Sleep difficulties

Children with special needs or a disability (for different reasons) are much more likely to have problems with sleep than other children. Without specialist support, sleep problems can continue for years. Sleep deprivation not only affects a child’s learning, behaviour, mood and health but also the physical and mental well-being of the whole family.

If your child is under the age of one, night waking is common and babies often wake frequently to feed.

The Infant Sleep Information Source www.isisonline.org.uk/ gives information about typical sleep patterns for children.

Some sleep problems are common with certain impairments, so you need to take account of your child’s diagnosis. But the large majority of sleep problems are behavioural or down to the child's environment and routine - so there's a lot you can do.

How to create a better sleep environment

Bedroom environment
Environment is one of the common reasons children have difficulties sleeping.

Room temperature
Is your child too hot or too cold? Ideally the temperature in the bedroom should be between 16–18 C.

An over-stimulating bedroom
Does your child get out of bed to play with toys? If so, your child may be over-stimulated by the bedroom environment. Bright colours are often stimulating to children. You will need to consider creating a restful bedroom environment. It’s important that your child’s bedroom is a calm and suitable environment for them to get to sleep in.

Screens
Is your child playing computer games or watching TV before they go to bed? Light from screens - such as tablet computers, mobile phones and TVs - blocks melatonin production. Melatonin is a natural hormone in the brain which regulates sleeping and waking hours. It is best to not use screens the hour before bed.

Comfort
Is their bed comfortable? Try lying on it and seeing how it feels. Is your child wet or soiled? This will cause discomfort which could impact on their ability to sleep.

Bedding
Is your child kicking the bedding off during the night and waking because they are cold? If so, you can consider using a double duvet tucked under the mattress of a single bed. Or are they too hot or too cold, think about what you are experiencing at night time. If you are sleeping with just a sheet on, and your child has a heavy duvet, they could be getting too hot.  Please be aware: duvets are not recommended until your child is over one year. It is safer to buy a lighter weight duvet for a younger child, then a really heavy one.

Noise                                                                                                                       Is there any noise inside or outside the home that may be disturbing your child? Some children with sensory issues, such as autistic spectrum disorders, can be particularly sensitive to noise. What may seem like a quiet sound to you can seem very loud to them. The noise of an electric fan can mask other noises in your home and may be worth considering if noise is an issue.

Light
Is the room dark enough? Melatonin is produced when the room is dark. You might consider buying black-out blinds to make the room darker.

Hunger
Could your child be hungry? What time are they having their tea-time meal? Does their meal-time need to be later? Giving your child a snack mid-afternoon can help if you want to try moving their meal-time to later in the day.

First Steps Nutrition Trust - Eating Well Resource

Thirst

Is your child using ‘I’m thirsty’ as a distraction technique, or are they genuinely thirsty? Monitor what they are drinking during the day and give them a drink with their bedtime snack. If your child is breastfeeding we encourage you to continue breastfeeding as long as you wish. However, formula or cow’s milk is not recommended after the age of one, at night-time. Try offering water at night time instead in a cup.

Lack of understanding about day and night
Does your child understand the difference between day and night? Sometimes children with additional needs require help to learn when it’s daytime and when it’s time to sleep, particularly if they have a visual difficulty. Tried and tested strategies can help with this. The same sequence of events should happen every night. Visual or other timetables can help a child understand the order of events and what is going to happen next.

Bedtime routine
Does your child’s bedtime routine encourage sleep? Has their routine become unsettled lately because of an event like a family holiday or Christmas? Are you using visual props or time table to inform your child its bed time e.g. dinner’s finished now bath time and then sleep time?  Do you do the same thing with your child at the same time every night?  Do you introduce calm activities 30 minutes before bed time e.g. looking at books?

Getting up too early
If your child wakes in the night do you treat it as a night awakening, or as the start of the day? You should consider what is a reasonable time to begin the day. If your child wakes before that time, return them back to their bed. This will help to strengthen their body clock.

Pain
Is your child in pain? Could they be teething? Some disabled children cannot reposition themselves at night which can disrupt their sleep. If you think that your child may be in pain you should seek advice from medical professionals.

Medication
Is your child on any medication that may affect their sleep? Or do they have to be given medication during their sleep which may be disturbing them? Check with a medical practitioner if you are unsure.

Daytime sleeps 

What happens to your child in the daytime can affect how your child sleeps at night.  How long does your child sleep during the day? Do you have set times for sleep during the day? Does your child have the day time sleep late afternoon, early evening? If so, it may be worth making the day time sleep a little earlier.

Services that can offer support

For children under 5 the health visiting service can help. Contact them here

The school nursing service will also help children age 5-19 contact them here

Cerebra and Scope offer sleep support and information on sleep issues for disabled children and young people.

The national autistic society have a information on strategies that can help with sleep issues for those with autism spectrum disorder as do Autism speaks

If your child has a complex medical condition then talk to their neurologist or paediatrician especially if they are on medication as these maybe affecting their sleep.

If your child has physical difficulties that affect their sleeping positioning then they may be recommended to use a postural sleeping system.  In Hounslow this will be provided by the wheelchair service. A referral will need to be made by another health professional, such as Physiotherapist or Occupational therapist.