Since the start of the COVID-19 pandemic many children and parents are spending more time at home. Many families have been reporting that their sleep is affected. This can be particularly evident for children with neurodevelopmental issues such as autism, who are often very sensitive to changes in routine.
Here are some brief tips from Dr Shreena Unadkat, clinical psychologist in the Evelina London sleep team, about how to help maintain sleep quality.
Circadian rhythms/body clock
Our natural body clock is affected by many things, including daylight and daytime activities. When you spend more time indoors it is hard to get the external cues we all need to keep our body clock in rhythm. You may find that your sleep pattern becomes more unsettled. To give your body the best chance of staying in normal time, think about using these tips:
- It is tempting to allow your routine to slide, we recommend sticking to your normal wake and sleep times as much as possible.
- Limit lie-ins to the weekend, and make sure that everyone wakes up no more than one hour later than you would on a normal/school day.
- Get creative about how to get as much daylight as possible (staying within the Government guidelines). If you are self-isolating and need to stay indoors, open all the curtains/blinds first thing in the morning. Opening windows for 20 minutes in the morning will help you to get a blast of fresh air.
- Make a daily timetable of what you will be doing as a family to keep some structure. This can be a loose timetable and should involve lots of fun activities. For younger children or children with neurodevelopmental difficulties, making this a visual timetable can help to soothe the anxiety that comes from a change in routine. Helpful information about creating a visual resource, including templates, can be found on the Autism UK website: www.autism.org.uk/about/strategies/visual-supports.
- Get some exercise during the day. Going outside is best, but if this is not possible, try to use the spaces in your home creatively. Follow an exercise video together as a family, set up an obstacle course in your living room, or make up some games that involve jumping, skipping or running. When we have less physical activity in the day, we often find it harder to get to sleep, and sleep quality may be worse.
- At night, make sure you are closing the curtains/blinds and dimming the lights at the same time every day. Keep your calming bedtime routine the same as you normally would. There may understandably be an increase in screen time during the day at the moment. We still recommend turning off screens for the hour before bedtime if you can. Switch instead to hand-eye co-ordination activities such as drawing or puzzles.
Anxiety and worry about COVID19
Many children might be feeling anxious and worried, which may affect the quality of their sleep. This is understandable and normal as we are in extraordinary circumstances. In fact, feeling totally relaxed and at ease at all times may not be realistic. If you find that this anxiety and worry is impacting on bedtime or sleep, here are some tips to try and manage this:
- Start by acknowledging your child’s feelings, and letting them know that their reaction is normal.
- Make a dedicated time and space to talk about this in the daytime. This should be earlier in the day, and separate to the bedtime routine. Talking through difficult feelings too close to bedtime can raise anxieties, which can stop your child from feeling sleepy.
- Drawing out your feelings about the situation as a family (using coloured pens and paper) can open up conversations and be a good place to start.
- If you find that your children are wanting to talk through their worries at bedtime, it may be helpful to note these on a piece of paper together and put them in a box. Alternatively, you can give them to a Worry Monster or teddy bear to look after overnight. Find a time the next day to look at the worries together. It is very important that worries are talked through together with a suitable adult so that they are not ignored.
- Carry out some body-based relaxation exercises to try and calm the body down before bed. One example of a fun exercise is “Bumble bee breathing”. Sit together with your child and take a deep breath in. See if you can notice how the air feels in your nose. Then as you breathe out through your mouth, say buzzzzzzz quietly for as long as you can. Repeat six times, with different sounds (such as hmmmmmm, or ahhhhhhh). Many other exercises are available online.
Read more information about coronavirus, including actions we are taking to care for patients and to reduce the risk of spreading the infection.