Because we can accidentally ‘train’ our bodies to have problems falling asleep, it is very important to practice good sleep hygiene to prevent this unintentional ‘bad’ learning from occurring. Children with ‘leaky brakes’ may have bodies that are more susceptible to this kind of learning. Good sleep hygiene can also make it easier for children who  are biologically predisposed to sleep difficulties to adapt to regular sleep schedules. Below are a number of ways to improve sleep hygiene. At the end of this handout is a checklist with further ideas to assist you.

So let’s give them a brake

Keep a regular sleep schedule. Don’t vary bedtime/wake-up times by more than 1 hour even on weekends, and stick to a set routine. Do the same things in the same order every time – you might even want to create a ‘script’ together so the words you share when your child is in bed are the same each night. Structure, as a general rule, is always very helpful for children with ‘leaky brakes’ – it fosters a predictability in their lives (and therefore a feeling of control) that can be otherwise lacking given their poor control over their own bodies, attention, emotions, and thoughts. This schedule should have a child in bed before 11 p.m. and up before 8 a.m.

No naps during the daytime.  Instead, wear them out during the day.  Regular  exercise is a good way to accomplish this. Physical activity at any time in the day is good (even in the evening), as long as it is not right before bedtime as this will raise your temperature and awaken your body. To fall asleep you need your body temperature to lower instead. One thing we know about the body is that it automatically lowers its temperature (making you feel drowsy) 4-6 hours after you exercise.  Therefore, by getting the blood pumping through some sort of activity 4-6 hours before bedtime, we can get our bodies to naturally prepare us for sleep right when we want them to!

Beds are for sleeping in! The bed should be used for sleeping only – this will actually teach the child’s body to prepare for sleep as soon as you are lying in this place and at this time. Lying in bed for hours reading or eating confuses your child’s body, because now a variety of activities (some involving powering the body up, some involving powering the body down) are now linked to the bed. If the child frequently plays in his/her bed, this can even train the child’s body to link activity with beds, meaning that (s)he will become stimulated rather than relaxed when (s)he lies down!

Stimulation is bad! In order to allow the body to shut down, sources of stimulation need to be avoided in preparation for bedtime. Avoid fights shortly before lights out.  Caffeine  is a stimulant, and so colas, Mountain Dew, teas, coffee, or chocolate in the late afternoon or evening should not be permitted. As a rule of thumb, eliminate these items from the child’s diet 6 hours before bedtime; no big meals should be eaten right before bedtime either. Finally, is the room too loud or too bright for the child to fall asleep? Remember that your child may have ‘leaky brakes’ over his/her senses, and so sounds and/or light in the room that wouldn’t bother you will prevent your child from falling asleep. Finally, dimming the lights an hour before bedtime is a good strategy regardless of whether you have ‘leaky brakes’ over your senses – doing so has a direct effect on the pineal gland which secretes a pro-sleeping hormone!

‘Graduated Extinction’. Decide how long you are going to wait before you check in on your crying child, and stick to it. Don’t pick your child up or otherwise reward your child for those behaviours – just go ‘in and out’ long enough to ensure everything is all right. Increase this amount of time each night over many nights. Because this plan means  that no one sleeps well for a few nights, you might choose a weekend/holiday to start using ‘graduated extinction’.

Bedtime Fading. Put some reverse psychology to use. “You wanna stay up? Fine –  stay up reeeally late”! Keep the activities boring (“this is what adults do when they stay up late”) and keep the child awake until they’ve gone through the bedtime routine and been put into bed at a time that is 30 minutes past when they would naturally fall asleep. The child is tired enough that putting him to bed is not a battle – and no fights equal no extra stimulation! Over time, this ‘re-trains’ your child’s body that bedtime is a time of relaxation and the bed is a source of relief for their exhaustion. Once this occurs, the bedtime can be inched back slowly (15 minutes at a time) and eventually to the desired time (or at least a time where the child still seems well-rested in the morning). It is worth emphasizing that this is not intended to ‘trick’ the child, but his/her body instead!

More reverse psychology.  Oftentimes it is the stress around wanting to fall  asleep that ironically causes people to have problems falling asleep. They are trying too hard! One way to take the stress out of the equation is to emphasize staying awake instead. Have the child prepare for bed and get settled in, and then tell them how important it is for them to not fall asleep.  It removes the pressure, and sometimes this is enough!

What if my child has Tourette Syndrome? If your child experiences painful tics, a massage or warm bath/shower may help to relax his/her body. If muscles are chronically tight due to long-standing tics, chiropractic care may be necessary to correct any subluxations and allow the body to be ‘re-trained’ how to relax.

What if my child is Obsessive-Compulsive? Does your child complain that his/her head won’t stop long enough for him/her to get to sleep? One technique to experiment with is the use of a TV in the bedroom. Sometimes a television program can serve as  a distracter long enough for the child’s body to relax and drift off.

For this strategy to work, certain components are very important:

  • Use a television equipped with a timer that can be set to turn off after a specified time period (e.g. an hour). That way the child is not awakened later in the night by the noise. If this technique works for your child, the amount of time the TV is left on can be reduced.
  • Choice of show is crucial: it should be a low-stimulation show (i.e. without lots of explosions and excitement). It should also be very predictable, either because the structure of the show is always the same (like the way Law & Order always follows the same formula), or the content is familiar (a show or episode  watched repeatedly). Knowing what’s coming next in the show is, in itself, comforting, and contributes to relaxing the child.

What if my child has Attention-Deficit Hyperactivity Disorder? Allow the need for longer-than-usual routines. Given the problems children with ADHD can have around regulating their energy levels, it is more important to ride their ‘waves’ (when their  energy is low and they are nodding off, don't re-arouse them by running them through a routine). If your child is on a stimulant medication, be aware that certain dosages at later points in the day can interfere with sleep. Be sure to speak to your physician and/or pharmacist about the appropriate administration of this drug.

Added bonuses – better brakes, fewer headaches! One way to avoid power struggles around the use of these techniques is to let children know “what’s in it for  them”. Arguments around lights out can easily look to children like just another way an adult is telling them what to do. Assure them that this isn’t the case – not only will their brakes work better the next day the longer they sleep (like a battery being recharged), but recent research suggests that using good sleep hygiene can reduce the frequency and duration of migraine headache episodes (Bruni, Galli, & Guidetti, 1999).

A final point: for the child who is genetically predisposed to sleep difficulties, these techniques do not “cure” the problem. Rather, they create an environment that allows the child to sleep in a regular schedule despite their natural tendencies. Light bulbs will shine brightly until they burn out, as that is how they are designed to be – only by attaching them to a timer will they follow the schedule we set without need for intervention. For this reason, you should not be surprised if problems re-occur after some sort of disruption in the schedule (due, for example, to an illness or a vacation).  Think of that disruption as being like a power outage on the timer – just as the light bulb would revert back to its natural tendencies, so do these children. We must simply reset the timer before we can expect the light bulb (or the child!) to again follow the schedule we desire.

If you’d like more detail than what is provided here, a good book to read is Sleep Better! A Guide to Improving Sleep for Children with Special Needs, by Dr. V. Mark Durand, Psychologist.