If bedtime means dread-time in your house, listen to this relaxed session of Sensory Chat where four international therapists chat over practical tips on helping your little one move towards a sleepy state. What is down-regulation? How can you use the sensory experiences of light, temperature, touch and taste to help get your toddler ready for sleep? Why does making the transition to bedtime longer and slower help, even when it’s probably the last thing you want to do! Listen to this final episode in the current series of Sensory Chat to find out how reframing your view of your child’s bedtime process can improve both your experiences of it.

Transcript

Lelanie

Welcome to sensory chat, in today's episode we're going to be looking at the end of the day, getting ready for bed. What is the process involved in that and how that can be quite challenging for little ones with sensory difficulties. This is for parents, but will also be useful for teachers and healthcare professionals to listen to.

Amy

So when we're thinking about the state that your brain and your nervous system needs to be in, in order to be able to rest, in order to be able to fall asleep. There's a process of sort of calming down and it's not just sort of chilling out, but that kind of whole body, whole brain calming down, that we call that process of regulation and down-regulation. So I'm wondering if maybe we could just start talking a little bit about what down-regulation means. Angela, is that something that you would be happy to kick us off with?

Angela

Sure. So down-regulation is, I guess, working towards this sleepy state, you know, we need to be in a sleepy state to be able to then fall asleep. I guess how far we are away from that sleepy state can change each day, you know. And so this can be a real challenge around bedtime because you know, children, you know, may present as quite excited. And so then we perhaps need to work a little bit harder, or for longer, to reach this sleepy state.

Amy

So definitely in ASI, one of the ways we describe that is trying to get down to baseline for bedtime. And when we mean that, we mean quite a lot of  work that goes into managing the chemicals in your brain. So your neurotransmitters and the hormones that are going to allow you to calm yourself down. So we know that neurotransmitters and hormones like adrenaline and cortisol, those pep you up, give you energy to keep you going, but we're talking here about the opposite. So the parts of your nervous system that allow you to chill out and calm down, Lelanie, what are some of the things, what are some of the kind of sensory strategies generally that are useful for helping people to down-regulate, helping people to calm?

Lelanie

So one of the things that I think about a lot is around evening time, children are exhausted, and they often get this extra burst of energy running around the house. And then you have excited parents coming from work, tossing children up in the air, which sometimes doesn't help the frazzled parent who is at home with the child that time of day. It's about, for me, it's about slowing down, being calm, getting calm down. I actually think in Europe and it's very hard in the summer because you have the sun shining until 11 o'clock at night in some places, thinking about my colleagues in Scandinavia where it's sunshine so that's really hard. You want to sort of create the atmosphere as well to set the scene because a two year old doesn't have that instinctive cue, it can't make the connection, I’m tired, I need to slow down. So you need to structure it for them. If you're somewhere bright and sunny, think about curtains that are lined and blacked out or in the winter start dimming lights and just turn the TV volume down, maybe change to a calming program. I know there are BBC programs that used to be on like ‘In the night garden’, which is super annoying, but the tune is very calm and relaxing and thinking about something that is low in excitement and arousal, just to bring that calm vibe. Also in terms of eating, maybe don't eat too late at night and have lots of bright toys or excitable things around and just start packing things away slowly to almost decrease the temptation to still keep going.

Amy

So I'm hearing that one of the things that probably would be helpful that parents might, might be able to kind of emphasize more, is making that transition into bedtime longer and slower.

So starting earlier with sort of just starting to change the pace down, to change the light levels that are around. It's very interesting to me, I’ve done quite a bit of research on, kind of what happens to your brain in terms of the light levels for sleeping. So one of the things that we know is some of the hormones that help you, it’s two different hormones, so one hormone helps you to fall asleep and a different hormone helps you to have the urge to go to bed and rest. So what you're hoping for is you're going to have high levels of both of those hormones at the same time. And for most of us as adults, we've had that experience of being really absolutely bone tired, but not being able to fall asleep.

And that's because we don't have enough of the hormone that allows you to drop off. So it will be the same for children that being ready for bed doesn't necessarily mean that they're ready to fall asleep. And one of the things that regulates that, is the light levels. So, towards the end of the day, looking for warmer light, and what we mean by warmer light is trying to find lights that have a more kind of  yellow or red tone rather than lights which have a very bright or a blue tone. So that might be for example, in your home, putting the sidelights on, the table lamps on in the evening, rather than the main overhead lamp.

But it might also be thinking about blue light from screens, from the TV, from computers, from phones and from tablets. Those are actually going to wake a child up more. So if you're using a tablet in bed that might not be helpful to help their hormones, allow them to go to sleep.

Emma

So, I mean in addition to the light, I think we also need to consider temperature as well because the body needs, the body drops temperature slightly just as it's falling asleep. And that's really difficult to do if we're in a very warm environment. So consideration of the temperature of the environment is really important as well for sleeping.

Angela

And adding to that, you know, in relation to taste and temperature as well, I'm thinking about the addition of a warm drink before bed, whether that might be hot chocolate, or it might be warm milk with some cinnamon or nutmeg. These types of tastes and spices are also generally quite calming and down-regulating and can help facilitate that process of moving towards that sleepy state.

Amy

I'm just going to pick up on that, the temperature, talking about temperature. So a study I did, we were looking at ways that for adults, you could help yourself fall back asleep if you were struggling with insomnia. And one of the strategies that we explored was changing temperature of your body. So if you were awake, making sure that you got up and got out of bed until your body got a little bit cold, and then getting back into a warm bed to help you drop off. But conversely, you could also do having a warm bath or a warm shower and then getting into a cool bed, so cool sheets. So that shift in temperature sometimes just triggered falling asleep. And I'm wondering if that would be also kind of something that would be useful for children.  Emma, I know you've done work with parents about bedtime.

Emma

Yeah, so bedtime is, I think what we forget, certainly in our sort of typical world, is bedtime, you go to bed every night, and this is a routine that happens, we go to bed every night, wake up in the morning, and it's just very common. But actually when we think about what it is, it's a big loss and separation for children. For any two year old, that's going to be a massive time, where they’re going unconscious and that can be a potentially scary time.

And even more so for children that had a difficult start in life or have got significant sensory difficulties. This process of actually the separation from the carers is going to be really, really tricky. So when we're talking about how to manage that, we're talking about being very nurturing, very caring and everything, but then we have to consider the parents state at the end of the day. And this is where most parents have reached their limit, they really haven't got anything left. That metaphorical cup we often talk about is completely empty and this is a really challenging time for a lot of parents. So one thing I talk about a lot with parents is how we can support the parent to have enough capacity to still be there and share that moment and reframing it as well.

I think, I go back to being a parent, and just desperate for my child to fall asleep so I could go downstairs and collapse. But it's that reframing of actually having that moment, that bedtime is a lovely moment. We can share that lovely, not necessarily joy and happiness, but that, that tenderness and love that is really important because that's when your child really wants you most, and spending that quality time, allowing that child to fall asleep. And one thing I've talked about with parents when they find this really hard, is to use some of those mindfulness techniques in that moment. So you can do some deep breath exercises while you're holding your child's hand in their cot, in their bed and you're there for them, but just use that as a time for yourself as well. I think typically when we think about our own regulation, we think we have to do that on our own, but how much easier would our life be if we can do that with our child.

So rather than dreading night time, reframe it in your mind to be a really positive experience. And I appreciate that takes a lot of mental effort for the parent, but if you know you're going to make that change, you can adjust the day to give yourself still enough left in your cup to cope with that bedtime.

So  yeah, just reframing how we see that difficult time and trying to use it as a time that's really positive. So you can give that nurture to that child that needs it at that really difficult time.

Amy

Okay, do you want to talk about oxytocin?

Emma

No. Lots of hugs, lots of big, long hugs. What is it? Thirty second hugs or something? Is that the latest knowledge?

Amy

So oxytocin is you know, they describe it as the feel-good hormone or the loved-up hormone. That feeling of being completely supported, completely loved. Completely connected with your child or with another person. So we know that what causes oxytocin release in a child is the touch or the smell or that looking in the eyes of the parent, but we also know it's what releases oxytocin in the parent too. If you want to feel better, you need to allow yourself to have time to touch and hold and look into the eyes of your child.

Emma

Absolutely. And that's what I mean by reframing it, reframe it from a stressful time to a really nice time where you can meet your own needs with your child and your child gets their needs met as well.

Amy

Yeah, I'm giving you a laugh. I'm thinking about some horrendous bedtimes I've been involved in where the last thing I want to do is look into somebody's eyes when really what I'd like to do is, who knows! It’s not always possible.

Emma

It's not always easy, and we have to be kind on ourselves as well, because we're only human and we get stressed and we get dysregulated. So we do have to be kind on ourselves as well and know your limits. And it's not always possible is it to get someone else to do the bedtime or what have you, but if that is an option and you really are feeling frazzled, then get help, you know.

Lelanie

Just thinking of little tips as well. Something for me, on a personal level is I don't like going to bed if I don't have a thick duvet or comforter, I like the weight of it. I'm not going to be talking about weighted blankets because that’s a controversial topic and actually not appropriate for this population, but just a normal, thick blanket. I am the type of person, if I'm going on holiday somewhere hot, I will turn on the air conditioning so I can have my blanket. And I think a lot of little ones find the weight of the blanket very comfortable. A favourite blanket or favourite toy, be careful of smothering risk though, so be really careful with pillows, but a favourite toy to cuddle and a nice comfortable blanket can go a long way.

Amy

Yeah, I'd say from a sensory perspective, we'd understand that what that's providing is deep pressure, and deep pressure is one of those tools that helps to down-regulate. So it all comes back to this, finding the things that help you to down-regulate, help your nervous system to get back down to baseline, to give you the best shot at falling asleep and staying asleep.

So wrapping up now, gosh, time goes fast! Who would like to kind of summarize and perhaps give us a couple of thoughts to go away with?

Emma

I think as in, you know, these summaries are probably going to all end up very similar aren't they? But the summary is really routine, consistency, preparation, being aware that actually, you as a parent are going to be probably at your lowest capacity to cope, but actually your child potentially could be, it could be the most difficult time for them. So prepare yourself, prepare your child and remember it doesn't have to be a difficult time if you can reframe that in your brain.

Lelanie

To add to Emma's comments, I just want to say that a lot of parents panic about bedtime, is eight o'clock the right time? Is seven o'clock the right time? And I think that will actually vary in the different seasons. And I wouldn't be too hard on yourself, you're not an epic failure of a parent if your child goes to bed at 8:30 once in a while, or, you know, every night, it's something to do, as with anything, don't compare your child to other children, I would say. And also just as hard as it is, sometimes you just have to go with the flow.

Thank you very much for joining us in this episode of Sensory Chat, we hope for you to join us soon. Thank you.

Sensory Chat is brought to you by Sensory Integration Education

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