Challenges in Establishing Bed Routines with Children: 10 tips from an OT’s Perspective

One of the most difficult obstacles to overcome in parenthood is establishing a child's sleep routine. At first, newborns take several weeks to adjust to formula or breast-feeding schedules, noises, and light which are items that they didn't have to worry about so much in the womb. Over time, while parents are crossing their fingers, infants start to cut down on day-time naps and gradually shift their sleeping hours over to night time. The journey isn't easy, and parents do lose sleep over this process but it's possible for a young child to sleep throughout the night.

The National Sleep Foundation (2018) has made the following recommendations regarding sleep duration for young children:

Age Recommended May be appropriate
Infants 4-11 months 12 to 15 hours 10 to 11 hours/16 to 18 hours
Toddlers 1-2 years 11 to 14 hours 9 to 10 hours/15 to 16 hours
Preschoolers 3-5 years 10 to 13 hours 8 to 9 hours/14 hours
School-aged Children 6-13 years 9 to 11 hours 7 to 8 hours/12 hours

Lack of sleep or too much sleep can lead to functional disruptions during the child's waking hours. Symptoms can take the form of drowsiness as well as hyperactivity.  Over and over again, sleep experts reiterate the importance of children getting on decent sleep regimens to support their rapidly growing bodies. So for parents who are struggling to establish healthy sleep routines for their children, what can they do?
Below are 10 tips backed by the AOTA (American Occupational Therapy Association) for how parents can improve their children's sleeping habits:

  1. Establish a consistent time to sleep: This may take some sacrificing of out-of-the-house activities, but choose a specific time for bed and stick with it. If your child is still very young, you may need to select two or three bed-times (i.e., 9am morning nap, 1pm afternoon nap, 8pm bed-time).  
  2. Select Relaxing activities immediately before bed-time: Eliminate over-stimulating activities (i.e., jumping, running, watching television or the I-Pad) about an hour before bed-time and concentrate on assigning relaxing activities for your child (singing slow songs, coloring, reading books, etc.). Find an activity that you can observably see your child reacting to in a calming manner.
  3. Consider bed time clothes: Instructing your child to wear pajamas provides them a cue like, "Oh, it's time for bed".  Additionally, night-time clothes are usually soft material with minimal seams that allow for a more soothing sleep.
  4. Take care of bathroom needs: Prior to bed time, check with your child to see if all bathroom needs are met: teeth-brushing, potty needs, and bath-time. Some parents may try to incorporate bath-time as a relaxing activity because the warm water can cause fatigue.
  5. Acknowledge lighting: Notice what your child sleeps better with: night-light or no night-light? Lamp or no lamp? Hallway light on or hallway light off? You want to find a balance between not over-stimulating your child with light but not letting them be fearful of the dark.
  6. Noise or no noise? Some children sleep better with some white noise in the background, and others can't sleep until the entire house is dead quiet. Pick what best suits your child's needs.
  7. Pick specific bed-time toys or objects: Note: avoid letting your child bring light-up toys or I-pads into bed with them since that can contribute to keeping them up at night. Encourage the use of soothing toys like stuffed animals or small blankets. Reserve those toys specifically for bed-time so that your child has a cue he or she can count on.
  8. Create a cut-off time for foods and drinks: This goes for adults as well, but create a "kitchen is closed" policy" where your child can no longer access food or water after a certain time in the evening.
  9. Ensure a safe environment for bed time: For small children, be mindful of bedding and objects that can create a choking or suffocation hazard.
  10. Role model good sleeping habits for your child: If you model healthy sleeping habits, your child just might pick up and use those habits as they get older. Let your child know (and let them observe) that you also have a specific bed time routine and time of day in which you retire for the night.

REFERENCES

  1. How much sleep to babies and kids need? (2018). Viewed on March 17, 2018.
  2. Establishing Bed-time Routines for Children (2013). American Occupational Therapy Association. Viewed on March 17, 2018.