How can an Occupational Therapist help my child with their sleep?
Sleep is critical to a child’s overall growth and development. Getting adequate sleep supports a child’s mood, behaviour, learning, physiology and just generally how well they feel. Sleeping well impacts on how a child functions each day.
Sleep develops as a child gets older, typically:
- Newborns sleep usually 14-17 hours in every 24 hours in short bursts of 2-3 hours each. They take lots of naps and wake frequently for feeding and changing. They sleep during the day or night because the parts of their brains that controls day-night sleep patterns haven’t developed yet. They often need help to settle between each sleep cycle (about 40 minutes). By the time a baby reaches 3 months, they may be starting to sleep for longer stretches (3-4 hours).
- Infants 3-12 months usually sleep for 12-16 hours every 24 hours. They might start moving towards a pattern of 2-3 daytime sleeps of up to two hours each and night-time sleeps get longer at this age. For example, some babies might be having long sleeps of six hours at night by the time they’re six months old. It is expected that babies still wake at least once each night
- Babies 6-12 months usually sleep for 11-14 hours every 24 hours and have their longest sleeps overnight. By this age, babies sleep cycles are getting a lot closer to adult sleep cycles. This means that your baby may be waking less during the night (however it’s still really common for a baby to need an adult’s help to settle back to sleep). Day naps are usually between 30 minutes to 2 hours 2-3 times a day.
- Toddlers need 11-14 hours sleep every 24 hours. Usually this is a sleep of 10-12 hours a night, and a nap of 1-2 hours during the day. It is common for toddlers to want to have more control and independence. Some toddler sleep problems include having trouble settling to sleep and not wanting to stay in bed at bedtime.
- Pre-schoolers need 10-13 hours of sleep a night, and some still nap during the day. Pre-schoolers can sometimes have sleep problems like getting out of bed, as well as nightmares and night terrors.
- School aged kids aged 5-11 years need 9-12 hours sleep a night.
When a child is not sleeping well, it can impact safety and performance in daily tasks and lead to a range of health concerns. Poor sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Children that regularly sleep less than the recommended amount of hours for their age may have difficulties with attention, behaviour, and learning. Decreasing a child’s sleep by only one hour can have a negative effect on emotions, behaviour, and cognitive skills, all of which play an important part to a child’s ability to participate in school. It can look like your child isn’t behaving, but it may actually be because they’re tired!
Children with developmental delays and disorders, including those on the autism spectrum, often face challenges with sleep. Sleep disturbances are particularly prevalent in children requiring autism treatment, as well as those with ADHD, intellectual disabilities, and Down Syndrome. It is important to work with a team of sleep specialists to develop a plan tailored to your child’s specific sleep needs. A key support on this team is an occupational therapist.
How can Occupational Therapy help?
For some people it is easy to have good sleep, but for many it is not easy, and requires attention to the impact of environments and routines, and the use of a range of skills. This is where occupational therapists can help. Occupational therapists use their knowledge of how sleep works, sleep disorders, and evidenced-based sleep practices to help parents to address their child’s sleeping problems.
OTs will look at your child’s entire sleep process (going to sleep and staying asleep) and then make recommendations based on bedtime routines, habits and patterns on a trial basis to see what works best for your child. This might include:
- Providing strategies that address sensory-seeking or sensory-avoiding behaviour (e.g. a bedtime book that depicts bedtime routines, lightweight or weighted blanket, tighter or looser fitting pyjamas)
- Making changes to the physical sleep environment (e.g. reducing the number of toys in a child’s bedroom, dimming the lights, adding a fan to ensure the room is cool and white noise muffles other sounds in the home)
- Making adjustments to bedtime schedules and routines (e.g. introducing calming activities to help make an easier transition to sleep, working out ways to make routines consistent, consistent nap/wake up times, adequate physical activity during the day)