Written in collaboration by Renfrew’s occupational therapy team and Calgary based sleep consultant Melody Patton.
Why is sleep so important for kids!?
Sleep is when our bodies get physical restoration, time to heal, and our brains get a chance to file and sort through all the information we acquired during the day.
When kids sleep, their brain puts information into short- and long-term memory, new motor skills are solidified, and the immune system gets a chance to work to keep them healthy.
Parents of children with disabilities have identified many sleep struggles and often feel lost in all the information about sleep that’s available to them.
The good news is that sleep researchers have found that children with disabilities, such as Autistic individuals, often don’t require medication to get a good night’s sleep.
So, take a read through this document and see what small steps you can start to implement today to help your child get the sleep that they need.
Daytime strategies to help with sleep:
Screen time management:
*Note this is recreational screen time such as watching a cartoon show, not using a communication device*
- Cap screen time to 90 minutes per day.
- Turn off screens at least 1 hour prior to bedtime.
If screens are part of your child’s bedtime routine (and can’t be changed at the moment), make sure that it’s not stimulating or distressing for them.
Example: Consider the videos they are watching or the games they are playing, is it agitating them? Or violent? Consider switching to a more calming video or game.
Physical activity and time outside:
Physical movement helps to create the need for sleep within our bodies. Plus the sunlight helps to regulate our circadian rhythm which helps with regulating when we wake up and when we sleep.
See below for suggestions on how much outside time to aim for each week.
Physical activity suggestions:
- Walk (not run) outside for 30 minutes, 4 x a week. You can start with less time and work up to 30 minutes.
- There is such a thing as too much activity, if you’re outside or doing lots of physical activity on the same day as other physical activities or therapies, it may be too much for your child.
Pro-tip: Keep a physical activity log to track how little or how much activity your child is doing and pay attention to the nighttime.
- If your child isn’t walking, floor play is a great idea! Get them out of equipment and get them on the floor to move around and play.
- If your child needs lots of tactile stimulation, meaning they need a lot of touch throughout the day, let’s incorporate that! Hugs, gentle massage, picking them up (if able to!), etc.
Setting the stage for bedtime:
There are numerous steps you can take to prepare your child for a restful night’s sleep. By implementing subtle adjustments, you can better align their bodies with the natural rhythms of sleep, fostering a healthier bedtime routine.
In the evening:
- Turn off recreational screens 60 minutes prior to starting the bedtime routine. Set a timer or alarm for this to create consistency in their routine.
- Close curtains at home and turn down lights and sounds.
- Consider offering a bedtime snack each night, whether or not they eat it, make it part of the ‘evening routine’.
Room environment:
- We want a dark room. Blocking out as much light as possible.
- Night lights are okay, but we want to avoid blue lights, so warm colors are ideal (e.g., yellow, orange).
- Keep it cool. It can be difficult to fall asleep if our bodies are too hot, a cool room helps to induce sleep (e.g., aim to keep bedrooms around 19-20 degrees for sleep onset and set the thermostat to warm an hour or two before waking).
- Consider how much clutter is in your child’s room. Is it a sleep sanctuary? Is it too stimulating? Do toys need to be removed?
- Trial the use of a sound/ white noise machine. For some children, the use of white noise can support in falling asleep faster, and staying asleep longer. However, for kids that are sensitive to sound a sleep machine may actually be making it difficult for them to sleep and in fact, add to their chaos.
Bedtime routine:
- Print out images of the steps of the routine: snack, swinging/massage, bath, pajamas, brush teeth, books, goodnight hugs & kisses, etc. Your child’s OT can also help with providing these visuals so please reach out.
- For many children, including non-speaking children, setting out items that represent each step of the bedtime routine may be helpful instead of images (e.g., toothbrush, pajamas, books, a piece of toilet paper, lotion, etc).
- Children that are neurodivergent may need more time to complete their bedtime routine to help get in any sensory stimulation, time with the parent, time to unwind etc. 45-60 minutes is a typical amount of time for a bedtime routine.
Meeting your child’s sensory needs
If your child needs more sensory input, here are some ways you can incorporate that into their evening or bedtime routine:
Using an actual swing or a bedsheet (two adults needed for this!) and have your child sit in the ‘swing’ and swing them back and forth. About 5-10 minutes is typically enough.
Bubbles in the bath. We’re not talking about a bubble bath, but rather, bringing a small jar of bubbles to blow while in the bath. If bath time is challenging, then incorporating a fun activity such as blowing bubbles may help, plus it helps with practicing deep breathing without coaching them to breathe deeply.
Bath crayons are also a great way to get the wiggles and movement out at the end of the day!
Keep in mind that you know your child best, and if they get overstimulated easily, you’ll want to set the stage well, and then add these different activities one at a time, and slowly. The goal isn’t to do all of these things each night, but rather use them as tools to help your child unwind for sleep.
Also please keep in mind that changes take time to show effectiveness, so each strategy should be given a minimum of 2 weeks to determine if they are helping!
FAQs
Q: What about melatonin use?
A: First, speak with your doctor about using melatonin for your child.
Sleep researchers who research autistic children and their sleep, found that behavioral interventions are very, very effective and that only rarely do they use melatonin as a tool to help sleep. Of course there are special cases where it’s needed, but the good news is that making changes to your child’s bedtime routine, and how they go to sleep, is shown to be effective in most kids.
Q: What about magnesium?
A: Magnesium is a great tool to help your child (and yourself!) sleep better. It has over 300 functions in our body and helps with muscle relaxation, coping with stress, and sleep.
For kids, an Epsom salt bath is a great way to get more magnesium. Adding a scoop of baking soda to their Epsom salt bath is also a great way to increase their magnesium absorption and it helps their skin stay soft!
Magnesium lotion or cream (avoid oil initially as it can sting on the skin) is also an idea.
Start low and go slow. As always, speak to your child’s doctor first.
Q: These are all great suggestions, but where do I start?
A: Start with one change at a time. You can make the adjustments to your evening routine, such as closing curtains, and turning down the lights right away along with other changes.
Starting with bedtime routine images/items can be a great way to set the stage for your child.
Consider adding in ONE sensory activity.
Start by tracking their physical activity, start low and go slow to see how your child responds to the changes.
Q: Do you have any additional resources?
A: Yes! There’s a great book that a sleep researcher published for parents, and you can check it out here. https://www.amazon.ca/Solving-Problems-Children-Spectrum-Disorders/dp/1606131958/&tag=actcommunity-20
For more in-depth information, here’s a symposium on sleep and kids with autism that you can watch for free: https://www.actcommunity.ca/education/videos/solving-sleep-problems-in-children-with-asd/?gad_source=1&gclid=EAIaIQobChMI5dnH4P-ChAMV4xitBh3DrgDOEAAYAiAAEgLzQvD_BwE
Children’s best bedroom environment for sleep manual- helping parents understand sleep hygiene https://cbotlabs.wixsite.com/cbbes-workbook
Q: How much sleep does my child need?
A: Check out the image below as per the National Sleep Foundation to see the average amount of sleep your child should need. Keep in mind, some kids with disabilities may require a different amount of sleep so please check in with your child’s healthcare provider about the specifics.
If you would like individual sleep advice for your child, please reach out to your Renfrew OT team member and/or use Melody’s resources.
Important to note: Keep in mind that there are such thing as sleep red flags. If you notice any signs of sleep apnea, excessive snoring, mouth breathing, grinding teeth, seizure activity etc, you do need to seek immediate assistance from your child’s doctor.
Melody Patton
info@mpsleepconsulting.com | 403-660-2112
Baby Sleep Consultant | Melody Patton Sleep Consulting | Calgary (mpsleepconsulting.com)
