Explain sleep and the need for sleep. Stories can reassure your child that they are safe when asleep or alone.
keep to the same bedtime and wake up time if possible. This helps to support natural rhythm and helps prevent sleep times shifting later.
Have a realistic expectation about how long your child sleeps. Match time in bed with time asleep and don’t set an early bedtime because you think your child isn’t getting enough sleep. See the National Sleep Foundation for recommended hours, but also how those hours can be flexible.
Use visual timetables to help with transitions as some children don’t like change.
Activities to help the natural hormone production of ‘Melatonin’ production can be added to the hour before bedtime such as dimming lights and reducing sound levels. Some sensory calming activities like stretching and even carrying heavy items can help to calm.
Tidy up the bedroom, as clutter can be distracting, make sure the bedroom is a restful place.
Reduce noise levels, shut doors, move bed away from walls where there is noise next door.
Blackout blinds can be helpful
Reduce the risk of any new smells entering the room, sensitivity increase the risk of waking
Think about bedding and your child’s sensory preferences
Think about comfort; is the bed comfortable, is clothing comfortable/without labels.
Introduce calming activities into the evening schedule. These can include any activities that the child finds soothing eg. colouring, drawing, playdough, reading/listening to a story, gentle massage.
Consider reducing the amount of naps if any, are taken during daytime as sleeping during the day can reduce our body’s need for sleep in the night. However, everyone is different and for some children/young people (eg children with physical health conditions) taking rest during the daytime helps to manage their energy and mood levels. Use sleep diaries to explore whether naps have impact on child’s quality of sleep in the night.
Encourage the child/young person to spend some time in sun/fresh air every morning. This helps to reset internal body clock and sync it with day/night cycle.
A comforting object (eg toy, blanket, clothing item) can help the child settle at night. If possible, include the child in choosing this object. When introducing a new object do this slowly and gradually and during the daytime. Provide the child with support and opportunity to build attachment to the object and start using it to self-soothe.
Some children and young people find warm baths before bedtime relaxing. However, hot bath can also increase our body’s temperature, wake the body up and this can make falling asleep more difficult. Explore the child’s/ young person’s preferences.
Audio books can be helpful although nothing too exciting though, just calm restful content.
Decorate the bedroom in neutral colours where possible.
Think about not using the bedroom as a sanction, otherwise the bedroom might not be seen as a restful and positive environment.
Routines need to be age appropriate
The best time for a child to go to bed to sleep is when they are sleepy and not when they are already asleep. This is so that they can learn to fall asleep on their own.
Bedtime snack choices Banana, oats, yoghurt, milk, cheese.
- Have a consistent bedtime
- Encourage a good routine at bedtime
- Make the morning routine consistent too
- Limit food and caffeine before bed.
- If food is needed, make it a bedtime snack box of ‘sleepy’ foods which are melatonin rich like bananas
- Avoid screen time, games and phones before bed
- Exercise during the day before transitioning to sleep
- Make sure the environment is quiet and comfortable for sleep
- Consider the sensory environment
- List worries, share worries or draw worries before bed
Try not to
- Break the bedtime routine at the weekend
- Food: try not to give in to requests for food, it might be a misinterpretation of body clues (anxiety)
- Allow homework to be done in the bedroom or watching TV in bed.
- Leave devices in your child’s bedroom at night
- Try to stop electronic device use 2 to 3 hours before bedtime, but use a blue light filter if absolutely needed
- Break the morning routine at weekends, it might disrupt the weekday pattern.
- Forget that parents need sleep too, so a good structured routine for your child gives you more time to sleep.
Other things to think about
Incontinence which can lead to wet and uncomfortable clothing and bedding, or waking up in the night to use the toilet and having difficulty getting back to sleep
If brushing teeth is problematic, attempt to clean, but don’t put too much pressure on it if the child is becoming upset/dysregulated. brush teeth more thoroughly in the morning rather than at night
Try not to put pyjamas on too early as this is a nonverbal cue for bedtime.
Engaging in a heavy muscle activity late afternoon early evening.
Drink a thick drink e.g. milkshake or smoothie through a straw or encourage eating chewy foods
Safe Space – Allowing special teddys/dolls in the bed with the child.
Social Sense – young people with autism may have difficulty understanding why and when they need to sleep. Problems with ‘social cueing’ (learning why and in what order things should happen) , visuals and developing a daily pattern will help.
Play in the bedroom during the day, and build up the amount of time the adult is away from the child , take breaks away from the bedroom
Try some games like a treasure hunt, making the activity more difficult over time so that more and more time is spend in the bedroom
Spend time in the room when it is dark and think about the environment, are there shadows and noises which might be a bit scary
Talk about fears, talk about worries, taking small steps to build confidence. Try working on these in daylight first. Sleeping is very difficult when you feel afraid. Understanding worries from the child’s perspective will help to understand a bit more about why they can’t sleep.