In trying to understand why a child or young person may be having difficulty sleeping, think about the following:
- Think about whether the child is getting enough sleep.
- Think about what the child/young person has gone through recently in their lives. Have there been any unusual or upsetting events, for example a family bereavement, parents separating or other losses like the death of a family pet.
- Has the child/young person had any traumatic experiences recently, for example, being abused, a fire or domestic violence.
- Think about the actual physical environment the child is in:
- is it warm enough?
- is it safe?
- is it too light?
- is it too dark?
- is the bed comfortable?
- is there enough fresh air?
- is it too noisy?
- Think about the child/young person’s favourite evening activities. Some activities act as stimulants that can interfere with or prevent sleep, for example, watching an exciting TV programme or playing computer games.
- Think about what the child/young person is eating and drinking during the evening. Some food and drink items act as stimulants that can interfere with or prevent sleep, for example: caffeine as in coffee or cola; additives in some foods; and for older adolescents, nicotine or alcohol.
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When a young person is not sleeping well, it commonly affects the sleep of those who care for them. This can lead to irritability and expressions of anger which are not often helpful in settling the young person. On the other hand, becoming over-sympathetic to the young person’s fears can lead to them getting worse. Managing your own emotional response effectively during the night is best achieved by understanding your feelings about the situation.
For more advice, see section on being aware of yourself and your own response.
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- Establish a bedtime routine. This should be pleasant and calming. It could involve, for example, a warm bath or shower, a light supper, a warm drink or reading a story in bed.
- Remove or unplug televisions or computer games. This prevents the child being distracted from sleep by these items.
- Find out if there is any reason that the child is fearful of going to bed, for example they may be frightened of the dark.
- If the child is frightened of the dark, talk to them about ways of helping them overcome this, for example by using a night light in their room or leaving a hall light on.
- Introduce a behavioural reward system e.g. a star chart. For more information, see section on behavioural techniques.
- Notice if there are occasions when the child does go to bed more normally. See if there are things that you and others are doing at these times that you could repeat to increase the chances of success. For more information, see section on solution-focused techniques.
- It could be that the child is gaining some advantage by not going to bed, such as getting some one-to-one time with adults. If you think that this may be the case, make sure that the child’s needs are met outwith the bedtime routine, for example, set aside some 'special time' with the child earlier in the day.
- Be firm, but reassuring.
- Insist that the child must return to their bed or stay in their bed.
- Find out if there is an obvious cause for the child waking up, for example are they hungry, thirsty, cold or hot?
- Find out if they are having nightmares.
- Introduce a behavioural reward system, e.g. a star chart. For more information, see section on behavioural techniques.
- If you are trying to solve this problem night after night, try and make sure that you are gradually increasing the physical distance between yourself and the child when you are reassuring them.
- Avoid returning to the child’s room every time they wake and call out.
- Make sure that you are not inadvertently giving the child attention by responding to their every wish.
- By not responding immediately, it gives the child an opportunity to fall asleep and also gives them the message that you will not respond immediately.
- Avoid taking the child into your bed because this could become a pattern that is hard to break.
- Notice times when the child does sleep right through the night. See if there are things that you and others are doing at these times that you could repeat to increase the chances of success. For more information, see section on solution-focused techniques.
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- If the lack of sleep is causing persistent problems and the carer or child/young person is deeply distressed by it.
- If the prolonged lack of sleep is causing the child/young person to become unwell or to fall behind at school.