Children’s Sleep Schedules Matter – In and Outside of the Lab
For a child, a sleep schedule is everything.
Dr. Lynelle Schneeberg, PsyD, knows this better than most. A pediatric sleep psychologist and a mother herself, she’s been coaching families for years on how to get their kids to be better sleepers.
“I work at the Connecticut Children’s Hospital, and I found that I was writing the same sleep plan for families pretty much over and over,” she said. “I took the plan that I came up with through a lot of trial and error, and I made what I call a five step guide. And I turned it into a book.”
Schneeberg is the author of Becoming Your Child’s Sleep Coach: The Bedtime Doctor’s 5-Step Guide. She is also a distinguished lecturer at AAST’s 2019 Annual Meeting, which takes place September 6-8 in St. Louis.
In her session, she hopes to touch on how parents can help train their children into better sleep routines, and what role sleep medicine professionals can play in aiding kids who come in for sleep studies.
“I expand on how to help kids sleep at home and in the lab,” she said.
There are two main reasons kids have trouble sleeping at home: their parents stay with them for too long during the sleep process, and they return for “extra requests” when the bedtime routine is supposed to be over. Schneeberg describes these things as “sleep crutches.”
“Parents come back for callbacks and curtain calls,” she said. “Kids are inventive. You think to yourself, ‘If I grant all these things, my kid will finally fall asleep.’ But any behaviorist will tell you you’re rewarding awake behaviors.”
It’s OK for a parent to lay down with their child for a bit, give them a goodnight kiss and read stories. That’s part of a regular bedtime routine. It’s not when a parent stays with them until they are asleep, or gives in to multiple requests for a parent to return once the routine ends.
One of her tricks is to give a child two tickets for after-bedtime requests. It teaches a child that a parent won’t come running every time, and they need to let themselves go to sleep. Another is to give a child an unwinding activity they can do alone—like reading a book with a bedside lamp they can turn off themselves.
“There’s no pressure – they don’t have to hurry up and sleep,” she said. “When we’re rushing children to get to sleep, they know you need to go and do your work or whatever it is you need to do at night. They feel a bit of a rush. It’s hard to fall asleep when you’re in a rush.”
That feeling of anxiety can transfer into the sleep lab, too. Child patients don’t always understand what a sleep study is. The equipment used in a sleep lab can look scary to a child, too, which only adds to anxiety about their sleep habits.
Schneeberg says any sleep center should have tools to help children feel more comfortable and at ease. At her office, they have children’s books that explain what a sleep study is in a fun way. She also recommends using imaginative words that help desensitize the process. Instead of “electrodes,” maybe call them “golden circles.”
Her hospital provides desensitizing kits to parents before a sleep study is performed. In it are tape, electrodes and a cannula. They encourage kids to perform “sleep studies” on a teddy bear or their parents to make them feel comfortable with the equipment.
“We take the cannula and we pair it with something really positive,” she said. “The language sleep technologists use can make a sleep study a lot less scary for a little kid.”
She said sleep centers must also be aware of what kind of sleep schedule the child has prior to the test. If a child has bad sleep hygiene, a test won’t do them any good.
“What if a child needs a binky or a bottle or to be driven in a car to fall asleep?” she said. “You need to sleep train your kid before we can do the test. We do an approach where we send everyone a letter saying ‘This is what we’re going to do to your kid, and this is why we’re going to do it.’ We hope their kids can put themselves to sleep fairly independently, and if they can’t, we have a plan for that.”
For technologists, understanding not only how to perform a good test on a child but what makes good sleep hygiene for a child in the first place will better equip them to work with their patients. Because when a child finally can sleep independently and undisturbed, the whole family benefits.
“If you can help an 8-year-old fall asleep, then the entire family is better off,” she said. “The marriage benefits, his parents benefit individually, his brother who hears him freak out benefits. Overall, this is a positive thing that can have lasting effects.”
Schneeberg will be speaking at AAST’s 2019 Annual Meeting on Sept. 7 during the Saturday Distinguished Lecture.