Positive Relationships: Behaviour - Off to sleep

Some of our children seem to have really late bedtimes and arrive tired and listless in the mornings. Also, parents often ask us to keep their child awake and not let them have a nap during the day so that they will sleep at night. How do we juggle parents' and children's needs in the advice we give about sleep and bedtimes?

Our understanding of sleep has developed significantly as neuroscientific research has progressed. Whereas sleep used to be thought of purely as a restful time, we now recognise it is actually a very active time for the brain.

While we sleep, hormones are released to support muscle development and growth in our bodies. In our brains, memories and learning are processed, supporting myelination -the building of fast connections between neurons. Regular and healthy sleep patterns help these processes to happen naturally and are especially important in early development when the most rapid brain development takes place (Oates, 2012).

Each child is unique, so will need different amounts of sleep to enable their well-being and development. Total sleep in a day for a three-month-old might vary from eight hours to 18 hours. However, it is important to help babies and young children develop healthy sleep patterns.

The feeding, sleeping, activity pattern that a baby is encouraged to develop can have as much impact on parental well-being as the baby. Lack of sleep can reduce our decision-making, tolerance levels and regulation of our emotions. So when parents talk to practitioners about their concerns related to their child's sleep, they may themselves be trying to manage with less sleep than usual.

Families have very different views about bedtimes and it is important to recognise that there is a lot of variation in what works in different situations. However, there are some common elements that will help children to gain the maximum benefits of sleep most of the time.

Firstly, a predictable pattern of preparing for sleep will help. This should include a calming, soothing period before bedtime. Adults can thoughtfully develop a routine based on knowledge of their child and what helps them be calm and relax. This will vary from family to family, but the important elements are the adult setting the calm tone of preparation for bed and the child feeling safe and relaxed.

SLEEP PATTERNS

Unfortunately, even if a child usually has a regular pattern of going to bed and sleeping well, things can still go wrong, though this is more likely to be temporary. As a parent, it can be hard to believe things will return to the preferred routine, especially if you are missing sleep yourself. When parents ask about or share concerns about their child's sleep, the first step is to talk together about how things go on 'a good night'. This will give you insights about the routine that the child is used to and what has worked for them.

Changes in sleep patterns can result from a range of things, including changes in bedding, lighting, decoration and holidays, as well as being unwell, excited, anxious, hungry, thirsty or losing comforters. Natural growth patterns not only affect appetite but also sleep patterns, which may be the first outward sign of changes.

Teething is the most obvious disruption, but other developments such as awareness of the sensations relating to toileting can also disturb established sleep patterns. Overtiredness, particularly when children are very active in their daily lives, can be a major factor in making bedtime routines difficult and maintaining amounts of sleep.

An in-depth discussion with parents gives you the opportunity to talk through your shared understanding of the child's perspective at this particular time.

• How much sleep is the child generally getting through the day?
• What changes have you both noticed?
• From the range of possibilities, what is most likely to be affecting sleep at the moment?

Mostly parents would prefer children to have the majority of their sleep at night, so working towards this is a reasonable aim. However, many children continue to need a nap either morning or afternoon to help them cope with the day. Reviewing with parents how the child's day looks in terms of balance between levels of activity and sleep can highlight natural changes in energy, growth and tiredness.

Bedtimes will have a significant impact on the amount of sleep and ability to cope through the day. Most young children need about 12 hours sleep to enable them to be at their best through the day. So if they need to be getting up at 7am in the morning, they need to be asleep at by 7pm the night before.

After a period of disrupted routine, perhaps through teething or nightmares, it can take a while to get back to regular bedtimes. Perseverance and realistic expectations are essential to help children to do this. Here are some key points that may help:

• All adults at home need to be involved and agree on the approach.
• Changes in bedtimes are gradual. If currently 9pm, bring this forward by ten to 20 minutes at a time rather than going straight back to 7pm.
• Routines for preparing to sleep are focused on relaxation and 'unwinding'.
• Children are put in their bed or cot when drowsy, not once asleep.

As children gradually need less of a daily nap, the transition can be a struggle, with children sometimes doing without a nap for several days then having a 'long' nap that then affects night-time sleep. This can be frustrating for parents, but can be helped if you talk - as soon as you both feel there are times when the child does not need a nap - about how you will work together to help the child gradually adjust their routine.

Kay Mathieson is an early years consultant and author

MORE INFORMATION

• I Am Two! Working effectively with two-year-olds and their families by K Mathieson (2013), The British Association for Early Childhood Education
• Early Childhood in Focus 7: developing brains edited by J Oates, A Karmiloff-Smith, MH Johnson (2012), The Open University Press, available from www.bernardvanleer.org

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