see if you need a referral for a specialist opinion.
  • Some anti-histamines have useful sedating side-effects and can be a real help short-term.  For instance, if your child has eczema a dose of Piriton at bedtime can really help relieve the itch and help them sleep.  Other similar medicines include Phenergan and Vallergan - talk to your GP or pharmacist about these and always read the label first!
  • There are other medications available that are used in special cases (e.g. the sleep hormone melatonin) - this is usually done by a specialist.

 

OTHER IMPORTANT BITS

Some other things to bear in mind:

  • Make sure the reason you child is not sleeping isn’t because they are in pain or unwell – this often causes a temporary sleep problem which gets better.
  • Never give your child somebody else’s sleep medication.
  • Putting ‘a little something’ in their bottle is never recommended!
  • The above information applies to toddlers and older children - it is not necessarily appropriate for young babies.