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Establishing Bedtime Routines for Children

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Sleep is an essential part of our day to ensure we are healthy and ready to engage in what life has to offer. Going to sleep and getting enough sleep are important skills for children to learn. Optimal sleep helps to ensure that children are able to play and ready to participate in daily activities at school or at home, and it promotes growth and development. Parents often struggle with bedtime routines and making sure children go to bed at a reasonable time. A bedtime routine can help both parents and children make the daily activity of going to sleep a pleasant experience.

Sleep is one of the many daily occupations (activities) that occupational therapy practitioners help to promote. The following tips are from pediatric occupational therapy practitioners who have experience with educating parents on promoting healthy daily routines, including bedtime.

If you want to:

Consider these activity tips:

Establish a specific bedtime and a bedtime routine.

Select a bedtime that you feel is appropriate for your child based on his or her age and schedule, and be consistent, even on weekends and during vacations. If you have multiple children, you may want to identify different bedtimes to ensure you can help each one.

Establish a predictable, regular sequence of events to prepare for sleep and relaxation. Begin this bedtime routine about a half hour before.

If your child is able to talk, share reminders about when bedtime is coming, stating something like, "First we eat dinner, then we play, followed by taking a bath and putting on our pajamas. Then we read a story and get into bed to go to sleep."

To reinforce the bedtime routine, encourage your child to be part of the process. Ask what step comes next; offer choices of books, songs, etc.; and suggest he or she put a favorite doll or stuffed animal to bed. Use a transitional item, such as a blanket or a soft toy.

Help your child relax to get ready for sleep.

Avoid exercise or TV immediately before bedtime because these can make children more alert.

As part of the bedtime routine, have your child pick up and put away toys. Reducing clutter can help the child focus on bedtime.

Turn off the TV and play soothing music during the bedtime routine, to help your child calm down and signal that bedtime is arriving.

Help your child feel comfortable for bedtime.

If a child expresses fear of the dark, make checking the closet or under the bed part of the bedtime routine. A nightlight can also help reduce these fears.

Dim the lights while getting ready for bed to help the child prepare for the dark and to reinforce that nighttime is for sleeping.

Think about sensory experiences: are pajamas or blankets itchy? Do the fabrics breathe? Is the room too warm? Too cool? Are the window coverings letting in too much light? Are there smells wafting in from the kitchen?

Support the child by saying things like, "I believe in you," or "I know you can do it" in response to anxieties or fears that interfere with sleep. Overcoming a fear in a safe, supported environment can help the child gain confidence.

Ensure that your child is safe while sleeping alone.

For young children, help prevent sudden infant death syndrome (SIDS) by not putting items like blankets or stuffed animals in the crib. Minimizing stuffed animals in the bed of any child teaches that the bed is for sleeping, not for playtime.

If a child makes nighttime trips to the bathroom, place nightlights in the bedroom and bathroom.

Make sure there are no cords dangling from the blinds or other items that could be a choking hazard. If a child is at risk for falling or rolling out of bed, consider placing a large pillow on the floor to prevent the child from getting hurt. Use a baby monitor or intercom system to listen for your child's needs.

Help your child become more independent in sleep.

Beginning at about 2 months of age, place a child in bed prior to being asleep so he or she can learn to fall asleep independently. White noise can provide comfort and help to drown out other noises. Sound machines, fans, or even aquariums can be used for white noise.

Make sure your child isn't drinking soft drinks that contain caffeine during the day.

Older children should go to bed at the established time even if they don't feel tired, so they don't fall asleep in another room and have to relocate to bed. Encourage them to read in bed or read to them for a set amount of time to help them relax.

When old enough, the child can learn to make his or her bed.

Need More Information?
An occupational therapist can evaluate your child for any issues underlying his or her ability to go to sleep and stay asleep, then create an intervention plan to address them. For example, an evaluation could reveal that the child is particularly sensitive to noise, textures, or odors, making it very difficult to relax enough for routine sleep. The occupational therapist can work with the entire family to help create an individualized strategy based on their particular situation and needs. You can find additional information through the American Occupational Therapy Association at www.aota.org.

Occupational therapy is a skilled health, rehabilitation, and educational service that helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations).

Copyright © 2012 by the American Occupational Therapy Association. This material may be copied and distributed for personal or educational uses without written consent. For all other uses, contact copyright@aota.org.