Sensory Strategies for Bedtime

By: Christine Hemelians, MSOT, OTR/L 

Did you know that difficulties with sensory integration can negatively impact sleep? Close to 30% of children have trouble sleeping; that includes either falling asleep, staying asleep, or being comfortable while trying to sleep (Vasak, Williamson, Garden, & Zwicker, 2015). Stimuli (i.e. sights, sounds, touch) may make it difficult for some children to calm their bodies in order to fall and stay asleep. There is research linked to sleep behaviors/ patterns and the way bodies experience and interpret sensory stimuli. Children with sensory integration needs are more likely to have challenges falling asleep or staying asleep. Children can have difficulty falling asleep for many different reasons, including but not limited to, the clothes the child is wearing when going to sleep, the activities that are done prior to bedtime, and the habits surrounding the child’s bedtime routine. Many parents actually find that the only way they can get their child to sleep is by either having the sleep in their room or bed or having the child come into their bedroom in the middle of the night when they wake up. However, it’s important the allow your child to learn how to fall asleep independently starting at a young age. If co-sleeping is necessary here are some tips/ strategies to so that you can eventually transition your child to fall asleep on their own.

• Use a wall barrier for the bed if you have an infant so as to prevent rolling over them
• Have your child sleep in a sleeping bag or portable mattress on the floor of your room rather than right next to you in bed
• If sleeping in your child’s room, transition to sleeping on the floor instead

(May-Benson, 2018)

Sleep Intervention to Promote Healthy Sleeping Habits

1. Create & Maintain Bedtime Routines: One of the best ways to support your child’s sleeping habits is to create a routine for bedtime and stick to this regimen. Routines cue the body that it’s time to go to bed. Start with something simple and short and complete the same set of activities around the same time each night. For example, brushing, changing into pajamas, and reading a book/ bedtime story. 
2. Calming Pre-Bedtime Activities: Sometimes it’s important to lower the child’s arousal levels and return to a calm state prior to transitioning to bedtime. One of the best ways to alter environmental factors is to reduce the amount of alerting stimuli in the environment. 

• Avoid screen time! (no bright lights)
• Relax & prep for bedtime in a dim, quiet space before heading to bed
• Choose relaxing activity (reading, drawing)
• Listen to quiet music (i.e. white noise machine)
• Wrap body in tight blanket for added deep pressure (i.e use of weighted blanket or stuffed animals)
• Warm shower/ bath
• Deep breathing exercises or sucking to calm the body (i.e. blow up a balloon, drink room temperature water using a straw, or suck on a sugarless mint)
• Rhythmic rocking (i.e. rocking chair, hammock swing)
• Heavy work activities can be especially helpful if your child needs to move before going to bed. Activities such as wall push-ups, game to pour stuffed animals while lying bed, pulling apart clay or putty
• Try inverting the head (head upside down) throughout the day and right before bedtime for regulation and calming

3. Changing the Sleep Environment: 

• Hang room darkening shades/ blackout curtains 
• Change linens/ comforter to solid, soothing, simple pattern
• Keep door closed to limit light & sound
• Use weighted blanket/ quilt or tuck the sheets under child’s mattress on one or both sides to increase deep pressure
• Sleep with stuffed weighted animal or body pillow
• Put sheets or pajamas in dryer 5 minutes before bedtime- this creates warmth that can be soothing for some children 
• Use white noise machine
• Use sheets and pajamas that make the fabric feel softer (this might mean tearing any tags or washing & drying them multiple times to make the fabric softer)
• Use a vibrating pillow or place a hand-held massager under the pillow or mattress
• Lycra compression can be another alternate to weighted blanket
• Use chewy toy for oral sensory input
• Use a humidifier in the room

(May-Benson, 2018)

If your child struggles with falling or staying asleep, work with an occupational therapist to come up with a routine/ schedule, as well as a sensory diet, to promote improved sleeping habits. 

May-Benson, T. (2018). Sleep and Sensory Integration: A Guide for Parents. https://thespiralfoundation.org/wp-content/uploads/2018/10/Sleep-and-SI-brochure_final.pdf

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