Sleep and Complex Trauma
Why do traumatised kids struggle with sleep?
It is common for children who have experienced trauma to struggle with sleep. This can affect mood and concentration during the day, and parents and carers can feel powerless to help. Here are some reasons why trauma may affect a child’s sleep:
Traumas occur more frequently at night making night time particularly scary.
Brainstem-mediated hyperarousal inhibits melatonin production making sleep onset difficult.
Traumatised children are unlikely to be ‘tired out’ during the day due to constant hypervigilance.
Sleep is a separation from caregivers and can be frightening for kids.
Sleep involves dreaming, and dreaming can involve nightmares. Dreaming is the brain’s way of processing emotional content (trauma) and can be unsettling and scary for kids. They may not want to go to sleep out of fear of having a nightmare, and may wake irritable and tired due to poor sleep.
What can we do to help kids with their sleep?
Have a visual routine for each step of routine. This could be a chart or post-it notes on a piece of paper to keep it simple. Avoid including times so that it doesn't create stress trying to keep up with it.
Keep the routine the same each day as much as possible to create rhythm and predictability.
Avoid screens and stimulating activities close to bed time. This can includes reading exciting stories that can be stimulating for kids. Quiet reading is okay for older kids. For highly anxious kids, rhythmic stories can be good, especially if the rhyme and can be read in a ‘sing'-song’ or soothing style.
There are a number of great audio sleepy stories that are designed to induce sleep. Get in touch for some examples!
Calming songs can be powerful, either sung or recorded.
Using a bottle of milk at bedtime for children who have experienced neglect can be soothing and nurturing - even if they are ‘too old’ for a bottle - if they missed early experiences of nurture they will need them to ‘catch up’.
Bananas contain melatonin
Setup breakfast before the kids go to bed so they know there will be food and a plan for the next day. This can reduce worry about the next day.
Have a nightlight in the child’s room that is soft and warm warm.
Lower houselights towards bedtime to signal to the child’s brain that sleep time is coming.
Have a time (perhaps as dinner time) where kids can share any worries or ‘hurts’ they feel, offer empathy and acceptance in response.
Recount the day slowly at bedtime. This is generally better than a bedtime story as kids often struggle to recount events and thread them together. Using a story format in a very calming and soothing way is relaxing and reassuring.
Sleep toys that are soft and offer some help with sleep (maybe they glow or have soothing sounds) can help anxious kids sleep better.
Try using proprioceptive input such as a weighted or stretchy blanket, check your local sensory store for options.
Gentle massage can be helpful for some kids if they feel ok with it. Our hands contain many nerve endings and a hand massage can be as good as a back massage. Be cautious as massage can also be activating, especially as the child is close to sleep.
Offer lots of reassurance that you will not leave them alone in the house, that you’ll check in on them intermittently, that they can call for you or come in to ask for help if they need it.
Consider using a baby monitor to create safety and increase a sense of closeness and connection even when alone in their room. This can be especially helpful with transitions, such as moving home.
Sometimes kids sleep problems persist and it may be necessary to consult a specialist who can develop a systematic plan to address sleep disturbance. Don’t give up if it is hard, there’s always a way!