35 – 40% of children and adolescents experience some form of sleep problem during their development. Sleep problems are either those that:
Are intrinsic (come from the inside) and include nightmares, night terrors, bed wetting and snoring or those that.
Are extrinsic (come from the outside) such as bedtime reluctance, anxiety related insomnia, inability to fall asleep alone or environmental and social problems that get in the way of sleep.
What happens when we don’t get enough sleep?
Many things can be affected when we do not sleep enough such as:
Behaviour – aggressive, antisocial, withdrawn, hyperactive, unable to control or regulate behaviour
Emotion – Moody, depressed, anxious, stressed, uneasy, unconfident, irritable
Planning – poorly organised, poor time managers, repeating grades, forgets lessons
Concentration – inattentive, lack of concentration, falling behind in school
Creativity – not working at full potential
Problem solving – poor behaviour control and difficulty in social situations
Complicated thinking – struggles with maths, sciences, languages, abstract concepts
Motor coordination – less sporty, more accidents, clumsier
Weight – being obese and overweight is more likely with less sleep
Health – poorer immune system – sicker more often
Learning – it is though that sleep, particularly dream sleep or REM sleep, is necessary for storing certain types of memory, particularly more difficult memories such as mathematical concepts and language.
How we sleep
There are two main kinds of sleep. One is light sleep called REM sleep ( for Rapid Eye Movement Sleep). This is when we dream and when we “go over” the day’s events and wake feeling refreshed. It is also the kind of sleep where we wake more easily because it is so close to ‘awake’. Toddlers have more REM sleep than adults do.
The other kind is deep sleep (or NonREM sleep) where growing and healing takes place. It is the deepest sleep. This is when children may have night terrors. It is much harder to waken people from this kind of sleep.
Each night we all go through sleep patterns where we go from lighter sleep to deep sleep then lighter again as shown in the diagram. Toddlers usually take about an hour for each sleep pattern or cycle.
How much sleep do toddlers need?
Younger toddlers usually need somewhere between 12-14 hours over the 24 hour period, spread between day and night time sleep.
Older toddlers usually need a little less, somewhere between 10-13 hours a night. By five, most of them have given up their day sleep.
The reason that there is not a specific and precise numbers of sleep need is because children’s sleep needs are individual and can vary a lot from the average pattern.
If you want to check roughly how much sleep your own child needs, keep a sleep chart for a few days. Write down exactly how long your child sleeps. Whatever average amount you come to is probably about how much sleep your child needs. Remember that as you child grows, their sleep time will get shorter.
Managing sleep and going to bed is one of the most common concerns for parents of toddlers.
Everyone wishes that their child would go to bed at seven o’clock, sleep soundly all night and wake up cheerfully at eight in the morning! If your child doesn’t do this you might think that there is something wrong. Before you start thinking that you have a problem child, let’s look at some of the facts about sleep.
Many problems in this age group stem from a child’s struggles between a need to develop independence and the need to be close to those they love. Common sleep disturbance in this age group include:
- Inability or unwillingness to fall sleep or stay asleep alone.
- Bedtime fears, bedtime refusal.
- Chronic and persistent night time waking.
- Sleep walking, sleep talking and nightmares.
- Parent’s being inconsistent or unable to follow through on bedtime rules or routines or in the middle of the night.
- The child associates something which stops them from being able to get to sleep alone. Sometimes a parent will stay or sleep with a child until they fall asleep or the child will sleep in the parental bed.
WHAT CAN YOU DO?
Teach young children how to put themselves back to sleep alone. Withdraw your presence from their sleep environment slowly but surely.
Regulate bed and wake times. Set limits at bedtime.
Be aware of the signs of fatigue in this age group during the day (hyperactivity, acting out, irritability).
Have a soothing and gentle routine before bed. Negotiate the routine with your child and make a deal.
- “We can ???? (e.g. read two books) if you want, but then you have to do ???? (e.g. go to bed now) “
- “Would you like to do ???, then you have to do ???”
- If your Toddlers sleep problem is to do with behaviour and bad bedtime habits, use the BOSS OF MY SLEEP BOOK
How successful is the book in helping toddlers to sleep alone?
The Boss of My Sleep© process has been successfully used for many years by Prof Sarah Blunden, clinical psychologist and founder and director of the Paediatric Sleep Clinic.
What problems can The Boss of My Sleep© book deal with?
If your toddler is typically developing (that is hasn’t been diagnosed with any syndrome or disorder), it can help with most toddler sleep problems including:
- Resisting bedtime: not wanting to go to bed, not wanting to go into the bedroom, making excuses about what they need before they can go to bed or to the bedroom.
- Not wanting to stay in their bedroom alone.
- Coming out of their bedroom by making excuses, using a whole range of reasons once the parents have left.
- Not being able to fall asleep unless someone is with them. This is true at the beginning of the night and after a night waking
- In fact, any sleep problems that are BEHAVIOURAL in nature.
Parent goals are usually to get their toddler to stay in their room, to be calm and confident enough to stay in their room when you have left, and AS A RESULT OF THAT to fall asleep alone. This means that when they wake up in the night (which they willbecause waking is normal), they will also be confident enough to be go back to sleep with minimal intervention. The Boss of My Sleep© can achieve these goals.
What problems are not fixed with The Boss of My Sleep© book?
The Boss of My Sleep© book cannot make a toddler sleep because that is a physiological drive. But it can help those children (typically developing) whose BEHAVIOUR around sleep time is a problem to be calm and confident enough to stay in their own bed so that they WILL fall asleep. The Boss of My Sleep© is essentially a behaviour management system for bedtime.
What happens if they keep coming out of their room despite the rewards system?
Sometimes children will come out anyway, even though they are rewarded for staying in their room.
Remind them about the-staying-in-bed rule. Excite them about being the Boss, getting the stickers (and the prize if applicable). But if and when they do come out (and therefore they are not sticking to the rules), take them back and offer them a choice they cannot refuse: Such as:
- “Would you like me to come back/stay in the room a while” Yes? I promise I will but then you have to stay in bed and wait”
- Put your hand on the door handle (DON’T close the door, just put your hand on the handle) and say:
“Would you like me to close the door? No? I promise I WILL NOT CLOSE THE DOOR but you need to stay in bed and I will come back and check on you” .
(please note: we NEVER advocate closing the door and we do not actually WANT you to close the door. It is the CHOICE that your toddler has that will make them understand that they must stay in bed). If they trust that you won’t close it they will stay in bed. If you close it they will react to that. The aim of this is to get your toddler to make the choice to wait, NOT to punish or close the door. Try not to make him wait too long when you leave the room. Make him successful by going in and saying “Good waiting”!
What happens if they say they don’t care about the stickers?
If they decide that they are not particularly interested in the stickers, then you don’t have to use them, but the rules about bedtime (that is, not coming out……waiting in bed…) still remain the same, it just means that you don’t have stickers to help make it smoother. It means that you, the parents, have to ensure your toddler follows the rules even without the rewards!! It is therefore much better if you can interest your child and excite them about the new game and the stickers. It makes it easier for parents.
What happens if they don’t stick to the rules and therefore don’t get the two stickers the first night?
Remember the first sticker is for doing their bedtime routine and the second is for “waiting” in their bed for mum/dad/carer to come back and check on them. Waiting can be rewarded, (even if they come out of their room once). So it will be the most helpful if you MAKE SURE they get the stickers (and the prize) the first night. When they do, they will feel accomplished and proud of themselves and you will be proud of them and so they will want to do it again. Make the goals achievable and flexible – the sticker is for waiting for mum/dad/carer, not sleeping, not sleeping all night, maybe not even lying still, just waiting. WE MUST REALLY TRY TO ALLOW YOUR CHILD TO WIN because then they will try again to get it right. They will feel inwardly proud and will be motivated to do it again. Even if they wait, even for a little while, they can get a sticker!
Can I give a prize even if they don’t get the two stickers?
If you give them a prize when they haven’t stuck to the rules, they will know that and they will learn that you don’t follow through with rules – they will learn that they don’t need to wait for you and stick to the rules in order to get a reward. So the rules mean nothing and the reward means nothing (and the behaviour will not change).
Why do they need two stickers? Isn’t one enough?
This reward system might seem contorted and excessive but it is because it works!! Those reward programs that expect a child to do something difficult for a long time before they get a reward are often doomed to failure because they are too hard for a toddler to get right. For example, if you offer a sticker for sleeping in their bed all night, or a treat if they sleep/stay in their bed all week, this is less likely to work, particularly in the longer term. Those time frames are often too long for a toddler. The The Boss of My Sleep©reward system is immediate, instantaneous, builds on the easy success of the first stickers and therefore it is effective.
What happens if they don’t get the second sticker?
If they don’t get the second sticker then they can’t get the lucky dip prize and they are not the The Boss of My Sleep©. (This is why of course, the lucky dip prize is a good idea). Try and encourage them to try again the next night. The younger the child the harder it is for them to overcome a ‘failure’ and try again. I would try very hard to get them to get the two stickers the next night. Perhaps by making the rules easier so they WILL achieve it and then you can make the stickers harder to get later.
When do they get the second sticker?
In the morning. Yes that is a long time to wait, but they have already got one sticker and should be excited about getting the next one. Because they are ‘actively waiting’ for the sticker while they are lying in bed and trying to fall asleep and they have to ‘wait’ all night long (even after a night waking), the second sticker has to be in the morning.
What happens if my child is already doing a bedtime routine? Do I still have to reward him for doing it, as the first part of the The Boss of My Sleep© book says?
Yes even if they are already doing one, they should get a first sticker for the routine. The reason we do this is so that the child is rewarded for something easy and this taps into their desire to get it right, to achieve, to please you and to be the Boss! Try and make the bedtime routine somehow different, give them some new choices in their routine (for example, one book or two? 2 kisses or 3?).
Why do toddlers say they will follow the rules when it is bedtime but then fail to do so when the time comes?
Usually for one of following reasons:
- They will say anything you want them to because they want to please you.
- They really believe that they will do it.
- They are not very good at planning and thinking ahead.
- The motivation to come out of the room is stronger than the motivation to become the BOSS and get a reward.
Why do toddlers react this way at bedtime?
As parents, understanding why toddlers do things may make it easier to change it. Toddlers are at a stage in their lives where they want more independence, are learning the new rules that apply to them for behaving correctly, and yet they really want to be with their parents as much as they can. For sleep, it seems that toddlers do not really want to sleep alone, it may just be that our society expects them to. They are also at a stage when they are beginning to understand how things work. Let’s remember that sleep habits are a learned behaviour – habits are learned, and then can become ingrained. With this method, we change behaviour, we encourage (with tools) your toddler to go along with this new change, and normally this is done with a minimum of stress.
What happens when we have finished the book and we stop giving him rewards? Will they still stick to the rules?
Once your Toddler has achieved being the boss for all those days, you know they can do it. You know they have chosen to do the correct behaviours. And they are confident to be able to sleep alone because now they have had practice. So if they stop when there are no more rewards, it is probably because they have chosen to. As a parent your rules still need to be followed with or without reward. But if you want to wean them off the rewards, you can reduce the rewards and make them less often, or replace them with special activities or time with you rather than something monetary. But ultimately it needs to be your rules, that are fair and not punitive, that ensure success in the long term, not rewards.
“Sleep hygiene” – this can be defined as habits that can help us to sleep or stop us from sleeping. If you or someone you know is having trouble sleeping you can try to change or include some of the things on this list and see if it helps. For toddlers sleep hygien includes:
- No TV/computer games 1 hour before bed. No TVs in bedrooms.
- No coke or chocolate foods high in sugar or high spicy food before bed.
- Ensure relaxing and regular bed time routine –
- Finish eating about 2 hours before bed – digestion competes with sleeping – hot milk is OK.
- Make sure the bedroom is comfortable.
- A night light is OK but avoid bright lights over night.
- Keep bedtimes and wake times regular – try and keep these as regular as you can even on the weekends.
Throughout many children’s lives there are times when their sleep is disturbed because of nightmares, night terrors or sleepwalking. These can be frightening for children and a worry for parents.
Toddlers are at an age where they are particularly prone to nightmares. They are most likely to happen in between 3-6 years of age although they can happen at any age. This is because they have a lot more dream sleep (REM sleep) than adults do and so have essentially more opportunity to have them.
What are nightmares?
Nightmares are frightening dreams which most children have at some time or other. On waking from a nightmare, children will usually tell you what has frightened them. Lots of children wake and think that what they have dreamt is real. With comfort they can usually return to sleep. Toddlers particularly find it hard to tell whether their dream is real or not.
What causes nightmares?
All dreaming, including nightmares are linked with things that happened during the day. Sleep researchers believe that dreams are actually the brain working through information that we have learnt or seen during the day. However, because we are unconscious when we dream, the images and stories in dreams often don’t make sense.
Dreams and nightmares are normal ways for people to deal with their worries and to draw our attention to them. As children gain confidence in dealing with the problems of growing up, nightmares tend to get less.
Nightmares can increase when we are stressed or worried. If they are happening a lot to your toddler, think about what is going on in your child’s life. For example, has there been a recent upset in the family (break-in, death, loss of job, parents arguing)? Has there been a recent change in their lives like starting child care, school, going to hospital or parents starting work.
In 3-6 year of age range children develop a vivid imagination in their day time play and sometimes have nightmares about monsters and robbers.
Tips for parents :
- Be comforting and calm when your toddler has a nightmare. Consider staying with them a little linger after the nightmare.
- Telling them the dreams is not real often is to difficult for your toddler to understand so sometimes this is not helpful.
- Bedroom doors can be left open and a night light left on.
- It often helps the child to talk about it, but try not to get into long talks in the middle of the night.
- If the dream is often about the same thing (a monster) or has the same ending( a robber coming into the house), discuss with your toddler how they could change their dream so it ends happily . For example, tell the minster to go away, or make the monster laugh.
- TV and video games can be powerful triggers which disturb children’s sleep. Carefully choose what programs your children watch. Make sure they do not watch these things close to bedtime.
- Turn off adult TV when your toddler is in the room. Even when they are not “watching’ they still absorb that information and that can be very scary for them.
- Make sure bedtime routines are calm and loving and make sure your toddler feels safe and secure in their bedroom.
- Evening routines are often helpful in settling children into bed. Wind down the day’s activities e.g. with a bath, story, talk with a parents, tuck into bed and goodnight hug.
“Bed time with some toddlers can get very stressful. Sometimes parents can loose their cool.! We have to be aware of what we say and how it can make things worse.Below are some examples of what we may say and how this can sometimes be unhelpful. The BOSS OF MY SLEEP BOOK can help parents to direct bedtime so it is not as stressful
What you may say
How they may interpret that.
You said you were not going to come out of your bedroom
They cannot predict what they do. They don’t actually plan in advance much.
They say what you want to hear at the time and forget it later.
They may well be TRYTING not to come out but the motivation to see you is too great!
Why are you doing it (coming out) then?
They cannot answer this question. Sometimes it is just automatic. They probably just want to see you.
Why are you doing that?
They have no idea why they are doing it. They cannot answer this question. And they are probably doing it because of their established behaviour pattern that you have with them.
YOU can change it – he can’t without help from you The BOSS OF MY SLEEP BOOK ‘ can help change this behaviour.
You said you were going to sleep
They often say what you want to hear at the time but they are unable to get it right when it gets hard.They probably thought they would sleep.
Remember sleeping in not under their control at but behaviour is.
Why aren’t you sleeping?
They cannot answer this question. WE cannot make a child sleep, only follow a routine like in the BOSS OF MY SLEEP” and this will lead to sleep.
What is the matter with you?
There is nothing the matter with THEM – it is not about THEM it is about their behaviour. The matter is that they can’t put themselves to sleep – WE need to teach them.
If you stay in your bed all night we will go the beach on Saturday together.
Planning is not developed in toddlers. This will be too far away and the motivation to do it will be overwhelmed by how hard it is. Rewards need to be instantaneous and immediate, like in the BOSS OF MY SLEEP BOOK.
If only you would be nice Mummy would not get cross
It is not the child that is not nice it is the behaviour that is not nice.If we teach them ‘nice’ behaviour and reward and praise them for it, they will do it again.
You really have to sleep all night
Very frustrating – they HAVE to do it but they can’t. What does this mean for them – they can’t change it and you are saying they MUST change it.
Remember that toddlers do not sleep all night but wake up naturally. What you mean is that when they wake that they can put themselves back to sleep (see “ About sleep in Toddlers”).
Questions to ask yourself
- Do you think you child is doing this on purpose to make you angry?
- Do you think your child wants to be in trouble?
- Why do you think your child SHOULD be sleeping better? Is this realistic or are you comparing your child to other people’s children?
- Are you embarrassed because your child does not sleep well and everyone’ else’s does?