Getting Kids to Sleep using a Bedtime Routine

​​​​​​Most parents accept and even expect fatigue when caring for infants. However, when sleep problems persist into the preschool and school age years, strategies can be used to help your child (and you as parents) get a better night's sleep. Many children get far less sleep than the recommended amount. For instance:

• 3 year-olds typically require approximately 12 hours (including a nap)
• 10 year-olds generally need about 10 hours
• Teenagers should have about 9 hours of sleep each night

Insufficient sleep is linked with a variety of consequences, some of which include irritability, delayed motor responsiveness, poorer memory and focus, and an array of health problems. Whether your child refuses to go to bed, repeatedly gets out of bed before falling asleep, crawls into bed with you during the night, or takes a long time to fall asleep, the guidelines below will help your child get a better night's rest.

Before Bedtime:

1. Create a bedroom environment that is conducive to sleep
   • Remove electronics from her bedroom (telephone, television, videogames, etc.).
   • Keep the bedroom cool and dark. If she wants some light, use one nightlight.
   • If your child enjoys playing with toys when it's time for bed, make the toys inaccessible at bedtime (store them in the closet with child-proof handles).
   • Keep it simple. Bedding and one security item (a stuffed animal or favorite blanket) are sufficient. Additional toys provide extra sources of distraction at a time when we don't want her to be distracted.
2. Develop a bedtime routine
   • Create a short routine before bedtime that involves quiet activities that occur in the same order every night. For example, have a snack, put pajamas on, brush teeth, go to the bathroom, say prayers, and read one book. It is important that this routine remains the same every night because the routine cues your child that bedtime is approaching.
   • The length of the routine depends upon how much time you have available at night. Every night, you should allocate roughly the same amount of time for this routine. If you are like most families, your evenings are busy and keeping the routine relatively short will ensure that you have time to complete this routine every night.

Bedtime:

1. Put your child to bed when she is still awake. Children learn how to fall asleep through practice. If you always rock your child to sleep, she will rely on rocking whenever she wakes during the night and needs to go back to sleep - yes, even at 3 in the morning.
   • It is okay to leave the door cracked open if you feel more comfortable doing so. If she attempts an escape, return her to bed and close the door for the rest of the night.
2. Tell her good night and remove yourself from the bedroom.

After Bedtime:

• Ignore all of her attempts to summon you back to her room. This may include crying, pleading, demanding, coaxing, and even bargaining. Though this is difficult and even painful for some parents, it is highly effective and will resolve bedtime problems in a relatively short period of time.
• If your child gets out of bed, transform into a robot-like version of mom or dad and immediately return her to bed. Specific techniques are as follows: lift her up under the arms so that she is facing the same direction as you are, carry her to bed, gently place her in the bed, and adjust the covers. During this time, do not talk to her, do not provide any type of affection (hugs, kisses, soothing, etc.), and of course, do not allow your child to delay bedtime.
• If your child is behaving unusually at bedtime, it is okay to walk into the bedroom to check on her. When you are in the bedroom, walk around the room but do not talk to her. If your child stops protesting, it is likely that she simply wanted your attention. If your child appears unaffected by your presence, investigate further to ensure that there are no problems (soiled diaper, fever, etc.).
• Persistence, persistence, persistence! When your child gets out of bed, return your escapee to her own bed every single time that she attempts an escape. It will be exhausting and time consuming initially, but in the long term, it will make the process much easier!

Using Rewards:

• Reward your child for going to and remaining in bed. Rewards could include adding a star to a sticker chart that eventually earns her a prize, getting a special breakfast cereal, or hiding a surprise under her pillow. Just as adults work in anticipation of a paycheck, your child needs to know that some type of reward will follow. Be sure to explain that she earned the reward because she did a good job going to bed.

Additional considerations:

• If you think that your child may have a medical problem that affects her sleep or if you suspect that your child is sick, discuss your concerns with your pediatrician before using any of these strategies.
• Nightmares and night terrors are relatively common among children. When they occur, provide comfort for your child as quickly as possible. You can do this through playing relaxing music, speaking quietly, or reading. Once she is calm, return her to her own bed.
• The more regular your child's sleep schedule, the easier the bedtime and morning routines will be. Consistency is very important, even on weekends and summer vacations from school.
• Be consistent - insist that your child sleep alone in her bed every night. If you allow her to crawl into your bed in the middle of the night when she is sick, she may request this on nights when she is not sick.
• If you discover your child in bed with you during the night, immediately return her to her own bed.
• There are risks associated with sharing your bed with your child, including adults rolling onto the child, the child falling out of the bed, and increased sleep interruptions. In addition to these risks, this is a habit that is incredibly challenging to break.

Initially, your child will probably resist your use of these strategies, though if you are consistent, it won't take long for her to realize that the changes will remain in place. Though it can be very difficult (and even painful) to listen to your child cry and plead at bedtime, the long-term benefits far exceed the short-term challenges.

Final Comments:
These strategies are more difficult to implement than one would think. Wars are won through a series of successful battles. Try to view each night as a battle that will help you to win the bedtime war! If you continue to experience problems surrounding bedtime, discuss your concerns with your pediatrician or ask your pediatrician for a referral to a pediatric psychologist who specializes in these types of problems.

Resources

Do you need help getting kids to sleep using a bedtime routine? Buy this book:
Good Night, Sweet Dreams, I Love You Now Get into Bed and Go to Sleep! from Boys Town Press.