James’ family were struggling with his bedtime routine and night waking. Our Sleep Practitioners, Pattie Everitt explains what sleep and advice she was able to give to help them tackle the problem.
Seven year old James has ASD and had great difficulty settling to sleep. He needed a parent with him until he fell asleep. He also woke in the night, went to his parent’s bed, and would then stay there for the rest of the night. This would result in his dad moving to sleep on a mattress to be able to get more sleep. The parents were finding this a great strain, as they did not have an evening together or a good night sleep.
Pattie explained that the waking in the night is something everyone does, normally without realising, but because James settled with a parent at bedtime, he would wake up, notice that they were not there, and then need their assistance to settle again.
The normal approach to this problem would be to reduce the contact gradually, by sitting a bit further away every few nights as the child is falling asleep and keep doing this until the parent is back downstairs. Pattie advised the family to try this, along with keeping the wake times the same each day so that James would get into a more consistent sleep pattern. A couple of months later, James’ mum replied with the following:
“Thank you for your response and advice. We have started the process of removing ourselves from James’ room at bedtime and he is now accepting us being out of the room – just outside. I suspect that the next step is to move further away which will then, as you say, reduce the nighttime anxiety, as he will get used to being on his own. We have also been sleeping with him during the night to keep him in his own bed and out of the habit of coming into our room. We are now thinking about whether we can move out but looking at your advice, we would also have to do this slowly.
Thanks for the advice on consistent bedtimes/wake times. We have managed to get him to bed a bit earlier by creating a more consistent routine but it can still take him a long time to go to sleep. I suspect that might just be the autism and a need to wind down? If we can get him to stay in his bed this, together with an earlier bedtime, is perhaps not so much of a problem.”
The parents persevered with the technique over the next few weeks, and also introduced one of their own:
“We have recently turned a corner with James’ sleeping with the use of a book on CD at bedtime. We listen to the CD with him, following the book, and then we turn the lights out and leave it on repeat at a quiet volume. James has learnt that when the CD is on, it is time for bed and that he should stay there. Although he still takes a while to settle to sleep, with the help of the CD, he is staying in his room. We leave the CD on very quietly through the night and he now stays in his bed. This is a dramatic turn-around and I think this strategy has worked because it provides a clear structure/cue about what James should be doing, and the CD helps his anxiety about being on his own/going to sleep.”
According to Pattie, using sound such as a CD to help with sleep can be beneficial, but if used for settling at bedtime it is often best to keep it at a low level all night as James’ family did so that he is exposed to the same environment when he wakes in the night. This can help the child fall asleep again on their own.
James’s mum was grateful for the support through the process:
“There is so little help out there for sleeping difficulties so your service is so valuable!“