Sleep issues and children with disabilities- by Charlotte Bateman

A good night’s sleep is essential for mental and physical health. But it is not always easy to get it, especially when you have a child with additional needs. Research shows up to 86% of disabled children suffer with sleep issues.

While it tends to be linked with neurodiversity, there are many conditions that can disrupt your child’s sleep. They may be experiencing pain or side effects from medication. Alternatively, visual impairment could be contributing to low levels of melatonin- a hormone that regulates the sleep-wake cycle.

“Melatonin is produced when light dims and this works as part of our body clock, otherwise known as the circadian rhythm” Jane Armstrong, Sleep Consultant and SEN expert, explains. “For those with a visual impairment, especially those who have issues detecting light, this can be a problem. Their melatonin production may be occurring at the wrong times, and this can make it harder for them to get to sleep.”

Jane continues that the impact of poor sleep is far bigger than we realise. “It affects memory so for children at school, they may struggle with concentration or learning. There is also a link between poor mental health and lack of sleep. As for physical health, it can impact growth, our immune system and tissue repair.”

If your child has sleep problems, it is likely that you and other members of the family are suffering too. So, what can you do to ensure everyone gets their 40 winks?

One thing worth looking into is melatonin as a supplement. This can only be prescribed by a specialist, and it is mainly used for children and adolescents with partial or complete blindness, Cerebral Palsy, ADHD, autism or learning disabilities. In terms of the amount, melatonin tends to be given in low doses which may increase until sleep improves. Your doctor will be able to work out a dose that is right for your child.

There are also simple lifestyle changes you can make to promote better sleep. Jane says: “If possible, you want to create two things. Firstly, a calm, peaceful environment in your child’s bedroom. And secondly a good bedtime routine. You should aim for things to be done in the same order every night. We start off by saying: dim lights and quiet sounds about an hour before bedtime. Then reduce play to quiet play, so for example Lego or jigsaws. It is best to avoid using any electronics before bed. This is partly because they emit blue light which can affect our Circadian rhythm, but also because tablets and phones can create stimulation or excitement.”

After play, Jane recommends having a bath. For many children, a warm bath can be very relaxing. She adds though for others, particularly those with sensory processing difficulties, bathtime may be too exciting, so it is important to do what is best for your child’s needs.

Once they are tucked up in bed, your child may find it helpful to listen to something, Jane says. This could be an audio book or even you reading them a story. If your child prefers music, you could put on a calming playlist for them. You could even get a Bluetooth speaker connected to your phone, so that you can gradually decrease the music as they drift off to sleep.

Finally, the way you say goodnight to your child can make a difference. “You’re aiming for your child to fall asleep on their own” Jane continues. “By doing this, it means when they wake in the night, they are not expecting mum or dad to be there. What we suggest is to say goodnight how you usually do, and then leave the room if you can. This is not always possible with some children. They may have severe anxiety or attachment. A sleep consultant can look at that with you and help come up with ways to gradually move away overnight.”

Of course, it is not just about a good bedtime routine. What you do in the day can also have an impact. For example, regular exercise can reduce stress, reset your Circadian rhythm, and improve quality and duration of sleep. Although studies vary, it is generally recommended for children to do physical activity earlier in the day. This is because it can be stimulating if done close to bedtime.

One final thing to consider is your child’s daily food intake. Having meals at regular times will help to manage their body clock. Meanwhile, there are certain foods which can affect the production of hormones.

Katharine Tate, Registered Nutritional Therapist and health coach, explains: “The body naturally produces a chemical called Adenosine. This accumulates in the brain during your wake cycle and increases sleep pressure which ultimately helps you to fall asleep at bedtime. Caffeine is a huge disruptor to Adenosine levels and blocks its accumulation, which is why it is best avoided after lunch if you are trying to optimize sleep. Be mindful that caffeine is not just in coffee. Fizzy drinks, energy drinks and chocolate can also contain levels of caffeine.”

She adds: “Tryptophan, found in protein-rich foods, has been well researched regarding sleep quality. It can be used in the body to make serotonin and melatonin which can directly influence sleep. Great sources include chicken, turkey, prawns, eggs, crab meat, dairy, nuts and seeds, and legumes. An evening meal containing Tryptophan and low levels of carbohydrates/starchy foods is thought to be beneficial.”

I spoke with a parent of a vision impaired child who has struggled with sleep issues throughout her life, Charlotte said: “My 13 year old daughter Scarlett has always had issues with sleeping as much as required and at appropriate times.  Although she sleeps better now it’s an ongoing battle to ensure both her and myself and her sibling are sleeping well.  Scarlett has no useful vision and has complex needs, when she wakes during the night, the whole house is awake!  Sleep has been one of the most difficult of issues to overcome with regards to her additional needs.  I work with parents now to try and help their vision impaired children sleep better- after the years and years of problems I have faced, I thought this would be a good way to give back to the families that I support through my role in Parent Services and national charity VICTA”

 

Expert bios and links to services

 

Jane Armstrong

I have been supporting parents of children with disabilities since 2005. I am keen to use my life challenges as a parent/ carer to help others. Families of children and young people with additional support needs are more likely to experience stress with insurmountable struggles for parents/ carers. Since 2008 I have trained with Sleep Scotland and the Southampton Sleep clinic (2012) in paediatric sleep support. I have a qualification of level 6 in behavioural paediatric sleep with EDS training. I have attended CBTI course with Oxford University and completed a Motivational Interviewing qualification with Wink Sleep. I currently work for Hunrosa as a Sleep Consultant. We run NHS contracts to support children and young people with disabilities and additional needs and support young people with mental health challenges. We also offer private assessments for young people and adults and training sessions for professionals.

https://hunrosa.co.uk/

 

Katharine Tate

I have worked as a teacher and education consultant internationally in primary and secondary schools for over 20 years. As a qualified registered nutritional therapist, I combine my unique education and nutrition expertise to offer schools, organisations and families advice, education programmes, practical workshops, and individual/family consultations through the Food Teacher Clinic.

I am incredibly passionate about the impact of nutritious food for all individuals especially growing children and families.

https://www.thefoodteacher.co.uk/

By Charlotte Bateman