If you feel that your child is the Energizer Bunny and never wants to go to sleep, you are not alone. Many parents and caregivers struggle to get their children to sleep. And for some children, staying asleep in their own beds is also a problem. Over the last 23 years, I have seen numerous families that are at their wits’ end and exhausted in trying to figure out how to cope with children who resist sleeping.
Chronic sleep deprivation takes its toll not only on children but also on the whole family. It is a well-researched fact that having adequate quality and quantity of sleep is crucial for the growth of children and their long-term mental health. Children who do not get enough sleep will have difficulties with executive functions such as planning, organizing, working memory, being flexible, or paying attention which all impact negatively on academic performance. These children will also have a harder time regulating their own behaviours (Edwards, 2019). Research also shows that children who have different mental health conditions such as Attention Deficit Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD) also have a higher level of sleep problems affecting daily behavioural and functional abilities and negatively impacting on these children’s quality of life (Craig et al., 2017; Valicenti-McDermott et al, 2019).
How Many Hours of Sleep Do Children Need? 
| Child’s age | Recommended sleep time in 24 hours |
| Infants 4 to 12 months | 12 to 16 hours including naps |
| Children 1 to 2 years | 11 to 14 hours including naps |
| Children 3 to 5 years | 10 to 13 hours including naps |
| Children 6 to 12 years | 9 to 12 hours |
(American Academy of Sleep Medicine, 2016)
More than 15% of Canadian preschoolers are not getting adequate quality or quantity of sleep (McCabe, 2019).
Sleep Hygiene – What is it?
Sleep hygiene is a term used to describe a set of activities that are completed to enhance the quality and quantity of sleep. These include following a consistent bedtime routine, setting up the environment for sleep, ensuring adequate physical activity, nutrition, and hydration are obtained earlier in the day, limiting certain foods or drinks or activities nearing bedtime, and obtaining therapeutic support to address physical or mental health concerns related to sleep.
Factors that Contribute to Better Sleep
1. Consistent Use of a Bedtime Routine
It is important to establish a bedtime routine that includes a calming, step-by-step plan to follow every night. This may include having a small snack, bath time, brushing teeth, toilet time, then reading a story in bed followed by good night hugs and kisses and lights out. Try to keep bedtime at the same time every evening, even on the weekends. Using a visual picture routine can also support a child’s awareness of the steps that will happen before bed.
2. Avoid Eating or Drinking Large Amounts before Bed
Caregivers will commonly provide a snack to their children before bed as a way to provide comfort and settling in for the night. Remember that a snack is a small portion and not a full meal. Digestion of large quantities of food at bedtime can disrupt sleep patterns and can also lead to gastric reflux. If you are providing a snack before bedtime, try to keep it healthy, simple and small. Also, drinking large amounts of fluids immediately before bed will also contribute to waking up to use the washroom in the middle of the night. If your child has issues with bed-wetting, consider how much fluid she or he is taking in right before jumping into bed.
3. Reduce Caffeine Consumption
Drinking caffeinated soda pop or eating a chocolate bar close to bedtime may be the culprit in your child’s sleep disturbance. Monitor how much caffeine your child is consuming throughout the day and try to limit this at least 4 hours before bedtime.
4. Increase Daytime Physical Activity
Ensure that your child is exercising daily through playing at the park, running around in the yard, jumping on a trampoline, swimming, biking etc. If your child doesn’t like to go out, try to be creative with increasing physical fitness in the home. Sometimes this may mean that limiting the child’s access to video games, iPads or other technology may be necessary in order to engage the child in other forms of physical activity. However, avoid intense physical activity immediately before bed as this can prevent your child from falling asleep.
5. Remove Access to Technology at Bedtime
Having cell phones, iPads, tablets, laptops, gaming systems and televisions available in a child’s room make winding down for sleep extremely challenging. Technology is very stimulating and wakes up your child’s brain. Not only does the blue light from screens interfere with being able to fall asleep due to this brain stimulation, but many children also have difficulty putting their technological devices away. It is recommended to remove technology from your child’s bedroom in order to promote healthy sleep hygiene.
6. Create a Relaxing Sleep Environment 
Have you ever tried to sleep in a room that was too hot or beside a gurgling water heater? Consider the different aspects of your child’s room that may be preventing your child from dozing off into dreamland such as lights, sounds, the temperature, the comfort of the mattress and pillow, the fabric of the bedding used, etc. Sometimes, having a library full of wonderful books and bins of exciting toys is enough to keep a child awake well beyond bedtime. Create a room that is slightly cool, dark or dimly lit using a night light if necessary, using a fan for white noise, covering windows with dark curtains to block out light, using bedding that feels good to the child, for example, consider the weight and texture. Remove toys or items that may be highly engaging or irresistible to your child to promote a more relaxing sleep environment.
7. Teach the Child to Self-Soothe 
In order to fall asleep, it is necessary to feel safe, secure, and at ease. Many children rely on their caregivers to provide this kind of support by giving night time cuddles, laying down with them to fall asleep, holding, and sitting with them until they fall asleep. Gradually, most children will mature out of this need. However, some children truly resist falling asleep alone. Each child is unique and has individual needs and abilities when it comes to self-soothing.
If you are struggling with trying to get your child to fall asleep alone, yet you know your child is safe and secure, you may want to speak with one of the clinicians at KIDTHINK to learn how to promote your child’s independence in falling asleep.
Written by:
Tamara Rogers, MSc., BMR(OT), OT Reg. (MB)
Outreach Clinician, KIDTHINK
MORE COMMON THAN YOU THINK
- 1 in 7 children suffers from mental illness in Manitoba (Chartier et al., 2016).
- 70% of mental health problems have their onset in childhood or adolescence (Government of Canada, 2006).
There Is Hope The good news is that mental illness can be treated effectively. There are things that can be done to prevent mental illness and its impact and help improve the lives of children experiencing mental health concerns. Early intervention is best.
How KIDTHINK Can Help
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References
Chartier M, Brownell M, MacWilliam L, Valdivia J, Nie Y, et al. (2016). The mental health of Manitoba’s children. Winnipeg, MB. Manitoba Centre for Health Policy.
Craig, S., Weiss, M., Hudec, K., and Gibbons, C. (2017). The functional impact of sleep disorders in children with ADHD. Journal of Attention Disorders, 1-10.
Edwards, Kristin, ‘Promoting Healthy Sleep Practices Among Parents of Young Children: A Preliminary Randomized Control Trial’ (2019). Graduate Theses and Dissertations. https://scholarcommons.usf.edu/etd/8022
Government of Canada. (2006). The human face of mental health and mental illness in Canada. Minister of Public Works and Government Services Canada. Retrieved from https://cpa.ca/docs/File/Practice/human_face_e.pdf
McCabe, Stephanie, ‘Supporting Sleep Hygiene in Preschool-Aged Children: Parent and Early Childhood Educators Role in Supporting Sleep Hygiene in Preschool-Aged Children’ (2019). Masters Thesis, Mount Saint Vincent University.
Valicenti-McDermott, M., Lawson, K., Hottinger, K., Seijo, R., Schechtman, M., Shulman, L., and Shinnar, S. (2019). Sleep problems in children with autism and other developmental disabilities: a brief report. Journal of Child Neurology, 1-7.
