I can’t sleep!
Food and Health
Photo: Andrew Stawarz
When lullabies won’t do the trick... Sleep therapist, Juliet Newson, shines some light over the question of sleepless nights Restless nights... we’ve all had them. Waking up from what feels like just a minute or two’s sleep, to a day of people commenting on how rough you look and how heavy the bags under your eyes are. But for some children, and adults, sleep doesn’t come easy even after a week of sleeplessness. Nightmares Some children in care have been through terrifying and unsettling experiences. Often, children relive these experiences in their sleep, making some children fearful to shut their eyes and drift off. Juliet Newson, sleep therapist at Millpond, says: “Nightmares can reflect an anxiety that the child has during the day. This is a normal reaction to any stresses going on in their life.” However, nightmares are fairly common and are not necessarily linked to the child’s past. Juliet says: “A large percentage of children have nightmares.
“However, if the child in your care has nightmares every night over a period of time, then I recommend you take them to a GP.” Nightmares happen during REM sleep, in the second half of the night, meaning children often remember them. The child may be anxious or frightened when they wake up. Juliet says: “The best thing to do is to listen to them, reassure them, and stay with them until they calm down. It is important for you, the carer, to stay calm. “If you’re calm, you can help the child to calm down. Hug them and talk gently to them, but don’t try and discuss the nightmare. “If they want to talk about it, then listen and reassure them. But it’s best to talk about the nightmare the next day, not at night time.” If the child keeps having the nightmare on a regular basis, i.e. every night for a number of weeks, then the child may need to see a
GP. The GP may possibly offer a referral to a child psychologist, to talk through their anxieties. Preschoolers Children under the age of five find it hard to tell the difference between reality and fantasy. Juliet says: “At that age, it is hard for children to understand what a dream is.” For example, reading a book or watching a TV show about dinosaurs can lead them to dream about a dinosaur chasing them. At that young age, they have very vivid imaginations. Many can see shadows and think there are monsters hiding. If this applies to the child in your care, gently comfort them. Juliet says: “Don’t go looking for monsters, as this will not help young children. Instead, reassure them and make them feel safe.” When you talk about it the next day, ask them why they think they had the dream. Juliet suggests creating a happy ending for when the monsters chase them. She says: “In the meantime, distract the child with a milky drink and a snack.” Putting a night light on may stop them from worrying about monsters under the bed. Night terrors Night terrors are similar to sleep walking. They both happen when the child is in a deep sleep, just 30 minutes Winter 2009 after drifting
Food and Health off. Children are unaware of either happening. During a night terror, the child will wake up wide-eyed. Often the carer is disturbed, but the child has no awareness of the night terror. Juliet says: “Night terrors are common in preschoolers. The best thing to do is just wait with the child until it passes. Don’t wake them, as seeing your panicked face may scare them.” Juliet recommends that you keep a sleep diary if the child in your care has night terrors regularly. You’ll notice a pattern for when the night terrors occur, so 10 or 15 minutes before they are due to happen you can go to the child and gently hold them or rock them to prevent the night terror. Juliet says: “Be gentle. There is no need to wake them.” What causes night terrors? Night terrors can be caused by stress, developmental changes, separation anxiety, or they can run in the family. Another cause is sleep deprivation. Teach them to sleep independently Some children, particularly anxious children, may depend on you when
falling asleep. Juliet recommends a gradual retreat approach. She says: “This happens in stages, with three nights in each step. The carer can stay with the child for 10 minutes after they fall asleep for the first three nights. Move the chair further away for the next three nights, gradually distancing yourself, and so on. This is a reassuring way of training children to go to sleep independently.” Bedtime routine Juliet says: “At Millpond we recommend you have a 30-40 minute bedtime routine. If the child is particularly anxious, the full hour before bed should be wind down time.” In this time there should be no TV or computer games, as these make the brain active. Instead, read a book with the child, play a game with them, have a cuddle and let them have a drink. Juliet says: “Milk contains tryptophan which the brain converts into the sleep hormone melatonin. Lavendar in the bath can be relaxing too. “Older children may enjoy a massage - you can tell them a story and trace it on their back to help them relax. “Or you can try visualisation relaxation, 32
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Did you know? For some children the slightest change in condition, whether that be a light switching off, a door closing, or even a pillow being rearranged, can wake them. Juliet says: “We sleep in 90 minute cycles consisting of deep sleep and light sleep. After each cycle we subsconsciously check our surroundings. If something changes, it can wake us.” If the child needs a night light on, switch it on before you say goodnight, and keep the condition of the room the same after that. such as telling the child to close their eyes and imagine they are on a beach. Describe a story for them to picture in their mind. This should help them to feel secure.” It’s not a good idea to discuss the day’s events one hour before bedtime because the brain may trigger off thoughts and anxieties, making it difficult to go to sleep. Juliet says: “Instead, choose a time earlier in the day to discuss the days events... and then it’s done and dusted.” She adds: “If the child doesn’t like talking straight after school then give them half an hour before asking about their day. Just make sure you don’t talk about things at night!” Look out for more techniques in The Millpond Book ‘Teach your child to sleep’. For more information visit www.mill-pond.co.uk.
Juliet Newson is a registered nurse, health visitor and infant massage instructor with 17 years experience in NHS and private healthcare settings.