All About Sleep

Ahh...sleep. I bet this word didn't carry the weight it does now before you became a parent. Sometimes I can remember the coziness of sleeping in on the weekends, or the carefree sensation of falling asleep with the assurance that nothing will interrupt your night's rest. But mostly, these days sleep is something to be wrestled with.

I will say right here that I am not an expert on sleep. My toddler mostly sleeps through the night but it took a very long time, and it doesn't take much (teething, colds, travel) for the sleep routine to implode.

This article probably will not make your son or daughter sleep through the night. But hopefully my knowledge of the sensory systems will help you learn a few more tricks to make your night-time, or nap-time, routine a little less stressful. Sleep can be especially tricky when your child has special needs, so I am going to focus on a few things that may contribute to the special needs child having difficulty sleeping.

But first of all...

How much sleep does my child need anyhow?
Here is what the National Sleep Foundation recommends. Keep it mind that this includes the time spent napping during the day.

Age	Recommended	May be appropriate	Not recommended
Newborns 0-3 months	14 to 17 hours	11 to 13 hours  18 to 19 hours	Less than 11 hours  More than 19 hours
Infants 4-11 months	12 to 15 hours	10 to 11 hours  16 to 18 hours	Less than 10 hours  More than 18 hours
Toddlers 1-2 years	11 to 14 hours	9 to 10 hours  15 to 16 hours	Less than 9 hours  More than 16 hours
Preschoolers 3-5 years	10 to 13 hours	8 to 9 hours  14 hours	Less than 8 hours  More than 14 hours
School-aged Children  6-13 years	9 to 11 hours	7 to 8 hours  12 hours	Less than 7 hours  More than 12 hours

You can check out their website for recommendations for older children and adults. https://sleepfoundation.org

Help my child is bouncing off the walls at bedtime!
It seems counter-intuitive because you know that your child is tired, but their energy level seems to peak at bedtime. They are running from room to room, laughing, hyper, the opposite of sleepy. There could be a few things going on here:

1. Your child is already over-tired.  Over-tired for children, especially young child, often looks like hyperactivity.  Try moving up bedtime by a half an hour, then an hour if that does not work. Look at the sleep chart above to figure out how much sleep your child needs before you determine a bedtime.

2. Your child is sensory seeking.  Children with this sensory profile constantly seek stimulation and action. You may need to help your child's nervous system calm down with the following supports, until they learn to implement some of these strategies themselves:

• Provide calming movement like rocking them (or having them rock themselves if they are older) in a rocking chair, swinging them in a blanket, or using a hammock. Avoid spinning as this can just re-energize them.
• Provide heavy blankets, weighted stuffed animals, or pillows to hug to help them start to calm their nervous systems. Make sure your child is able to remove these items by themselves if they are sleeping with them. The weight should be 10% of their body weight for a weighted blanket. 
• Try calming essential oils in the room (try out different scents together first to see what they can tolerate. Lavender tends to be calming but this does not work for everyone)
• Implement a routine of bath time before bed
• Play soothing classical music or put on a white noise machine before or during bedtime (unless your child is sensitive to background noise)
• Try giving them a massage with deep pressure strokes to help them calm
• Make sure your child is getting plenty of heavy work during the day! "Heavy work" is an OT term that refers to activities that involve pushing or pulling against the body (jumping, vacuuming, swimming, yoga, pushing a cart, etc.)

Help, my child cannot fall asleep!

It is a helpless feeling when your child cannot fall asleep independently. Sometimes children with special needs have a hard time turning off their mind and bodies in order to get ready for bed. Here are some aspects that you may want to consider:

• Consult your doctor. Some doctors will recommend melatonin for sleep issues. It is found over the counter, but I always like to check with your pediatrician before adding any supplements. Also, GI problems are common in children with autism and often interrupt sleep. You may need to work with your doctor to rule this out. 
• Consider the amount of screen time your child is getting. Experts recommend that you stop looking at screens (television, iPads, phones) 1-2 hours prior to bedtime. The blue light from the screen tricks our bodies into thinking its day time, and our kids are especially sensitive to this. 
• What is the child's bedroom environment like? Consider their sensory needs— do they need a sound machine to drown out household noise? Do they need blackout curtains because they are visually distracted? Are their toys too visible and inviting for them? Try to make the sleep atmosphere as calm and non-stimulating as possible.
• Play out sleep issues during Floortime play sessions. You may be surprised at just what your child brings up! Make sure they are having plenty of Floortime moments throughout the day to express any fears and to connect with their caregivers. 

Good luck parents! As always, consult your child's individual therapist for ideas that will best meet their individual needs. I wish you many, many nights of good sleep.