August 9, 2012

Difficulty sleeping!

Difficulty sleeping is a very common problem with children on the spectrum. As many as 50% of children on the spectrum experience some difficulty sleeping. This can be a real problem for both the child and parents getting their needed rest. For the child, who already has a fragile nervous system, lack of sleep will compound any other difficulties (sensory, emotional, behavioral, etc.) they are experiencing. Steady sleep patterns are essential to keep the nervous system calm and organized. Listed below are several of the common strategies used to stabilize sleep patterns.

1. Consistent bedtime routine: The body needs to calm down and relax in order to sleep effectively. One of the best ways to stabilize sleep is establishing a consistent, relaxing routine before going to bed. The child should go to bed and rise at the same time every day. This helps establish a consistent sleep cycle for the body. The bedtime routine should consist of a sequence of relaxing events that lowers the child’s arousal level. This means avoiding video games, and high stimulating activity for the last 45-60 minutes of the evening. Common activities in bedtime routines are taking a bath, brushing teeth, toileting, getting out clothes for tomorrow, getting a drink of water, reading a story, snuggling in bed, saying prayers, etc. Keep the same sequence of tasks each evening to build a consistent routine. This helps prepare the body for sleep.

2. Lessen any environmental distractions: If the child is a light sleeper, noise and activity going on in the house can disturb his sleep. Also, common noises occurring outside can be distracting for them. If needed, try using a consistent background noise (environmental tapes, soft music, white noise machine, fan, etc.) that will mask any other noises. Next, lighting can be an issue. If the child is scared of the dark, then a night light may be needed. Or, are there outside light sources that are disturbing your child’s sleep (street lights, house lights, etc.)? If so, make sure they are blocked out. Another factor that could disrupt sleep is temperature. If the room is too cold or too hot, the child nervous system will stay on high alert and not be able to sleep. Lastly, be aware of any tactile sensitivities that may present problems for your child. Are the pajamas a material that they feel comfortable in? How about the sheets and blankets? If any of these are too scratchy for the child, the nervous system will not relax.

3. Deep pressure, and snuggables: Deep pressure calms the nervous system and can promote sound sleeping. Provide large pillows, stuff animals, or body pillow to snuggle with. Lots of heavy blankets, or a weighted blanket, can assist with sleeping. Also, some child love the feeling of being wrapped up in a sleeping bag.

4. Diet and exercise! The three basic components to a organized nervous (sleep, diet, and exercise) all effect each other. A good diet and lots of physical activity will help stabilized the nervous system so it will sleep better. However, try to avoid arousing physical activity for the last hour before bedtime.

5. Avoid frequent napping during the day. If your child is having difficulty sleeping at night, try and avoid a lot of napping throughout the day. If naps are needed in mid-day, try and keep it short (30 minutes or less) and occurring at the same time every day.

6. Medical concerns: If the child has gastrointestinal problems, upper respiratory problems, or any other acute medical concerns, these can keep the nervous system on “high alert”, thus keeping it from falling asleep. Sleep apnea could also be a factor. If your child has any of these difficulties seek medical help to lessen their impact.

7. Sensory integration problems: If the child has sensory processing issues, they often have problems modulating their arousal level, making it difficult to fall, or stay, asleep. Their nervous system may be too “wound up” to fall asleep. A good sensory diet throughout the day can help calm and organize the nervous system.

8. Sleep aids: Melatonin has been an effective sleep aid for many children on the spectrum. It is used very frequently, with minimal, if any, side effects. There are a host of other sleep inducing supplements and medications that can be prescribed, but should be used as a last resort. Seek out your doctor’s advice when using these.

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