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Sleep Solutions

August 2016

Sleep Solutions – Part 1

Ensuring that your child gets enough sleep every night can be a huge challenge, and we all know how incredibly cranky and difficult our children can get when they haven’t gotten enough sleep. The behavior problems associated with not getting enough sleep are well-documented, but we only need to think about how we feel when we don’t get enough sleep to understand the impact of sleep-deprivation not only on behavior but also on emotional well-being and even learning potential in school. Most children need at least 9 ½ hours of sleep every night to be at their best. Let’s start off the beginning of this school year maximizing the chances that your child can get a full night’s sleep.

The Bed-Time Routine:
The Bed-Time Routine is crucial to helping your child settle down and get ready to go to sleep, however, many parents find this to be a time of huge battles – which of course has the opposite effect! Start thinking about bed-time long before your bed-time routine should start. Consider what kinds of activities your child is engaging in just before bed-time. Good choices are calming activities such as sitting and watching a television show or part of a movie, doing homework (as long as this isn’t another battle your child engages in), taking a walk, or playing quietly (dolls or legos). When it comes time to start the bed-time routine, make sure that your child has had fore-warning that bed-time is coming. Do not fall into the trap of allowing just a few more minutes before starting to get ready for bed because this will set you up for major resistance. If you’ve already fallen into that habit, explain to your child that you are starting a new bed-time routine, and that they will need to stop whatever they are doing at the designated time every night – but make sure you can offer something fun and rewarding for after they’ve gotten ready for bed. This might be in the form of a fun but calming activity at the end of the bed-time routine, or it could be a reward that your child gets for getting ready for bed without problems (be sure that you have clearly defined what “without problems” means). As you plan out your bed-time routine, note that it should not be long and drawn out. Twenty minutes or less should suffice, although of course you can make it whatever length works for you and the various tasks that are part of your bed-time routine. Key components of the bed-time routine must include: a) brush your teeth; b) put on your pajamas; c) go to the bathroom. At the end of your bed-time routine, it is nice to have some quiet parent-child connection time, preferably while your child is laying in bed, either by reading a book, writing in a journal, or just snuggling together. These activities should be time-limited, especially the snuggle time. The most important thing about the Bed-Time Routine is that it happens in the same order and at the same time every night, with only a few special occasion exceptions.

Sleep Solutions Part 2

Staying in Bed After “Lights Out”:
Children often don’t want to stay in their bed after “Lights Out” for two primary reasons. The first primary reason kids get out of their beds is that they want to play instead. The second primary reason is that they are anxious. In either case, it is important to be really clear that if they get out of bed, there will be a consequence that they do not like. Time-Out is my preferred disciplinary consequence, and it works really well at night when kids especially hate sitting in the hall all by themselves. At the same time, you want to address their needs – so – make the right thing easy and the wrong thing hard. Give them something acceptable that they can do in bed, like playing with their stuffed animals (as long as they don’t talk loudly to them) or reading a book (using a book light, not a table lamp or overhead light). Whatever it is, it should not be anything too terribly exciting. For children with anxiety, you can also help them relax in preparation for sleep by practicing relaxation and mindfulness strategies. Ample resources are available on-line, in books, and upon the advice of therapists. For kiddos with anxiety about being alone in bed, you may need to implement a “Check In” plan where you check in at first frequently and then with decreasing frequency and proximity over the course of a few weeks. You can also give your child the option to get out of bed ONE TIME when he really needs to. This “Get Out of Bed Free” card allows him to get up one time to go to the bathroom, get a drink of water, or come see you wherever you are without penalty of going to Time Out. Many children will carefully save their nightly “Get Out of Bed Free” card in case of a time when they really need it – but if your son uses it every single night without fail, you can consider weaning him down to 5 cards a week, then 3, and finally just 1 card each week. You may also want to consider a reward or celebration when he has stayed in bed and fallen asleep on his own for so many nights in a row.

Sleeping in Her Own Bed:
Getting your child to sleep in her own bed after a life-time (hers anyway) of sleeping in your bed can be extremely difficult. The absolute most important determinant of your success in getting your child to sleep in her own bed is your commitment to making this happen. If you are not 100% committed, you are very likely to fail. Children can sense commitment, and on this topic, they are particularly accurate at assessing how serious their parent is when they are told they can no longer sleep in the parental bed. Once you make this commitment, make a plan (with your parenting partner, if you have one) to address all of the possible contingencies. Agree on how to handle it if your child shows up at your bedside at night – which should include some sort of disciplinary consequence for getting out of her own bed. Strongly consider a reward system. Finally, institute a schedule of either laying down with your child for a while, and/or checking on your child so that she knows you are still around to make sure she is okay. Which option you choose is up to you and what will work for your child.

Check Ins

While you are working on getting your child to sleep in his own bed, stay in bed, and accept a limited time for snuggling, it may be important to provide “check ins” to reassure your child that you are still around. I recommend that you start with what you believe your child can tolerate, but then follow a plan to reduce the frequency of your check-ins until your child can independently fall asleep in their own bed within an acceptable amount of time. “Checking in” should be pretty simple and not too rewarding – standing in the doorway for a moment to see if she is awake or asleep and blowing a kiss would suffice. Actually going in to tuck her in and give her a snuggle and a smooch would probably be too rewarding and might end up extending the time before she falls asleep. Whatever you decide your procedure will be, make sure that it works for you and stick to it. If needed, you may have to stay within eye-shot for a while to reassure your child that you are still around. Gradually extend the amount of time between check-ins, and/or your distance from the doorway. As long as you do not go backwards (i.e. one night give more frequent check-ins), it is almost certain that she will begin to “require” fewer and fewer check-ins until you’ve reached a point where bed-time is now manageable.

Most people in the United States would be considered to be sleep-deprived given the current research indicating how much sleep we need to be maximally alert, productive, and agreeable human beings. One of the most important gifts that you can give your child is the ability to fall asleep and stay asleep for the length of time that they need each night. I hope that the ideas in this 2-part series help you to help your child establish good sleep habits that will last a life-time.

Dr. Teri Bullis, Ph.D., BCBAI believe that every parent I’ve ever worked with loves their child and is doing the very best that they can. But while parenting is the toughest job anyone will ever have, children don’t come with a “how to” manual. I can provide those “how to” directions, tailored for your unique child and family situation.

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