Sleep problems are even more common in kids with chronic illness. We know that a good nights’ sleep is nurturing to our bodies and minds. As always, please consult with your child’s doctor prior to see if additional medical interventions are warranted and/or to see if any of the below tips are not recommended due to your child’s specific needs. 

The following are ten tips to try that I have learned through years of working with children and teenagers with sleep difficulties and from my work in a multidisciplinary sleep clinic.

1. Maintain a consistent bedtime and wake time. My experience has shown that this is one of the most important tips to follow to see change. How many times do we as adults wake up on the weekends and press the snooze button several times dreading that morning workout? Even on the weekends, aim for sleep and wake times within 1-2 hours of weekday times- this may be a good time to encourage kids to help out with the morning breakfast or kick around a soccer ball in the yard.
2. Consistent sleep environment. We have learned that children (and adults!) sleep the best in cool, dark rooms with minimal light. Aside from the occasional sleepover or night sleeping in parents’ bed due to feeling under the weather, encourage your child to sleep in his or her own bed at night. This includes calmly returning your child to bed if he/she awakes during the night and comes into your room. If music is playing at nighttime, ensure the music plays all night long to maintain consistency (Relax Melodies is a great phone app to try which has a number of free sounds to choose from). For those of you – or have children- who are more technically savvy, Alexa and Google Voice are great tools to use where you can ask it to play white noise, beach sounds, or even tell a bedtime story without your teen having to use their phone.
3. Relaxing bedtime routine. We know that routines are comforting to us all. Encourage your child to set up routines, making them comforting and relaxing. Some ideas that families have had success with are: warm bath, singing songs, telling or reading a story, talking about positive thoughts related to bedtime, having a comfort object such as a stuffed animal, going to a relaxing place using your child’s imagination (beach and forests are common favorites), and taking deep belly breaths together. For older teens, reading comics, listening to music, taking a warm bath, or listening to an audiobook or mindfulness exercise may be more in the mix. Research has shown that maintaining a relaxing bedtime routine signals our bodies to get ready for sleep.
4. Put down the phone! Studies have shown that avoiding electronics (e.g., phones, television, iPad) 1-2 hours before bedtime is recommended as the light from screens can prevent our bodies and minds from feeling tired. And that goes for adults too! We need to turn off the blue light that inhibits release of melatonin as well, and this will also help set a good example for children.
5. Exercise. Physical activity during the daytime usually helps promote a good nights’ sleep. But beware! Some physicians claim that exercising too close to bedtime can actually energize us. So find a happy medium and encourage exercise during the morning time or after-school hours. Even better- go on walks around the neighborhood with the kids (and pets, too) to model good habits, as teenagers especially don’t want to be told what to do!
6. Avoid naps. Long naps, particularly in the afternoon, can make getting to sleep harder for older children and adolescents. If a nap is absolutely needed, limit to 20-30 minutes, and prior to 3:00 pm. P.S. If your kid absolutely needs that midday power nap that’s a good time for you as parents to get in quiet time too.
7. Consult with your child’s doctor. To determine how much sleep is recommended for your child’s age group, and see if there are certain foods or caffeinated beverages that may be negatively impacting sleep. Most people don’t think about how their evening chocolate dessert may be making it harder to fall asleep at night.  Addressing any underlying medical conditions (including chronic pain) that may be impacting sleep is also important in diagnosing and treating sleep problems.
8. Avoid the bed for everything except sleeping. It’s often tempting to complete homework assignments or read in bed, but using the bed only for sleep helps strengthen the association between sleeping and your child’s bed. As enticing as it is to sit comfortably and watch television from the comfort of our beds, moving T.V. time, play time, homework time, etc. to areas outside of the bedroom helps our body develop the connection between sleep and bed.
9. Monitor mood. Children and teenagers who have anxiety and/or depression may have difficulty turning off anxious thoughts at night, or may show symptoms of loss of energy or excessive fatigue. In these cases, it is very important to treat the mood symptoms as untreated depression or anxiety may be an underlying cause to your child or teen’s sleep difficulties.

And finally…

Be patient. Overwhelmed by the 9 sleep tips above? This was a common reaction I noticed that teens and their families had when provided with all these tips by their doctors and mental health providers. Sleep habits are usually years in the making, and changes don’t occur immediately. Most children and families I work with find that it takes 2 weeks of consistent changes to see a difference. Being patient, making small tweaks to sleep habits using the tips above (try out one or two at a time!), and rewarding your children along the way by providing positive reinforcement (verbal praise, rewards, etc.) are often necessary components to incorporate into a sleep plan. Punishment or chastising your child or teen for insomnia or sleep disturbance rarely works and can make the problem worse. If your child or teenager continues to struggle with sleep, consult with a mental health provider to assist in developing targeted interventions. Know that you and your child are not alone- sleep problems are extraordinarily common particularly in youth with chronic illness and there are professionals available to partner with your child and family and provide help.