Dreaming Big: Supporting Sleep for Kids with Special Needs and Medical Conditions

It is often assumed that children with special needs struggle to sleep due to their disability or medical condition. However, inconsistency and learned habits can also contribute. While standard sleep hygiene practices benefit all kids, you may need to adapt to your child's specific needs.

Children with special needs thrive when they have routine and consistency! It can take a few weeks to get adjusted to a new routine.

For more tips on developing a sleep hygiene routine check out Dreamland: Nurturing Healthy Sleep Habits in Kids and Teens

There are many reasons for a child with medical issues or special needs to have sleep issues:

• Difficulty settling down and going to sleep

• Waking repeatedly during the night, or having difficulty getting back to sleep after waking up

• Anxiety or difficulty relaxing causing insomnia

• Irregular production of melatonin, which regulates sleep patterns, or having atypical circadian rhythms (sleep wake cycles)

• Neurological conditions such as seizure disorders

• Sensory issues: increased sensitivity to blue light from screens or to certain sounds and white noise can be upsetting or distracting, potentially keeping them awake.

• Sensitive digestive systems

• To prevent reflux or vomiting during sleep, avoid giving your child food or water at least 2 hours before bedtime. A full stomach can cause stomach acids to leak into the esophagus, causing that reflux sensation. If your child is followed by a GI specialist, share your concerns and discuss options to make adjustments to their regimen.

• Food allergies can lead to stomach issues and discomfort.

• Increased sensitivity to caffeine or other stimulants can disrupt sleep.

• You may want to discuss with your health care provider about getting a consultation for a GI specialist to help you navigate these issues.

• Hypersomnia: sleeping too much. This could be due to various factors, such as side effects from medication or increased exhaustion caused by overstimulation.

Children with ADHD are more likely to experience shorter sleep time as they transition into puberty. Fatigue may present through hyperactive and impulsive behaviors. It can be difficult to tell whether these issues are brought on by ADHD or by a lack of sleep. This could result in misdiagnosis or undetected sleep disorders. Experts recommend screening for sleep problems before prescribing ADHD medication.

Tips for a Better Nights Sleep

A good night’s sleep is important! Experiencing anxiety about bedtime and concerns regarding your child's safety throughout the night can make it challenging to achieve restful sleep.

• Safety proof your child’s room so you can relax knowing that they cannot harm themselves while you are asleep.

• Caregivers of children with disabilities may be eligible for respite services. Respite services can be helpful if you need help during a time of illness or injury or if you just need a break.

• Create a visual schedule: Getting your child into a bedtime routine, with the help of a visual schedule, will allow their body to get into a routine and recognize when it’s time for bed. Your visual schedule can include pictures, objects, or just a check list to show what needs to be done to prepare for bedtime.

• Involve your therapists! Depending on the specific sleep issue, it may be beneficial to inform your child's therapists. For example, your occupational therapist or ABA therapist could assist if toilet training is a barrier to sleep.

• If you are struggling with long-term lack of sleep, it may be time to talk to your pediatrician and discuss options including referral to a sleep specialist.

Specialty Beds and Bedding

There are beds that have soft edges to prevent injury and a 'zip-up' door for safety. Some children feel more secure and sleep better in them.

If your child has continence issues, consult their continence team for appropriate products. There are bed protection sheets for bedwetting that can help protect the mattress and to help your child to feel more comfortable.

For children with sensory needs there are weighted blankets and other products that can prevent falling out of bed and loss of sheets and covers.

Children with Cerebral Palsy or other neuromuscular conditions might benefit from a sleep system with specialty cushions to maintain proper posture.

Talk with your child’s pediatrician and specialists about what your concerns are and what products they recommend

What about melatonin supplements?

Scientific research indicates that melatonin supplements may help with insomnia in children with ADHD, autism, and other neurodevelopmental disorders. While effective short-term, some children may need longer-term use. Melatonin should not be the only solution; it should be monitored by a pediatrician and used in combination with behavioral interventions.

Bottom Line: Every child deserves sweet dreams! Work with your pediatrician, specialists, and therapists to craft a personalized sleep routine tailored to your child’s needs. It might take some trial and error, but the rewards of restful nights are truly priceless!

Got any game-changing tips or must-have products that worked wonders for your child? Share your success stories—we’d love to hear what made a difference! Contact us: tinywellnesscollective@gmail.com

References

Berenguer C, Rosa E, De Stasio S, et al. Sleep quality relates to language impairment in children with autism spectrum disorder without intellectual disability. Sleep Medicine. 2024. 117; 99-106.

Duboc H, Coffin B, Siproudhis L. Disruption of circadian rhythms and gut motility: An overview of underlying mechanisms and associated pathologies. Journal of Clinical Gastroenterology. 2020. 54(5), 405–414.

Jan JE, Owens JA, Weiss MD, et al. Sleep Hygiene for Children with Neurodevelopmental Disabilities. Pediatrics. 2008; 122 (6): 1343–1350.

Ogundele MO, Yemula C. Management of sleep disorders among children and adolescents with neurodevelopmental disorders: A practical guide for clinicians. World J Clin Pediatr. 2022. 15;11(3):239-252.

Wajszilber D, Santiseban JA, Gruber R. Sleep disorders in patients with ADHD: impact and management challenges. Nature and science of sleep. 2018. 10, 453–480.