May struggle to settle or fall asleep.

 

1. Develop a positive bedtime routine that involves calm enjoyable activities in the 20 minutes or so before bed.  You can use this routine wherever you happen to be.

2. Set a regular, age-appropriate bedtime.  It should be when you know they will be sleepy, but not overtired.

3. Make sure you give plenty of warning that bedtime is approaching.  If they struggle with transitions, they may become upset if you suddenly decide it’s time for bed. 

4. Use Visual Schedules to add structure and predictability through preparation.  This may include ‘now’ and ‘next’.

5. Use Visual Schedules to break bedtime down into steps.

6. Use a Social Story™ to explain the need for sleep.

7. Be consistent in how you give warning that bedtime is approaching.  You could use a cue like a clock or visual schedule to indicate that it’s nearly bedtime.

8. Perhaps include a bath, yoga, relaxation or warm drink as part of your bedtime routine.

9. Avoid caffeine before bed.

10. Avoid hyperactive play 1 hour before bed.

11. Avoid TV, computer etc for 1 hour before bed, if appropriate.

12. If they won’t fall asleep without a particular object – for example, a toy, special pyjamas or pillows – try to think of ways to vary this.  It may help to gradually introduce new items at bedtime.  This might stop them from relying on just one item.

13. It may help to discuss their worries before bed to reduce any anxiety.

14. Ensure the sleep environment encourages sleep.  This may mean a cool, dark and quite room.  However, some individuals will not be able to settle without a nightlight.

15. Try a weighted blanket, compression sheet, bed tent, sleeping bag, a nightlight, music, white noise etc to help them feel more secure when they are trying to fall asleep.

16. If they get out of bed, quietly and calmly put them back in to bed.  You might need to do this many times, especially if you’re trying to develop a new bedtime routine.

17. Ensure any daytime naps are early in the day.

18. Encourage daily exercise as this aids sleep.

 

May wake repeatedly or struggle to fall back asleep once awake.

 

1. If they get out of bed, quietly and calmly put them back in to bed.  You might need to do this many times, especially if you’re trying to develop a new bedtime routine.

2. Ensure the sleep environment encourages sleep.  This may mean a cool, dark and quite room.  However, some individuals will not be able to settle without a nightlight.

3. Try a weighted blanket, compression sheet, bed tent, sleeping bag, a nightlight, music, white noise etc to help them feel more secure when they are trying to fall back to sleep.

4. Use a gro-clock so that they are able to visualise what time of day/night it is.  This may help them understand when they should be awake.

 

May not understand the need for sleep.

 

1. Use a Social Story™ to explain the need for sleep.

2. Use Visual Schedules to add structure and predictability through preparation.  This may include ‘now’ and ‘next’.

3. Use Visual Schedules to break bedtime down into steps.

4. Be consistent in how you give warning that bedtime is approaching.  You could use a cue like a clock or visual schedule to indicate that it’s nearly bedtime.

5. Make sure you give plenty of warning that bedtime is approaching.  If they struggle with transitions, they may become upset if you suddenly decide it’s time for bed. 

6. Use a gro-clock so that they are able to visualise what time of day/night it is.  This may help them understand when they should be awake.

 

May struggle with sensory issues at bedtime.

 

1. Ensure the sleep environment encourages sleep.  This may mean a cool, dark and quite room.  However, some individuals will not be able to settle without a nightlight.

2. Block out any unnecessary noise by having thick carpets, turning off appliances, using earplugs or headphones.

3. Remove labels from bedding and night clothes, or try bedding and nightclothes made from other more comfortable materials.

4. Reduce smells coming into the room by closing the door fully, or by using scented oils that the person finds relaxing.

5. Remove distractions, such as toys on the bed and pictures on the wall (unless the person finds these relaxing), and consider calming plain colours on the walls.

 

May struggle to sleep alone.

 

1. Encourage them to fall asleep in their own bed.  You could do this by gradual retreat sleep training.

2. Try a weighted blanket, compression sheet, bed tent, sleeping bag, a nightlight, music, white noise etc to help them feel more secure when they are alone.

3. If they get out of bed, quietly and calmly put them back in to bed.  You might need to do this many times, especially if you’re trying to develop a new bedtime routine.

 

May oversleep.

 

1. Ensure they are getting enough sleep by having a structured bedtime and waking routine.

2. Set a regular, age-appropriate bedtime.  It should be when you know they will be sleepy, but not overtired.

3. Ensure the sleep environment encourages sleep.  This may mean a cool, dark and quite room.  However, some individuals will not be able to settle without a nightlight.

4. Encourage daily exercise as this aids sleep.

 

May overheat during sleep.

 

1. Use less layers, this may include short sleeved pyjamas, thinner duvets/blankets.

2. Leave windows on vent at night (if appropriate) or during the day if not able to at night.

3. Make sure there is plenty of ventilation or try a fan (if appropriate).

4. Include a luke-warm bath as part of their bedtime routine.

 

Additional Support

 

1. Keep a sleep diary.  This may help you identify any patterns or factors that may be affecting sleep.

2. Check that there are no medical issues that may be affecting sleep.  This may include epilepsy, anxiety, breathing issues, stomach issues, parasomnias, insomnia.  Please see a doctor for further advice on these issues.

3. Check with a doctor whether they may have problems with their body clock or lack of melatonin (the sleep hormone that regulates the sleep cycle).

4. Check that there are no medicines that they may be taking that are affecting their sleep.