MAGIKO SYMPAN LOADING . . .
Magiko Sympan
Research and Intervention Centre for Children, Adolescents and Family
Dr Katerina Dounavi, BCBA-D
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Sleep: A nourisher in life’s feast? How to teach your child to sleep well

Although sleep is very important to a healthy development (see how many hours of sleep humans need at different ages by clicking here), sleep disorders appear very often during childhood. At the age of 3-6 months, most children can sleep through the night without needing an adult’s intervention, however 25 to 50% of children at this age still present sleep problems. Research has shown that the way children sleep reflects the practices of the community to which they belong and their parents’ habits, thus the child’s ability to fall asleep fast and sleep through the night is a result of learning, with parents playing an important role in the learning process.

In order to face sleeping disorders, which if still persistent at the age of 5 are more likely to become chronic and remain until adulthood, research suggests that behaviour-analytic methods can bring excellent results in a short period of time. However, parents will more often discuss their children’s sleeping difficulties with the paediatrician, who will in turn recommend in at least 50% of the cases medication and very often waiting for the problems to resolve with time. However, studies have shown that not only do problems not resolve automatically as time passes but they can also become chronic, while behaviour-analytic methods are more effective than medication and socially acceptable by parents.

Sleep disorders vary and can include the child’s difficulty to fall asleep at the beginning of the night, frequent awakenings during the night, a difficulty to fall asleep after awakening during the night, resisting to go to bed, a difficulty to fall asleep in the child’s own bed, as well as other behaviour issues related to sleep (e.g., not complying with bedtime routines such as putting pyjamas, crying and calling parents).

The consequences of children’s sleeping disorders/problems impact negatively the child’s and the entire family’s quality of life. Children are agitated and stressed because of tiredness, they are sleepy during daytime and as a result are more likely to suffer accidents/injuries and cannot concentrate at school or enjoy and learn from any activities they complete during the day. Parents are also distressed due to chronic insomnia and exhaustion, they perform less well at their job, face more frequent conflicts within the couple and have less force and patience when interacting with the child.

Child sleeping
Photo kindly provided by www.traveling-shapy.de

 

In order to prevent sleep disorders, parents can follow a number of tips as described below, always adapting them to the child’s and family’s needs.

  • Establish and follow a bedtime routine. A child that always sleeps at the same time and place feels safe and can predict what will follow and respond better to expectations. Activities completed before sleeping time should be the same across days and help the child relax (e.g., bath-milk-change diaper-story telling-sleep).
  • Keep a relative flexibility in norms and routines (e.g., for weekends, holidays, exceptional circumstances). A child that has learned to adapt to natural changes in life is an independent child.
  • Make sure physiological needs are covered before sleep time (e.g., water, food, diaper change, appropriate temperature, no discomfort/pain).
  • Dim the light in the bedroom where you complete the bedtime routine and turn the lights off as you put your child to bed.
  • Use pyjamas and bed covers that keep the child’s temperature at the desired level. The child should neither feel cold nor sweat.
  • Avoid television/bright screens, toys or activities that can over-stimulate the child right before bedtime.
  • Do not put the child in bed much earlier than an appropriate time for his/her age, as this will make it likely that the child is not tired and gets used to staying in bed awake.
  • Reduce the number of hours your child sleeps during the day to match what is necessary for his/her development.
  • Establish routines for sleeping times during daytime (e.g., mid-day sleep should last a specific amount of time and you should not make the room completely dark-“do not convert day to night and vice versa”). Your child should learn to distinguish between daytime and night time and get used to sleeping at specified times, so that the biological/circadian clock is adjusted. This includes keeping your house full of light, natural noises and enjoyable social interactions during the daytime and reducing light, noise and play/interactions during night.
  • Do not allow your child to sleep with you, as this decreases his/her ability to fall asleep without an adult’s presence (i.e., their independence). If your child comes to your bed during the night, accompany him/her back to his/her bed. If you are reading them a fairy-tale before bedtime, sit at a small distance from the children’s bed.
  • Avoid to feed your child during night (with the exception of newborns and a few months of age babies), as like this you are teaching your child to sleep through night and only seek food at appropriate times.
  • It could be a good idea to give your child a favourite plush toy to hug before falling asleep.
  • Reassure your children when they wake up frightened during night, hugging and caressing them until they calm down but remain next to their bed with the lights off and don’t bring them to your own bed.
  • If your child wakes up during night and they have wet their bed, change them calmly with dim lights and do not reprimand them for not using the toilet if they already use it during daytime, since this does not help them learn and makes them feel embarrassed.
  • Praise your children for getting ready to go to bed (e.g., putting their pyjamas).
  • To make positive changes to your child’s sleeping habits, you need willingness, patience and persistence as well as to be ready for the first difficult days. Remember though that if both parents consistently collaborate, results will not take long to be observed and long-term consequences will be extremely positive for the entire family.
  • If despite your efforts you have not managed to help your child overcome their sleeping disorders/problems, do not hesitate to seek help from an expert.

Watch this video by Prof Neville Blampied (University of Canterbury, New Zealand)  for a behaviour-analytic approach to sleep.

Part 1               Part 2              Part 3