The Importance of Sleep in Children with Special Needs and How to Get More of It!

Written By: Sarah Bossio of Your Zen Baby Sleep

Gosh..SLEEP! It’s the one topic that connects all parents around the world. We are typically not getting enough sleep and trying everything to get more. Do you laugh at 21-year-old-self, thinking about that time in college when you complained you were tired? I do, too.

My name is Sarah and I learned about the Extra Lucky Moms community when I was teaching at the school where ELM founders, Taryn and Jess, brought their daughters for Early Intervention. As a special educator who has spent her career teaching in a self-contained setting, I was blown away with the resources this community provided for parents of children with special needs. I have never come across anything like it in my 15 years in the classroom.

I became a certified sleep consultant because my oldest daughter gave us a run for our money when it came to sleep. I realized that severe sleep deprivation was the trigger to my postpartum depression and anxiety and getting her sleep in order was the first step in my journey toward healing. And because every child learns differently, when my second daughter came along, the techniques I previously used to help my oldest learn how to sleep of course didn’t work! I had to modify and accommodate a different learning style, as I did in my classroom every day. My business was born out of the need for caregivers to have a safe, judgement-free space to teach healthy sleep habits, in a way their child would learn best, which does not include one-size-fits-all methods. I am excited to help the ELM community this month with not only my sleep expertise but also my teaching and behavior experience serving children with disabilities.

Sleep and the Body

Sleep is a fundamental part of human life and serves many functions for our bodies. Not only does it provide the essential rejuvenation we need after a long day, but it helps to flush toxins from the brain, allows communication between nerves, and affects nearly every system in the body (immune, digestive, metabolism, etc.)

However, for children with special needs, sleep becomes an even more critical factor in their overall well-being and development. Whether a child is diagnosed with autism, ADHD, Down Syndrome, or any other special need, ensuring that they (and their caregivers) get adequate and restful sleep is crucial for their physical health, cognitive function, emotional regulation, and overall quality of life.

But, how can we worry about getting more sleep when we already have our plates filled with therapy appointments, sleep apnea diagnoses, and challenging bedtime behaviors? Let’s explore the importance of sleep in children with special needs and the various ways caregivers can support healthy sleep patterns not only for their children but for themselves as well.

Sleep and Brain Development

We all know that sleep is important and that when we do not get enough sleep, we feel subpar. But why is this the case? Scientists are just beginning to understand why sleep serves a biological purpose and the research we have thus far is incredible.

While we are asleep, our brains consolidate memories, enhance learning and repair neural pathways in order to help us better adapt to our environment and learn new skills during our waking hours. For children with special needs who face unique challenges in processing information and forming connections, good nighttime (and/or naptime) sleep can help to better support their activities throughout the day.

Have you ever taken your child to a therapy that was scheduled during their usual nap time, and it felt like a missed session as a result? That is the real-time effects of sleep deprivation at work. Don’t be tempted to skip ahead, but I’ll be explaining how you can support sleep and therapy schedules later on in this post.

Emotional Regulation and Behavior

Children with special needs sometimes experience challenges with emotional regulation and behavior. Sleep can be a key factor in managing emotions and behavior. When a child is well-rested, they are more likely to be calmer, focused, and better able to cope with stressors. On the other hand, sleep deprivation can lead to irritability, impulsivity, and difficulty managing emotions, which can further exacerbate behavioral issues.

Sleep is not the only solution for challenging behaviors but when paired with behavior support with possible medication supplementation, you may see fewer or shorter incidences of behavioral outbursts. Keep reading for suggestions on troubleshooting bedtime and naptime refusals!

Managing Sensory Input

Do you find that your child has difficulty falling asleep and staying asleep and suspect it could be because of various sensory stimulation they are processing? Environmental factors such as light, noise, and temperature can impact their ability to rest comfortably. Creating a sleep-conducive environment that takes into account their sensory input is crucial.

You know your child’s preferences best, but general recommendations for reducing sensory stimulation at bedtime are: using blackout curtains, including a red night light if over the age of 2, using a white noise machine, incorporating a weighted blanket if over the age of 2, and purchasing tag-free or seamless pajamas.

Remember that screens can also increase sensory overload, so do your best to reduce tablet or T.V. time about 1 hour before bedtime. Incorporating proprioceptive activities (in the occupational therapy world, this is also known as heavy work) as part of your bedtime routine can help calm your child’s body. These activities can include: pushing a heavy laundry basket across the floor, deep pressure or squeezes, and yoga poses such as downward facing dog.

Managing Sleep and Schedules

As a parent of a child with special needs, you likely have an exponential amount of medical and therapy appointments to schedule throughout your week. Managing this schedule is a full-time job in and of itself. However, if you have a child who is under the age of 3, they still have a certain amount of daytime sleep needs in order to help keep their body well-rested during the day and receptive to the wonderful work your therapists or doctors are providing.

But HOW do you manage a packed day of appointments, your own to-do list, and possibly other children?

Let’s start by looking at a baseline for age-appropriate nap schedules, and work from there. The biggest factor that I find helpful in organizing naps during the day, especially with multiple appointments, is to use times on the clock (or biological nap times) and not wake windows once your child is at least 4 months old.

0-8 weeks old: Wake windows approximately 30-45 minutes

8-16 weeks old: Wake windows approximately 60-90 minutes

4-5 Months Old:

Wake Up: 6:00 a.m.

Nap 1: 7:30 a.m.

Nap 2: 10:00 a.m.

Nap 3: 12:30 p.m.

Nap 4: 3:00 p.m.

Bedtime: 6:00 p.m.

6-8 Months Old:

Wake Up: 6:00 a.m.

Nap 1: 8:30 a.m.

Nap 2: 12:00 p.m.

Nap 3: 3:30 p.m.

Bedtime: 6:30 p.m.

8-15 Months Old:

Wake Up: 6:30 a.m.

Nap 1: 9:00 a.m.

Nap 2: 1:00 p.m.

Bedtime: 6:30 p.m.

15 Months-3 Years Old*

Wake Up: 6:30 a.m.

Nap: 12:30/1:00 p.m.

Bedtime: 6:30 p.m.

*Children will drop their nap sometime between 3 and 5 years old, depending on their daytime sleep needs and overall nighttime sleep quality.

In an ideal world, your appointments would work around your child’s nap schedule. Unfortunately, we all know this is a rarity. When scheduling your therapy sessions or doctor’s appointments, try not to stress if it is during a scheduled nap time. Instead, attempt to offer your child a nap in the car on the way to the appointment to take the edge off. They will likely nap in the car on the way home, which is also perfectly okay. One time per day, attempt to have them nap in their crib or offer an extended contact nap to keep them well-rested during the daytime. If naps are off during the day (super short or skipped altogether) always offer an early bedtime to help them make up for lost daytime sleep.

Bedtime and Nap Refusals

Even the most well-rested, independent sleeper may put up a fight at bedtime or naptime. This is developmentally appropriate- they want to be part of the action ALL THE TIME. It is okay for them to protest bedtime and it is okay for you to hold your boundaries around your sleep rules. Here are some tips to help prevent or mitigate sleep refusal:

Implement a consistent routine: children love structure, so when we offer them the same routine every night, they know what to expect and what is expected of them
Use timers (with the volume on OR on vibrate if you have they are sensory-sensitive): it’s harder for children to argue with timers, so set them and stick to them. Allow your child to be the one to set the timer and when it goes off, you are moving to the next step in the routine, regardless of their push-back.
Be fair but firm: Give them space to express their emotions and honor them, but always provide the firm boundaries for the sake of their healthy sleep.
Use visual cues: I love this resource for our little ones who are visual learners in need of a prompt to help them transition between each step. (I still use this in my house to this day with my child with SPD!)
Give extra time: Your child may sense if you are rushing bedtime and this could increase anxiety and/or resistance. This is hard to do, given schedules, after bedtime chores, and siblings, but spending an extra 5-10 minutes of uninterrupted time with your child, and given it a special name (i.e.- “special mommy/daddy time”) can help them feel secure and soothed.

Sleep and Medical Implications

If your child is frequently mouth breathing or snoring, it is important to make your pediatrician aware and meet with an ENT or sleep medicine doctor. This could be a sign that they have enlarged tonsils/adenoids and could be experiencing sleep apnea. We want to be sure any medical diagnoses are resolved prior to implement behavioral sleep modifications.

If you are interested in learning more about implementing behavioral sleep modifications, two methods I recommend researching are the chair method and timed checks. As always, confirm with your pediatrician that your child is ready to begin sleep training and reach out to help from a certified professional, life myself, for modifications and accommodations to general sleep plans.

Conclusion

Your child is brilliant and you are their best advocate. If you are struggling with sleep right now, remember to lean on your village for support and get help to get their sleep on track. Jump over to Instagram and follow me @yourzenbabysleep and stay tuned throughout the month of August for weekly sleep tips on the ELM account.

Stay tuned for information on our SLEEP GIVEAWAY that will be given at the end of August! More details to come!

**Want to learn more about working with Sarah? Head over to the website: www.yourzenbabysleep.com or feel free to schedule a free 15-minute sleep assessment call here.

Instagram: @yourzenbabysleep