Bedtime routines and sleep for children with additional needs

Child tucked into beed with blue sheets and a blanket, and a teddy bear tucked under their arm

If you have a child with additional needs who has sleep issues, bedtime can be really tricky. But often, persevering and trying different approaches can eventually bring success. Finding the right bedtime routine for your family and child, using calming activities, visual clues, and relaxation techniques can be incredibly beneficial

Children benefit from bedtime routines because they help them settle down and fall asleep more easily, which leads to better quality sleep and reduced nighttime awakenings, and this in turn improves children’s mood, emotional regulation, and overall health and well-being.

A bedtime routine can be particularly helpful for children with SEND as it provides predictability, helps with relaxation, and promotes a sense of safety and security, which can be particularly beneficial for children who may struggle with transitions in the day or who have sensory sensitivities.

For some children with specific disabilitiesparticularly those who are neurodivergent, bedtime routines and sleep can consistently be a challenge. While it’s not universally the case for all neurodivergent children, sleep difficulties are very common and often ongoing due to a range of neurological, sensory, and behavioural factors.

For example:

  • Autistic children often struggle with sleep due to sensory sensitivities, anxiety, or differences in melatonin production.
  • Children with ADHD may have difficulty winding down, regulating their internal body clock, or staying asleep through the night.
  • Those with PDA (Pathological Demand Avoidance) or anxiety-related disorders may resist the structure of a bedtime routine due to the demand element it represents.
  • Children with trauma-related attachment disorders may feel unsafe when separated or in the dark, making sleep particularly challenging.

But persevering and trying different approaches can eventually bring success. Finding the right bedtime routine for your family and child, using calming activities, visual clues, and relaxation techniques can be incredibly beneficial

Most children benefit from bedtime routines because they help them settle down and fall asleep more easily, which leads to better quality sleep and reduced nighttime awakenings, and this in turn improves children’s mood, emotional regulation, and overall health and well-being.

A bedtime routine can be particularly helpful for children with SEND as it provides predictability, helps with relaxation, and promotes a sense of safety and security, which can be particularly beneficial for children who may struggle with transitions in the day or who have sensory sensitivities.

 

Top tips and ideas

You may want to use a ‘now and next board’ or other visual clues to help your child understand the routine and what is coming next:

bedtme routinews checklist: bath, put on pjs, snack, brush teeth, read story, bedtime

Below are some general tips that may help if your child struggles to drop off to sleep or to stay asleep through the night:

  • Try to ensure that your child is in a bedtime routine (see above)
  • Avoid any screens in the hour leading up to bedtime – this includes mobile phones, TV and computer screens. Consider using the ‘Night mode’ which will dim the screen and is less stimulating before bedtime
  • Avoid anything sugar loaded before bedtime.

 

Review your child’s bedroom and assess whether it is a good environment to promote sleep:

A cartoon shows two versions of a bedroom. One is tidy and painted purple, the other is messy and painted green.

Light levels: A dark room helpsregulate sleep-wake cycles by promoting the production of melatonin, a hormone that makes you feel sleepy. Consider using blackout curtains or blinds to block out any light, especially during the summer months.

A soft nightlight can be helpful for children who are scared of the dark or just prefer some light at night. But avoid blue light from screens before bed, as it can interfere with melatonin production and sleep rhythms.

 

Quiet: A quiet room is crucial for good sleep. Minimize distractions like TV or noise from other rooms. If needed, white noise machines can help mask distracting noises and promote a sense of calm. If you have an Alexa or something similar there are a number of sounds or lullabies you can access for free, that help with sleep

 

Temperature: the ideal room temperature for sleep is around 18-19°C (65-67°F).  A room that is too hot or too cold can disrupt sleep.

 

Tidiness: A tidy bedroom can promote a more relaxing environment. Store away toys and belongings at night. Avoid having electronic devices, schoolwork, or other distracting items visible.

 

Sensory needs: Consider your child’s sensory needs, you will know best what your child might like – They might prefer a weighted blanket or specific textures in their bedding. They may like a calming scent like lavender in the room. They might require a specific routine before they are able to sleep

 

Getting ready:

  • Get the bedroom ready – Dim the lights, shut the curtains, and ensure the bedroom is tidy and free from distractions like lots of toys or very strong smells.
  • Give your child a warm bath to relax them.
  • Read a story or put on some soft music.
  • A gentle massage might work for some children (see video link below for techniques)

 

Consistency is Key:

  • Aim for a consistent bedtime each night to help regulate your child’s sleep cycle. And wake them at the same time in the morning if you can.
  •  The same routine each night helps the child understand what is coming next and be ready for sleep.

 

Explore your child’s sleep issues: If your child is struggling with going to sleep or staying asleep, then record what is happening at night by using a sleep diary.

Here are some useful tips on compiling one: https://parents.actionforchildren.org.uk/early-parenting/sleep/sleep-diary-child/

 

Getting help:

Lots of advice and tips are available through The Sleep Charity and other support organisations, through the Southend Local Offer on the Live Well site, and through the NHS – links to all of these are listed below.

If the tips on the different websites don’t help you, and the problems persist – speak to your health visitor or GP to explore any underlying medical or other issues which may be affecting their sleep. Share the sleep diary you have made, so that they can see what is happening for your child at night.

 

Video resources

Hands on Massage Technique https://youtu.be/tuPZx7XIxyw

Tips and Advice from Scope on helping your disabled child to sleep https://www.scope.org.uk/advice-and-support/sleep-podcast

 

Useful sources of information and support

The Sleep Charity is a good source of information and has a useful downloadable information sheet on sleep advice for children with SEND: https://thesleepcharity.org.uk/information-support/children/children-with-send/

Contact has a downloadable booklet on helping your child sleep for parents of disabled children:

https://contact.org.uk/wp-content/uploads/2021/03/Helping-your-child-sleep.pdf

 

The National Autistic Society has a guide on sleep for parents of autistic children:  https://www.autism.org.uk/advice-and-guidance/topics/physical-health/sleep/parents

https://sunshine-support.org/how-can-we-help-sen-children-with-sleep-problems/

NHS Choices healthy sleep tips 

 

This article was originally created as a resource for A Better Start Southend (ABSS). For other useful resources: https://abetterstartsouthend.co.uk/family-resources/

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