melatonin

May 18, 2022

Sleep and SEND- a guide for parents

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.

March 10, 2022

Daylight saving 27th March, helping your child’s sleep

What impact will the clock change have on your child’s sleep?

What can you do to help them move seamlessly into the new time zone?

The clocks spring forward on Sunday 27th March 2022 and we say goodbye to the cold dark winter evenings and welcome the longer brighter days we have ahead of us.

Losing an hour of sleep may not impact an adults sleep too much, but it can play havoc your child’s sleep patterns.

Your child may not seem ready for sleep at their normal bedtime and may struggle to fall asleep, laying awake restless and unhappy in bed. Then when the morning comes it’s hard to get them up and they seem groggy and not ready to start the day.

Our top tips to avoid bedtime battles and morning meltdowns when the clocks change 27th March…

For about 2 weeks leading up to the clock change start putting your child to bed 10 to 15 minutes earlier every 3 to 4 days.
You will need to move the start of their bedtime routine, nap times and just as importantly meal times too.
The aim is to advance your child’s body clock so they are able to fall asleep an hour earlier than before.
And just as importantly you will need to wake them up 10 to 15 minutes earlier in the morning.
In the run up to bed give your child clear consistent signals that bedtime is coming with a focused winding down routine.
Try including a short calming bath, a quiet story, a cuddle and then into their cot or bed.
Keep the bedroom darkened to help promote the sleep hormone melatonin and just use a small nightlight with a red or amber bulb to help prepare your child for bed.
As soon as you can in the morning get the family into daylight, this will help suppress the sleep hormone and wake your little one up.
If your child is already an early riser and 5.00 am is their usual wake up time, there is nothing you need to do to prepare other than enjoy a lie-in.

Then you can embrace the lighter mornings and longer days!

Written by Mandy Gurney Founder of Millpond Children’s Sleep Clinic

January 26, 2022

Is your teenager getting the sleep they need?

How much sleep do teenagers need?

The average teen needs about 8 to 10 hours of sleep every night to feel alert and perform at their best during their waking hours. But because their bodies are biologically programmed to stay up late, it can be difficult for them to get this much rest on a routine basis. Add to that the growing list of demands on their time such as school work, screen time, social media and friends; it’s not surprising that teens are at such high risk for sleep deprivation. According to the latest figures from the Office of National Statistics (2021), 38% of 11 to 16 year olds and 57% of 17 to 23 year olds were affected by sleep problems on three or more nights a week.

What’s the impact of lack of sleep on your teenager?

We know from the ever growing body of evidence the impact poor sleep is having on young bodies and minds.

Research shows that ‘night owl,’ teenagers who prefer to go to bed late but have to get up early for school, have a higher waist circumference and greater abdominal fat deposition (adiposity) than the ‘morning larks,’ those who prefer to go to bed early and get up early to begin their day.
Recent studies have considerably clarified the relationship between lack of sleep on young people’s mood, emotion regulation, planning, decision making judgement and moderation of social behaviours.
Young people who are not sleeping well are more vulnerable to sensation seeking behaviours, substance abuse, oppositional behaviour, moodiness, irritability and anxiety.

Why has your teen become a Night Owl

Teenagers naturally fall asleep later and wake later in the day. You might find it frustrating that your 13 year old turns the alarm clock off in the morning to try and glean an extra hours sleep leaving them seconds to get ready before they rush out the door, but remember that most teens’ natural sleep cycle puts them in conflict with school start times.

By measuring the presence of melatonin in teenagers’ saliva at different times of the day, we know melatonin levels rise later at night in teenagers-usually about 11.00pm- and remain at a higher level later in the morning. This natural shift in melatonin production, known as a phased delay, means your teen may seem full of energy in the evening and struggle to get to sleep, then can’t get up in time for school and seems sluggish and sleepy in the morning.

Teens Sleep-Wake Cycle- delayed melatonin production

2006 American Academy of Sleep Medicine

Researchers at Oxford University are exploring the benefits of later school start times, as studies have found that when teens start school later:

They sleep longer.
Surprisingly they don’t stay up as late at night when their school start times change.
They perform better and get higher grades.
Fewer students seek help from counsellors and nurses.
Sick days and tardiness decrease.
Parents’ report their teenagers are easier to live with and more connected at home.
Car accidents among teen drivers drop significantly.

What can you do to help your teen?

We know that to help our children reach their best potential and for them to lead healthy and happy lives, the best thing we can do is to help them improve their sleep. So how can you work with these developmental changes and help your young person plan their time and make healthy life choices in a world where sleep seems a low priority?

Educate yourself about sleep. One of the most important ways you can help your teen sleep better is to understand why sleep is so important; research has shown the more we understand about sleep, the more sleep we will have. Explore ways to help them and how you can make sleep a lifestyle priority for the whole family, so you act as a good example to your teen.
Encourage your teen to have a consistent regular sleeping pattern throughout the week and weekend. Studies have shown where there are parent-set bedtimes during the week children had earlier bedtimes, gained more sleep and had improved daytime functioning.
Discuss a bedtime and waking time that they feel is reasonable and that allows them to get the right amount of sleep each night.
At the weekends they can enjoy a lie-in, however it’s best to cap it at an hour extra to help keep their body clock on track. Sleeping in too long or too late in the day is likely to affect the following night’s bedtime and shift their body clock later. Many teens use the weekend to try to catch up their accrued sleep debt. They may be interested to know a sleep debt can never be fully paid back and if a large debt has built up over the week, a weekend is not long enough to rebalance the lack of sleep. Sleeping in at the weekend will also just reinforce the shift in their body clock and they are more likely to continue to feel jet-lagged, groggy and exhausted.

To help keep your teen’s body clock on track, lights dim in the evening but in the morning open the curtains to let the light.
Scientific research shows that screens have a direct impact on sleep. Negotiate when screen time is going to end, bearing in mind screens need to be off an hour before sleep. You may need to have a family rule of no phones in bedrooms.

Negotiate a cut-off time for gaming and films; not only will the light from devices impact melatonin production but your teen’s brain also needs time to relax and calm before bed.
Encourage your young person to have more exercise in the day. Think of alternative types of exercise such as yoga. Think outside the box and consider meditation with them. This has been proven to improve the length and quality of sleep.
Avoid any caffeine drinks from 5.00pm; caffeine has a half life of 5 hours and could interfere with your teen’s sleep on-set.

Encourage them to do homework earlier in the evening. The bonus is they will be able to relax and have their own time once it’s all done.
It’s best to avoid discussions or arguments with your teen just before bedtime. If they have particular concerns they want to go through with you it’s best to do this 1:1 in a quiet room before they start getting ready for bed. Having these conversations once they are in bed is likely to prevent them falling asleep.

Have a warm bath before bed. This will help trigger melatonin and relax your teen (and the added bonus of extra time in the morning)
Rather than screens encourage them to read a book before lights out.

Try suggesting they keep a diary or to-do lists. Jotting down notes before sleep, means they’ll be less likely to stay awake worrying or stressing.
And if they must nap, they should keep it to under an hour.

This article was written by Mandy Gurney- RGN. RM. Dip HV.

Founder Millpond Sleep Clinic

August 23, 2021

Back to school sleep tips

How to get your child’s sleep back on track after the summer holiday break

Over the summer break you may have been more relaxed about what time your children go to bed and get up in the morning. But now as the new term approaches the challenge of getting everyone up and out in the morning by 8.00am, seems a little daunting!

Fear no more…..we have a great set of tips ready to help so your child is all prepared for their 1st day back at school.

Reset your child’s sleep

For your primary school aged child:

At least a week before the new school term, start to put your child to bed earlier by 15 minutes every day.

At the same time wake them 15 minutes earlier every morning.
To help suppress the sleep hormone melatonin get them into the light as soon as possible in the morning.
You may want to offer an incentive to encourage your child to get up earlier.
Repeat this pattern until you reach the time that is right for your child’s school schedule.
Your child should be falling asleep within 15 – 20 minutes.

Help them to feel sleepy:

An hour before bed we recommend:

Start thinking about your child’s bedtime 1 hour before you want them to be asleep.
Put toys away and settle down for a cuddle, a snack and story on the sofa.
ALL screens should be off 1 hour before sleep; this includes phones, tablets and computers as blue light can interfere with the production of melatonin.
Lastly, in the hour before sleep don’t let your child have any caffeine or sugary food and drinks.

Their bedtime routine:

Have a quiet and calm bedtime routine focused around the bedroom and bathroom area.
Carry out the same series of steps every night so your child knows that sleep is coming. They will start to prepare for it as soon as you start the steps.
An hour before sleep set aside 15 minutes of Talking Time. Give your child your 1:1 attention so they can chat to you about their day or any concerns or thoughts they might have. This will help to avoid discussing these issues just before your child goes to sleep.
Then start go for a warm relaxing bath lasting about 10 minutes; a pre-bed bath should not be a play time.
Go straight from the bathroom into the bedroom – do not go back into the living area.
Pre-dim the lights in the bedroom – this will help with the production of melatonin.
Have 1 or 2 stories.
Avoid any confrontations or discussions at bedtime.
Say goodnight and leave the bedroom; your child should be asleep about 15 minutes later.

Reset your child’s morning clock:

Being back at school means an early morning start again for many families. Morning is when we reset our body clock so it’s very important children are woken at the same time each day. A big dose of light will help to get your child up and running, so open the curtains straightaway. Light suppresses melatonin – the hormone that makes us feel sleepy.

For your secondary school aged young person:

Due to a natural shift in the production time of melatonin, young people have a predisposition to go to bed later and stay up later. Over the holidays their body clock may have shifted later by 2 hours or more. The process of bringing their sleep pattern back in line with the school day will take longer. Follow the same steps as above but start 2 weeks before their school start date.

More more details on teen sleep download our free fact sheet.

June 7, 2017

How dark should my baby’s bedroom be?

Many parents ask us how dark should their baby’s bedroom be. Darkness is essential to our sleep and we know from numerous studies that even a small amount of bright light in the evening can profoundly effect our ability to go to sleep. The hormone, melatonin, is produced in response to darkness sending a signal to our brain that it is time for us to sleep and it initiates the body’s processes to prepare us for this essential activity.

But we now rely heavily on artificial lighting enabling us to spend more time in the evenings doing chores, reading, relaxing or working. Where would we be without it….well getting more sleep for sure!

So how can we ensure the lighting we use at this time does not impact on our sleep…

Use dim amber or orange coloured lights for night lights. This type of lighting has the least ability to suppress melatonin. Think of how our ancestors would have sat around the flickering glow of a candle in the evening.
Avoid looking at screens of any kind one or even two hours before bed. The blue light from screens has been proven to suppress melatonin.
Dim the lighting in your bathroom, using a mirror light or fitting a dimmer switch. Modern bathrooms are very bright making your body think it’s the middle of the day.
Your baby’s bedroom does not need to be pitch black. Use a small glow plug-in night light in your baby’s bedroom. It should be just enough light to see your baby by. Leave it on all night so the lighting levels remains constant.
Ensure you have lots of bright light during the day. This will boost your ability to sleep at night, as well as your mood and alertness during daylight.

Millpond Children’s Sleep Clinic – how dark should your baby’s bedroom be?

Image: Levi Gruber