Sleep Challenges with Sensory Processing Disorders

Judy Benz Duncan, Occupational Therapist

Children who have sensory processing and integration disorders, or SPD, typically display sensory seeking behaviors around bedtime, which make the bedtime routine a frustrating and challenging time for children and parents alike.

When a child’s arousal state seems to spike right at bedtime, it becomes difficult and often overwhelming to try and lower the arousal state, or to calm down a child’s behaviors to allow them (and the family) a good night’s sleep.

Exhausted kids and family members have a more difficult time dealing with sensory challenges on a day-to-day basis. Inadequate sleep times and rest usually lead to difficulty with day-time behaviors, ability to think or learn, attend and focus, and often results in a child being in an overall higher arousal state as their body works to compensate for physical fatigue.

Sensory Disorders Effect on Sleep

Children that experience sensory integration and sensory processing disorders struggle with sleep issues on a daily basis. There are many challenges for a child with sensory issues to be able to calm their minds and body, to rest, and to sleep adequately. No matter how tired their body may be, sometimes the smallest of things can interrupt their sleep, wake them up too early, make for a restless night, and impact on the whole family’s ability to rest and sleep as well.

Adequate rest and sleep influences everything from attention and focus, motor coordination, cognitive functioning, to behaviors. Parents of children who already have sensory disorders find that behaviors, reactions, and tolerance become more extreme and difficult to manage when sleep is an issue.

Some common reasons that bring a special challenge to sensory impacted children when it comes to sleep include:

• Difficulty filtering out sounds and noises inside and outside of their room and house

• Decreased ability to tolerate the sensation of their sheets, blanket, sleepwear, the temperature in the room, the firmness or softness of mattress and pillows

• Disturbed by the lighting in the room (too much light, too dark, shadows, light from outside shining in, color of nightlight)

• Inability to lower their arousal level to achieve a feeling of restfulness or calmness that is needed to allow them to drift off to sleep

• Not able to achieve “tiredness” level for nighttime sleep, possibly due to long or late daytime naps

• Having emotion-based issues that interfere at bedtime, such as separation anxiety, fear of being alone, fear of bad dreams or “monsters,” or even not wanting to go to bed and “miss out on things” because other family members are not going to bed too

Ideas and Activities to Promote Sleep

Some changes and modifications may make a big difference in the ability of your child to get to sleep and stay asleep.

Working to address sleep issues, calls for the whole family, and whole team to work together to support your child’s needs. Making some changes to start is great, but speak with your child’s pediatrician, service providers (OT/ST/PT/Teachers), and anyone that works with or knows your child for support and guidance.

Rule out any medical issues that may need to be addressed. Develop a plan. Track causes, what works, what escalates the situation.

Ideas and Activities to promote sleep include:

o    Be consistent with a bedtime routine; make routine predictable – stick to the plan 7-days a week

o    Develop a Pre-Bedtime schedule to follow (do what works for you – brushing teeth may over stimulating, for others it is a regular part of going to bed)

o    Remove access to blue light / electronic devices before bedtime

o    Limit eating and snacking too close to bed time, but a light snack may help them sleep longer as they will not wake up hungry

o    Avoid or reduce nap time during the day; avoid late day naps

o    Provide a relaxing environment prior to bedtime

o    Heavy, deep sensory work

o    Use of a metronome in background

o    Avoid any alerting sensory input close to bed time

o    Use a visual schedule / visual cue cards for bedtime routine

o    Weighted blanket or weighted stuffed animal (CLICK & GO for Blog on Weighted Blankets on TheraPlay4Kids.com)

o    Brushing techniques (CLICK & GO for Blog on Brushing /Sensory Texture Rubs on TheraPlay4Kids.com)

o    White noise in background (to help drown out small annoying sounds/noises like A/C vibration and auto settings, tic of a radiator, someone coughing or snoring in another room)

o    Use of sensory body sack, sensory sheets

o    Slow and rhythmic rocking or swinging

o    Strong sensory diet throughout the day

o    Therapeutic listening and calming talk time before bedtime

o    Track if vestibular stimulation and proprioceptive input at bedtime is calming or stimulating (change the time, and incorporate that into daily scheduled based on whether it helps or makes “it worse” at bedtime)

o    Use of essential oils (CLICK & GO for Blog on Essential Oils on TheraPlay4Kids.com)

o    Snack on items that promote relaxation and calmness for sleep, such as cherries, bananas, kiwi, raspberries, nut butters, almonds, pistachios. Discuss with a nutritionist!

o    Melatonin supplement (Seek guidance on amount and use of this)

o    Spandex hammock or swing to provide slow linear movement before bed time

o    Blowing bubbles is calming (not running after them though!)

o    Pre-bed sensory routine to calm and relax (what works for your child?)

o    Put their blanket or sleepwear in the dryer before bed, warming them up

o    Use of ILs Dreampad (slight vibration and very low music) or vibration sleep pad

o    Sleep music and/or audio books (low volume)

o    Pillow forts and snuggle up pillows

o Sleep with a pet

o    Noise cancelling headphones

o    Sleep study (talk to your pediatrician)

o    Go to better a little later may help with developing sleep patterns

o    Track diet (CLICK & GO for Blog on Food Dyes and Behaviors on TheraPlay4Kids.com)

o    Compression clothing

o   Room darkening blinds and curtains

o   Remove small sound annoyances (ticking clock, fan rattling blinds)

o   Check room temperature (is it too cold? Too warm?)

o   Track to see if changing bath time helps (a bath at bedtime could increase arousal as opposed to calming them down)

o   Have a snuggle in, bed-time story time

o   Use unscented laundry detergents

o   Buy tag free sleepwear, or remove all tags and irritations

o   Use the bedroom for sleeping and naps only, not for playtime or other activities that they associate with being awake and active

o   Consult with pediatrician regarding any medications being taken that can interfere with sleep

o    Avoid caffeine before bedtime (chocolate, tea, soda, hot chocolate, and so on)

CLICK & GO for More Sensory Blogs on TheraPlay4Kids.com

Time for Bed

Hopefully, some of these ideas, and working with your child’s team will help reduce night-time difficulty and allow the whole family to have a good night’s sleep. It takes time and patience, tracking what works, and being consistent day after day, but keep the goal of success with sleep at the forefront of your efforts!

Good Luck in your search for “happy dreams!”

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