By Michael Breus, PhD, ABSM
and Stuart J. Meyers, MD

	Routines can take the stress out of bedtime and help make it a special time

Regardless of age, regular schedules and bedtime rituals greatly impact our ability to obtain sound sleep and function at our best -- and the same goes for children, maybe even more so. Establishing and maintaining good sleep habits helps your child fall asleep, stay asleep, and awake rested and refreshed. It may also prevent future sleep problems. Good sleep habits can not only take the stress out of bedtime, but can help make it the special time it should be for you and your child.

There are no hard-and-fast rules for sleep behavior, and as always, there is individual variation. Your child is unique. If your routine is working, then it is probably best for you. That said, some approaches work better than others, and the following guidelines have been shown to be effective.

1. Make sleep a family priority and part of your daily schedule: Determine how much sleep each family member needs and ensure that they get it. Discuss any sleep problems with your child’s doctor. Most are easily treated.
2. Learn to recognize sleep problems in your child: The National Sleep Foundation recommends that you look for things like difficulty falling asleep, nighttime awakenings, snoring, stalling and resisting going to bed, having trouble breathing, and loud or heavy breathing while sleeping. These sleep problems can be evident in daytime behavior such as being overtired, sleepy or cranky.
3. Consistency: As in all aspects of parenting, consistency and follow-through are key ingredients for success. Without them, you just can't expect your child to learn or change behavior.
4. Teamwork: If you are co-parenting, it is important to discuss your strategy beforehand and work as a team. If you are beginning a nighttime program after having some difficulty with your child, explain your new expectations, if your child is old enough.
5. Set a regular bedtime and wake-time: This sets and aligns expectations for both you and your child and allows you to plan the bedtime routine accordingly. Otherwise, you may have a tendency to slip and slide late into the night. In addition, this helps keep your child's internal body clock, or circadian rhythm, on a 24-hour cycle. Since our normal daily rhythms are around 25 hours, we would tend to drift out-of-sync with the 24-hour day if it were not for external cues like a set bedtime, a bedtime routine, lightness, and darkness. There is not one ideal bedtime for each child, because sleep needs, lifestyles, and napping patterns can vary considerably. However, you can look at the typical sleep requirements for various age groups and use it as a guide. Note that this does not apply to newborns and infants, as their biological rhythms or internal clocks are immature and not yet regular.
6. Routine, routine, routine: Kids love it, they thrive on it, and it works. Routines set expectations and help train behavior; a nightly bedtime routine helps your child learn to be sleepy, just like reading in bed may put some of us adults to sleep (even when we're out of bed). The structure of bedtime routines also associates the bedroom with good feelings and provides a sense of security and control. Routines can take the stress out of bedtime and help make it a special time, especially if you have more than one child.

   This is a time to wind down. So calming activities, like taking a bath, reading a story, or perhaps a gentle massage are good choices. Keep TV’s, computers and the like out of the bedroom, as they tend to arouse your child and keep her up later. Let your child know what the routine is, including the time limits involved, and stick to them. It is often very helpful to give notice that time is almost up, like, "We have just three more pages of our story," but be firm and do not go past your limit. Uncertainty breeds tension, and arguments may follow. A key goal in any routine is teaching your child to soothe herself so that she may fall asleep unassisted and put herself back to sleep unassisted when she awakens at night. Key to achieving this goal is for parents to leave their child alone long enough for her to go to sleep.

7. Dress and room temperature: Again, there are no absolutes here, but a rule of thumb is to dress your child basically as you dress yourself, keeping in mind that younger children often kick off the covers at night and are unable to cover themselves. People generally sleep better in a cooler (but not cold) rather than warmer room.
8. Transitional object: Bedtime means separation, and that can be made easier with a transitional object, like a doll, teddy bear, blanket, or the like. This kind of object can provide a sense of security and control that comforts and reassures your child.
9. Room and bed sharing: Some parents may feel sharing their bedroom and/or bed with their child is more natural than having separate rooms, that it is important for emotional development. There may be cultural preferences as well. From the point of view of obtaining uninterrupted sleep and considering various social and psychological issues, it is generally not a good idea. First, everyone sleeps better alone -- that is, we have fewer sleep disturbances and awakenings. Children in the same bed and/or bedroom also may not learn how to fall asleep themselves and tend to have sleep problems. Smothering is also a concern. Having a child in the bed with you may also have serious effects on your intimacy and sex life. Leaving your child with a sitter may become an issue as well. The longer the child sleeps in your bed, the more difficult it becomes to decide exactly when he or she should stop and eventually move into his own room. Sleeping separately is also important to help a child learn to separate without anxiety and form his or her own identity.
10. One last thing! Kids will always have that one last thing -- kisses, hugs, a drink of water, using the bathroom. They can be quite inventive. Do your best to anticipate all this and get it done before getting in bed. And let your child know that once they are in bed, they have to stay in bed.

The National Sleep Foundation recently came out with a comic-book style activity booklet for children ages 7-10 to explore the benefits of sleep and its relation to health, safety, learning and productivity. There is also a Children’s Sleep Diary for school-aged children. They may enjoy recording the caffeinated beverages they drink, their bedtime routine, hours of sleep and amount of energy for seven days and nights. The Diary also contains a full page of tips and facts to help children establish lifelong positive sleep habits. Sleep for Kids( http://www.sleepforkids.org/ to learn more.

Medically Updated: March, 2006

Published May 28, 2003

SOURCES: Solve Your Child's Sleep Problems, Richard Ferber, 1985. Sleeping Through the Night; How Infants, Toddlers and Their Parents Can Get a Good Night's Sleep, Jodi Mindell, PhD, 1997. Helping Your Child Sleep Through the Night; A Guide for Parents of Children from Infancy to Age Five, Cuthbertson & Schevill, 1985.

Copyright © 2003-2006, Sound Sleep, LLC.

Already know your sleep disorder? Start Your Action Plan

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• Back to School, Back to Sleep
• How Much Sleep do Children Need?
• Good Sound Sleep for Your Child

Already know your sleep disorder? Start Your Action Plan

   Print this Article

• Back to School, Back to Sleep
• How Much Sleep do Children Need?
• Good Sound Sleep for Your Child