14 Ways to Improve Your Child’s Sleep
Monday December 20, 2021
Sleep is our superpower – consistent, quality sleep helps both mind and body function at their best. But many children struggle to sleep well, with potentially significant negative effects. Paediatric nurse and child life specialist, Cindy Pilchuk, explores simple, practical ways parents and caregivers can help children fall asleep more easily and have a restful night.
When our children are first born, as caregivers, we focus on their eating, sleeping, and pooping. It takes over our lives! Some caregivers keep logs and write it all down, some just go with the flow, and for others it can be very stressful and all consuming. Wherever we are on this spectrum, the conversations and resources available on these topics is vast and widely available…
And then suddenly… it’s not. Like somehow all these things we were so concerned about suddenly aren’t a concern, or the problems we had with them don’t occur anymore once the baby turns one year old. But you wouldn’t be reading this blog if that was true!
Today I am going to focus on children’s sleep. Anyone who has disrupted sleep knows how important sleep is for overall health and daily functioning. So, let’s dive right in to the nitty gritty of sleep – how to improve sleep, and what to do when traditional sleep supports are not enough.
How to Improve Your Child’s Sleep
Our goal for our children is to maintain good quality sleep. This means falling asleep easily, and staying asleep for long stretches throughout the night.
Factors that influence sleep are often modifiable, and can be adjusted for a child depending on their needs and preferences. When these factors are a good fit, the child is able to fall asleep within 30 minutes of being in their bed, and fall asleep without relying on a caregiver’s presence or assistance.
Sleep hygiene includes any practices (habits and activities) that promote healthful sleep, for the purpose of maintaining good health and preventing disease. These practices are an important signal for a child to begin to transition from active and alert, to calm and ready to sleep. Children will need help learning how to calm down the body and mind and prepare for sleep, and developing this skill.
Sleep hygiene is more than just a nighttime routine; it includes taking the factors that affect sleep, and translating them from theory into practice. Caregivers will choose the factors they believe will best support their child’s sleep, and are achievable within their household. Let’s take a deeper look at the factors affecting healthful sleep, which includes the environment, the child, and the caregiver.
Pay attention to the modifiable factors within your child’s environment before sleep is to occur – does the environment say “sleep”? Is it too bright or noisy? Are there distractions, like too many toys? Is the environment quiet and calm?
1. Calming the Environment
It is important to begin to calm down the child’s activity and quieten the environment 30-60 minutes before the bedtime routine begins. This might include quiet play with toys, reading stories, a feed, playing soft music, etc. and should not include screen time.
It is not uncommon for a caregiver who has worked during the day to come home in the evening and be excited to play with their child. Children need support to learn how to transition from excited to calm, and caregivers provide vital cues and education. You may want to include a calm activity at the end of your play time to support the child’s transition.
Light affects when hormones and minerals are secreted in our body. These hormones and minerals influence how our brain works – whether we are sleepy, hungry, or attentive, and how active we are. When it is light outside, we are more active. You can dim the lights and turn the TV/Media off before bedtime to help signal to your child that sleep is coming.
When we are warm, we tend to be more active, more alert, and sometimes more irritable. When we are cool, we tend to slow down or go to sleep. Our internal body temperature takes a natural dip and is at its lowest at approximately 5am, it then begins to climb as morning begins.
Keep temperatures pleasant so your child feels comfortable in their pajamas. If temperatures are too warm/hot, your child may be more restless through the night. For infants a pleasant temperature is 20-220C / 68-720F, and for toddlers and older children 16-200C / 61-650F.
4. Sound / Noise
All sounds should have a calm tone – this includes calm lullabies or music, and using a quiet tone within your voice. If a child is playing with toys before bed, ensure they do not make loud noise or have flashing lights. Even doing the dishes can make a loud, clanking noise. Be aware of the potential sources of noise, and keep them to a minimum as much as possible.
Factors that affect a child’s sleep will be as unique and individual as the child. Recognizing these unique qualities is important to support the child to obtain quality sleep, and modify the factors as appropriate.
5. Drowsy but Awake
The literature is emphatic on the importance of putting an infant or child to bed drowsy but still awake. Between sleep cycles, a child can be in a state of semi-wakefulness, open their eyes, and survey their surroundings.
If the surroundings are familiar, the child can fall back to sleep easily. If the surroundings are unfamiliar, or different from where they fell asleep (e.g. Child fell asleep in your bed, but you moved them back to their own), children will often progress to full wakefulness.
Putting a child to sleep in their bed, drowsy but awake, supports them to fall asleep without caregiver assistance, and encourages self-soothing that the child will use during night wakings.
6. Separation Anxiety
Children with higher levels of separation anxiety, beginning approximately 8 months of age, tend to have more night wakings, or a night waking that will require a caregiver’s support. A child who finds transitions and separation stressful will often also have difficulty self-soothing, needing a caregiver present to support them at bedtime and during night wakings.
If transitions between activities, and/or separation is stressful, you will need to focus on supporting your child to feel safe and secure during those times throughout the day. This will support better sleep overall.
7. Security Toy or Transitional Object
This is usually a soft toy or blanket, and serves as a familiar comfort to a child during times of transition (day to night), and separation from parents. A child who uses a comfort toy to self soothe, especially when trying to fall asleep, will also tend to use it during night wakings, instead of calling out to the caregiver.
8. Consistent Timing
Generally, timing of sleep should follow the sleep cues the child is displaying – caregivers need to be vigilant for early sleep cues. Ideally, try to keep your child’s bedtime and wake time consistent 7 days a week.
Even if a child goes to sleep late at times (maybe for a special occasion), it is important to keep the same wakeup times. This allows the child’s circadian process to adjust and fall back to its regular pattern. If the timing for sleep needs to be adjusted, you can change it by 15-20 minutes every 2-3 nights until the desired time is reached.
9. Avoid Caffeine
Caffeine is a stimulant that can delay sleep onset, reduce total sleep time, and increase the amount of REM/active sleep. Caffeine is found in chocolate, cola, and tea or coffee. To avoid the effects of caffeine on sleep, avoid caffeine intake for at least 4 hours before bedtime.
10. Avoid Screen-Time
Screen time includes the time a child spends in front of all televisions, computers, gaming consoles, smartphones and tablets. Screen times are a hot topic right now, especially since the pandemic began and our reliance on devices for school, work, and even extra-curricular activities has increased tremendously.
Although still a new topic, studies show there is a clear link between the length of time a child spends in front of screens, and difficulty sleeping. The more time spent in front of a screen, the more problems with sleep occur. From a health perspective, screen time takes away a child’s ability to be active, and to socialize in person. In addition, the lights and sounds activate and excite the brain, making it more difficult to calm the body down for sleep.
Avoid screen time for at least one hour before bed.
This is any daily activity occurring at a regular time (waking up, going to sleep, eating, and going to work, school, and play). These daily activities help to regulate our body’s natural rhythms by acting as time structures (or signals) that condition our biological clock.
Stimulating activity (activity that increases heartrate, uses loud sounds or bright lights, etc.), should be completed two to three hours before nighttime sleep. Ideally, stimulating activities and exercise should occur earlier in the day.
Overstimulation is when a child becomes overwhelmed with information from the environment (lights, sounds, scents, activity, or movement). They are not able to cope with all the information they are receiving at the same time. Children are constantly absorbing information from all their senses, and it takes them 16x longer to process this information than adults who are already familiar with their world.
Pace your activity accordingly, so that your child will have enough time to absorb all the information coming to them, and you have time to read their cues appropriately. Pacing an activity might include taking a pause every few minutes during the activity, watch your child, are they engaged in the activity, easily frustrated, mind wandering? It is really important to recognize the behaviour cues in your child. Children often become easily overstimulated when they are tired.
Sleep is deeply rooted in a social context where caregivers play a crucial role. The caregiver’s primary role is to determine the optimal amount of sleep their child requires, and sleep factors influencing the quality of that sleep. The literature is strong in stating that caregivers’ behaviours before sleep will greatly impact a child’s sleep duration, and number and duration of night wakings
The strongest negative associations with sleep problems are late bedtime, and the caregiver being present when the child falls asleep. This does not imply that a caregiver should leave a distressed child alone and ignore them. A child who is supported and guided to learn self-soothing strategies will have longer sleep duration and fewer night wakings.
When caregiver-child interactions are positive, and caregivers are focused on developing secure attachments with their child, the child will develop feelings of safety and security. This will, in turn, promote better-quality sleep.
13. Sleep Cues
Sleep cues are behaviours a child exhibits to express feeling tired or sleepy. Caregivers must be observant for these cues, and provide support in the early stages of tiredness, so the child does not become over stimulated or over tired. This will reduce the risk of the child having difficulty falling asleep, or having poor quality sleep.
14. Pre-Sleep Routines
Routines offer children the sense of predictability and security, support them through transitions from active to calm and ready for sleep, and help to strengthen the child’s circadian and homeostatic sleep processes. A pre-sleep routine is an external cue that informs a child it is time to prepare for sleep.
Pre-sleep routines in the evening should be no longer than 20-30 minutes before sleep and involve 3-4 activities that are the same every night. For example, bath, pajamas, read story, play lullabies.
Similar to a pre-sleep routine, you should also have a wake-up routine that signals to your child it is time to be alert and active. This routine can include letting light into the room, getting dressed for the day, and eating a healthy breakfast, or playing exciting music.
Trauma-Informed Sleep Supports
The principles of healthful sleep are relatively straightforward, needing attention and adaptation for the individual child. But many children with retinoblastoma experience disrupted routines, anxiety and strong emotions, and vision changes that can significantly impact their sleep.
In our next blog post on January 3rd, we’ll look at trauma-informed sleep supports for children, with practical steps you can take to help improve the amount and quality of your child’s sleep.
Join us on January 3 for a parent’s guide to trauma-informed sleep supports.
About the Author
Cindy Pilchuk is first and foremost a mother to three perfectly wonderful, imperfect children who are her inspiration and hope. After that, she is a Registered Nurse and Certified Child Life Specialist. She holds a Master’s of Science degree in Child Life and Pediatric Psychosocial Care.
Cindy has focused her entire 23 year career thus far supporting children and families to cope with stress. She has a particular interest in early brain development and attachment, and how stress and trauma effects early brain development and behaviour. For the past 13 years, she has worked as a public health nurse in the Child Health and Development division at Toronto Public Health.