I cannot stress enough the importance of good sleep hygiene and relaxation skills. Children with neurobiological disorders are often stressed - as they struggle to control their behavior, "fit in," and try to keep up with their schoolwork. They may also suffer from sleep-related side effects of medications that they are taking. Medications to treat mood disorders, stimulant medications used to treat attention deficit/hyperactivity disorder and some of the medications used to treat tics in Tourette's syndrome can all contribute to sleep problems.
If sleep problems continue to plague your child, work with your physician. Consider alternative therapies such as nutritional and dietary supplements, biofeedback and Chinese medicine. This is likely to be an adjunct to the care provided by your child's primary-care physician. To ensure maximum benefits and avoid any negative interactions between traditional medication and alternative remedies, be sure that all of your child's health-care providers work together. When you find the right healing modality for your child, you are likely to see a big improvement.
All children do best with healthy sleep habits. However, everything needs to be "buttoned down" if your child has special needs. For instance, while many children would have some difficulty settling down after a stimulating evening, it might cause a child with a neurobiological disorder to be up half the night. And while a consistent bedtime is always recommended, a child with autism is likely to feel very unsafe and unsettled if his bedtime routine is disrupted. For many children, it's as if their reactions have been cranked up to full throttle. Of course, each child is different and you will know best what sets off a problem in your own child. However, in general, the same rules apply - only more so.
Tips for a Good Night's Sleep
- Avoid late afternoon or evening caffeine and sugar consumption. (Sodas are usually a huge source of both sugar and caffeine.)
- Avoid eating dinner later than three hours before bed if it seems to energize your child. (Eating too late at night raises the metabolic rate and energizes some children.) If your child has a bedtime snack, have it half an hour to an hour before bed.
- Limit overstimulation. Limit television and video-game playing as well as reading an especially exciting book before bed. Play beautiful, soothing music of your choice to help calm and relax your household.
- Have a quiet period just before bed. An easing-off period is important because most children have trouble going from full throttle to sleeping peacefully.
- Have an evening bedtime snack that contains tryptophan. Tryptophan is an essential amino acid that the brain converts into melatonin, which assists in sleep. Many children find a glass of warm milk calming and it is a good source of tryptophan. Other sources of tryptophan include cottage cheese, yogurt, pineapples, plums, bananas, eggs, turkey, sesame seeds, sunflower seeds, cashews and peanuts. It's best to combine these tryptophan rich foods with complex carbohydrates like whole-grain cereals, bread or potatoes; it helps the brain to absorb the tryptophan. Bedtime snack suggestions: whole-grain cereal with milk, oatmeal with milk, peanut butter sandwich with ground sesame seeds, oatmeal cookies with milk.
- Give your child a ten minute warning before it's time to get ready for bed to help him make the transition and finish up what he is doing.
- Have a consistent bedtime and a consistent bedtime routine. A warm bath is particularly soothing for most children because it relaxes the muscles and gets their bodies ready for rest.
- If your child is overly sensitive to light or sound, keep the lights dim and speak quietly throughout the bedtime routine.
- Teach your child relaxation techniques such as those described in The Floppy Sleep Game Book.