QUESTION
My seven-year-old son really struggles to go to sleep at night. His bedtime routine starts at 7.30pm – he has a bath, a small glass of milk and a bedtime story. He might read for a bit but he keeps finding excuses to come downstairs and he starts playing with anything he can find in his room to play with.

I am constantly checking on him to settle him back and he doesn’t end up going to sleep until at least 10 o’clock or sometimes later. He can get quite anxious that he just can’t sleep and he is aware of this as a failing. He doesn’t seem to have the skills to unwind and I fear this anxiety is exacerbated at night time. This problem has been getting progressively worse and it is starting to impact on his attention and school work. His teacher says he is slumping at his desk and not engaging with certain activities.

We are really concerned as no matter how early we start the bedtime process, it is still very late when he goes to sleep. He looks very tired and it is just very frustrating and sad as we constantly spend the evening trying to manage this and it impacts significantly on our wind-down time. We would really value your opinion.

ANSWER
Many children and adults struggle with getting to sleep. Unlike other things such as eating or walking you can’t “decide” to sleep. Sleeping is not fully in your conscious control and all you can do is set up the best conditions for you to “fall asleep”. No matter how much you try, you can’t simply make yourself sleep and indeed “trying” to sleep is often part of the problem. If you become worried or frustrated about not sleeping then your body and mind become too agitated to sleep. As a result, not sleeping can become a vicious cycle which can become habitual over time.

You are right to take action to help your son as his lack of sleep is negatively affecting his functioning and school performance and I am sure it is exhausting to you as his parents.

Breaking the habit
So what can you do to break this habit and reverse it so your son gets into a restful habit of falling asleep which becomes a positive self-reinforcing cycle? The first thing you can do is to respond calmly and patiently when he can’t sleep. If he is agitated, remain calm and gently express a belief that he will get to sleep soon. Continue to soothe him as you gently tuck him back into his bed when he wakes, repeating relaxing mantras such as “just gently relax, you will be asleep soon”.

Have a clear plan when your son can’t sleep
Agree a plan of action with your son as to what he can do when he can’t sleep. This might be something like:
1. Lying on his bed and using some relaxation techniques to help him sleep (see below)
2. If he can’t sleep after 10 minutes and is stressing or getting anxious, suggest he get up for one minute and do something else.
3. Agree on the sort of things he can do when he takes a break from trying to sleep. These can include reading for a minute, doing some physical exercise or playing a short game. He should only do these things for a minute and they should all be in his room.
4. Return him back to his bed and go through his normal ritual of relaxing into his bed. You might help him by gently tucking him in, or you can teach him how to do this by himself
5. Repeat steps one to four as needed until he falls asleep.

The essential part of this routine is helping your son break the pattern of ruminating when he can’t sleep and instead learn to distract himself before gently trying again. You can help him with this by periodically checking in and being there at step four to tuck him in and reassure him.

Teach your son relaxation techniques
There are lots of different techniques you can teach your son that can help him sleep when he is lying in his bed such as:
– Noticing and counting his breaths.
– Playing relaxing music that turns off after 10 minutes.
– Going through each part of his body, tensing and relaxing each part one by one.
– Remembering three things he is grateful for in the day.
– Visualising a happy memory or a place he loves.
It is trial and error to find techniques that work but take time to teach him and do them together before bed and make sure the practice is fun!

Motivate your son
Motivate your son to try out a new sleep plan by agreeing it in advance. Find some good children’s books on learning to sleep or look up resources online together about sleeping and identify the relaxation techniques he would most like to try. You can also do up the action plan on a chart with him and ensure he gets stars or points for each step he completes (that lead to a bigger reward at the weekend).

Establishing good routines for sleeping
It is important to have a relaxing bedtime routine that starts early and gives your son plenty of time to relax. This routine should include an enjoyable period of quality time with you such as reading a story together or having a chat about the day.

In addition, it is important to review your son’s routine throughout the day in relation to his sleep. For example, there is evidence to show that children and adults who have a regular period of exercise tend to sleep better. Could you incorporate some exercise into the routine an hour or so before bedtime? This could be simply doing a kick about in the garden, doing 20 minutes on the trampoline or walking around the block together.

Prof John Sharry, Irish Times Newspaper, November 2016. John writes in the Irish Times Health+ every Tuesday.
AUTUMN 2018: John will give courses for parents in Dublin, Cork and Galway. Details and bookings at: www.solutiontalk.ie