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Keeping a sleep diary

When does your baby or child sleep and for how long?

What influences or interferes with their pattern of sleep?

Is the pattern repeated over successive days or weeks?

keeping a sleep diary

These are simple questions, but many parents would have difficulty answering them with any certainty, especially when they are busy and over-tired. However you will need this basic information to establish whether your child has a sleep problem and what is your best course of action.

One of the best ways to record this is to keep a sleep diary for two weeks.
It can be a very simple document, but the data that it provides can be used to address a whole host of sleep problems.

When is the best time to start keeping a diary?

The answer is almost certainly today. Even if you have not decided how to manage your child’s sleep, any information you gather now will give you a head start in determining which approach to take and subsequently when you start, how you are progressing.

You may also like to make a note of your aims on the diary page. Like a mission statement, this can keep you focused on your goal when you’re tired and emotions cloud your judgement and threaten to throw you off course.

You may be surprised what a simple daily diary can teach you, and how this knowledge will help you guide your child towards better sleep.

A sleep diary enables you to:

  • Assess whether your child is getting enough sleep and if this sleep is at the best times.
  • Track your progress day-to-day. Whether you are introducing a full structured sleep programme or just making small initial changes to meal and nap times, you will be better able to ascertain the impact of what you are doing.
  • To be more objective about a problem that is often emotionally charged. With the bare facts, it is much easier to spot the emergence of patterns, which you can then address quickly. These are simple questions, but many parents would have difficulty answering them with any certainty, especially when they are busy and over-tired.
  • To see the connections between what your child is doing outside sleep times and if this affects their sleep.
  • Assess your responses to your child’s sleep habits, enabling you to see where you are genuinely helping or unintentionally hindering the problem.
  • See baseline information against which you can assess not only changes in your child’s behaviour but also your management of those changes.
  • To remain consistent, which is especially important when you are trying to establish a routine.
  • Increase your motivation by revealing small improvements in your child’s sleeping habits when you have changed their routine.
  • Show health professionals you may consult with.

 

Sleep and SEND- a guide for parents

 

SEND and sleep

As any parent knows having a child who has difficulties with their sleep is exhausting! But as a parent of a child with SEND your child is more likely to be struggling with their sleep, in fact research shows about 80% of children with autism have problems sleeping.

Why your child is struggling with their sleep

  • Children with autism often have difficulties winding down and going to sleep. They may repeatedly get out of bed and refuse to go to sleep unless you are close by.
  • They may also have problems staying asleep and be awake for many hours during the night, perhaps coming into your room or going to other parts of your home.
  • They often find it hard to relax and can have high levels of anxiety, meaning emotional upsets at bedtime and taking a long time to go to sleep.
  • Social cueing difficulties can mean your child finds it hard to make connections in terms of pre bedtime activities and understanding that it’s bedtime. They may have developed a series of nightly rituals and routines that potentially delay bedtime.
  • They can have a poor concept of time and not realise it’s bedtime or recognise tired signs.
  • Research shows many children with autism have irregular secretion of the sleep hormone melatonin, impacting their ability to go to sleep.
  • Your child may have sensory difficulties such as sensitivities to smells, sounds, touch and light that could prevent them both falling asleep and staying asleep.
  • They may have medical conditions affecting their sleep such as sleep apnoea, epilepsy, restless leg syndrome, allergies and gastrointestinal problems such as reflux.

 What can you do to help your child sleep?

  • As most child sleep problems are multifaceted it will help you get a good understanding of your child’s sleeping pattern by filling in a sleep diary for a week or two. This information could also be invaluable when discussing your child’s sleep with health professionals.
  • A visit to your GP may be needed to explore underlying medical concerns, as well as a possible referral to a dietician.
  • Review your child’s sugar and food to ensure they are having sleep inducing foods rather than high sugar snacks in the evening.
  • To help your child understand sleep and the steps of their bedtime routine, visual aids showing their bedtime routine in picture form can really help. You may like to make a booklet or laminate cards and create a Velcro wall chart that you go through with them on the lead up to bedtime each evening.
  • You may also wish to create a social story for your child that you read to them each evening that describes their bedtime routine and makes them the centre of the story. Social stories were created by Carol Gray in 1991 and are meaningful short descriptions of activities and specific actions to help children understand and know what to expect.

Children love routine. You may wish to revisit your child’s bedtime routine:

  • Time your child’s bedtime routine so you have a consistent start time each evening and even more importantly, a consistent wake time in the morning.
  • Aim to avoid all screens an hour before bed. Light from screens can suppress the sleep hormone melatonin.
  • Start their bedtime routine with about 10 to 15 minutes of quiet fine motor such as colouring-in, fuzzy felts, sticking or puzzles.  Or your child may just like a relaxing story at this time.
  • To help your child unwind, from this point on it’s best not to chat too much. Instead use simple sentences or their visual aid booklet to guide and instruct them.
  • Then go for a short relaxing bath in warm water.
  • Go straight into the room they sleep in to get dressed for bed. To stop your child becoming distracted or loosing focus with the routine it’s best to keep everything around the bedroom and bathroom area.
  • Once they are tucked up in bed, read then a bedtime story, at this time of night its best to be to too lively or stimulating.
  • Some children find a massage and or soothing music will help them to go sleep. Do whatever you feel is right for your child’s sensory needs.

Check their bedroom environment.

  • Your child may have their own specific sensory differences that you need to consider. Is their bedroom dark, cool and quiet? Do they find it more relaxing to have gentle sleep sounds playing and a small amber night light? Are there smells that they find upsetting, can you minimise smells from the kitchen and would scented oils help them relax.

 

If you would like help with your child’s sleep please call us to discuss how we can help you.

 

 

Standing up or climbing out of their cot!

standing up in the cot

What if… my baby keeps stands up in their cot?

This tends to happen towards the end of your baby’s first year as they become more mobile and are excited to try out their new-found skill….how amazing for your baby to go from sitting to standing!

But problems arise if your little one cannot lower themselves back down or if your baby quickly learns that each time they stand you appear by their side. Once resettled by you, they may get up again numerous times and this can become a game and a battle of wills that lasts until your child eventually falls asleep exhausted.

What to do:

  • Ensure your baby has plenty of floor time in the day.
  • Teach them to lower themselves back down from a standing position by practising pulling-up and sitting-back-down games. When you are confident they can lower themselves safely, leave them standing for a short while you sit or lie by the cot. Occasionally tap the mattress and simply say ‘It’s sleepy time, lie down’. When they start to tire, quickly lay them down and say “well done for lying down” and then offer some positive feedback with some gentle stroking or patting. However if they spring straight back up continue to “ignore” this behaviour and to lie low by the cot patting the mattress. You may be doing this numerous times especially the first few nights. But with perseverance the habit of standing will gradually stop.
  • If your baby is happily standing and is content for you to leave them for a minute or two, you can come and go from the room, laying them down each time you return. You may have to repeat this numerous times, especially the first few nights.

What if… my toddler climbs out of their cot?

What to do:

  • Start by lowering the mattress if you have not already done so.
  • Remove objects such as teddy bears from the cot that your child could climb on and gain leverage to push themselves out.
  • Try not to inadvertently reward them for climbing out, for example, by taking them into your bed. Be calm and firm. Try to catch them early. Quickly go into their room and firmly tell them not to climb out. If you do this consistently, they will probably get the idea and stay put. However if your child continues to climb out, it will be best and safest to transfer them to a bed.
  • You may also decide to put a stair gate across their door to keep them safe if they decide to test out their new freedom and wander in the night and to childproof their bedroom, almost turning it into a large cot.
Contact
e: sleep@millpondsleepclinic.com
t: 020 8444 0040