Strategies to Improve Sleep in Children The Autism Speaks Autism Treatment Network and Autism Intervention Research Network on Physical Health published a free parent's guide to provide strategies to improve sleep. The guide is particularly aimed at children with autism spectrum disorders (ASD), but it is relevant for all children. Children with ASD frequently have difficulty with sleep. As discussed in the previous post, sleep problems may arise from health issues (digestion or bowel, breathing problems), from “body rhythm” problems (difficulties calming down at some times during the day), or from wanting to be part of the action or to be with the parents. Management of sleep involves: 1) providing a comfortable sleep setting, 2) establishing regular bedtime habits, 3) adjusting daytime eating and activities, and 4) teaching the child to sleep alone. Provide a Comfortable Sleep Setting: Take note of what works for your child. Make sure the room is the right temperature (not too hot and not too cold), has at least some light, and is quiet. If your child has irregular sleep patterns, write down what things were like in the room each night for a week or two to see what the room was like on the good nights. Consider changing curtains or shades or adding nightlights to get the lighting right. Avoid TV or radios just before sleep. Some children like constant low noise in the background (such as from a fan or air filter). If your child has sensory sensitivities or "body rhythm" problems, these sleep setting factors are particularly important to address. The fabric of the sheets and blankets and their weight on the child may make a difference as well. Establish Regular Bedtime Habits: The parent guide mentioned above gives several recommendations about setting up a routine. It also presents an example of a visual schedule to post in your child's room to review and follow each night (displayed above). They suggest starting the routine 15 to 30 minutes before the set bedtime. To reinforce the schedule, some favored activities (books, toys/stuffed animals) should be available just at that time. Adjust Daytime Eating and Activities: Avoid letting your child have caffeinated beverages or foods (e.g., chocolate, coffee, tea, colas) several hours before bedtime. Avoid large snacks and lots of liquids just before bed. Exercise during the day helps your child sleep better at night, but the exercise should not be too close to bedtime. Exercise and TV can make children more alert. Teach the Child to Sleep Alone: Teaching your child to got to sleep alone in the evening, or after awakening during the night, takes patience and should be done gradually and over a few weeks' time. You should wait increasingly long before going into your child’s room, spend increasingly less time in the room with your child, and pay less attention while in there. Similar techniques should be used at bedtime, during the night, and when the child awakes up too early. Importance of Data Collection: Trying to control all of these factors at once may overwhelm you. You don’t have to change everything at once. Keep track of what you've done so that you can be consistent. SymTrend Sleep and SymTrend ADL can help you keep track of these factors and will generate reports to show you how effective changes you are making have been.