Helping Teenagers Build Healthy Sleep Routines

Do school-based OTs have a role in sleep hygiene? Well, we know that for students to thrive academically, a good night’s sleep is paramount. And as an expert in promoting overall well-being and optimal functioning, you as a school-based OT play a pivotal role in supporting students and their families. While you (hopefully!) won’t observe students sleeping at school, you can still provide valuable suggestions and strategies to empower families to prioritize sleep, ultimately leading to improved focus, attention, and overall success within the educational setting. Here are some of those strategies:

School-Based OT Sleep Hygiene Strategies

  • Check in with your medical team.
    • If your child has any issues with sleep, start with your pediatrician. They may suggest a medication, supplement, or sleep study that can help.
    • It’s possible that your child has an underlying diagnosis such as sleep apnea that could be interfering with sleep. 
Is that blanket too warm to let you fall asleep?
  • Review the environment.
    • Could light be interfering with sleep? If so, some possible solutions are blackout curtains or wearing an eye mask.
    • Is the room the right temperature? Is your child too hot or too cold? Do they need more or less blankets?
    • Can noise be reduced? Would closing windows help? What about a white noise machine? Soft music? Ear plugs?
  • Form consistent routines.
    • Though it’s challenging, try to have your child go to bed and get up at the same time every day – even weekends.
      • There can be some flexibility here for older children, but if your child is having difficulty getting good quality sleep, this is where I’d start.
    • Set a time when the bedtime routine will start – and plan consistent activities.
      • For example, you could say that the bedtime routine will start at 8:30 and you will help your child change into pajamas, read a story, and have one small snack, with the routine being complete by 9pm. 
    • Be firm.
      • This is the hardest part, but once you’ve set a bedtime, be willing to walk away. Try not to give in to requests for one more story or glass of water. 
    • Use visuals.
      • You can use drawings or real-life pictures of your child completing the task.
      • Try taping them on the wall in your child’s bedroom.
      • Bedtime Routine Visuals
  • Use a reward system or positive reinforcement.
    • Consider using a token economy such as a sticker chart. Give your child a sticker every time they successfully go to bed when asked – then allow them to trade in a certain amount of stickers for a prize.
    • Consider praising each step. Some children benefit from really high levels of positive reinforcement.
  • Consider food and diet.
    • There is evidence that diet can affect sleep, though research is still fairly inconclusive on specific foods that aid in sleep. Instead, focus on having a balanced and healthy diet. 
    • Make sure your child is full before bed as this is something that can interfere with falling asleep. 
  • Consider exercise. 
    • Exercise’s relationship with sleep is another area that has been studied heavily. There is some evidence that exercise can help increase the quality of sleep, but not a lot of consistent data on the best type of exercise or the best time to do it. It’s definitely worth experimenting with to see what might work for your child – you can even take some easy data to measure an effect.
Even boba tea might be too caffeinated to drink in the evening
  • Reduce caffeine consumption.
    • If your child consumes any caffeine in the form of coffee, tea, or energy drinks, this can possibly interfere with sleep.
    • While you don’t necessarily need to cut out these drinks entirely, consider having a cutoff point for them during the day – say, by 3pm. 
  • Reduce screen use before bed.
    • Screens can interfere with falling asleep. Try to cut them out entirely (phone, tablet, and TV) 1-2 hours before bedtime. Definitely try to prohibit their use in bed. 
  • Limit liquids before bed.
    • This can help prevent nocturnal enuresis (bedwetting) as well as prevent children from waking up in the night to use the bathroom. 
  • Consider storing highly engaging toys or devices outside of the bedroom.
    • This way, if your child is having trouble falling asleep they won’t be tempted to stay up by engaging in preferred activities. 
  • Consider other sensory aspects of sleep.
    • Are your child’s pajamas comfortable? Are they bothered by seams or tags?
    • Would your child benefit from using a weighted blanket?
      • If going this route, try a weighted blanket during the daytime first. Make sure it’s not so heavy that your child can’t independently remove it. 
  • Experiment with what type of alarm works best for your child.
    • Waking up by alarm instead of by an adult is a key step to building independence. 
    • Some children may prefer tonal alarms, some may prefer music, some may prefer tactile, and others may prefer alarms that affect the light.
    • You can also consider an alarm that is based on natural sleep cycles
  • Build enough time into your morning routine.
    • Waking up is hard! Allow your child to have enough time to gradually wake up without feeling rushed. 
    • A wake-up routine can be just as important as a bedtime routine. 
  • Consider positioning.
    • Make sure your child’s bed is comfortable and the right size.
    • Make sure your child’s pillow’s loft (height) is correct – if it is too high or too low, this can lead to muscle soreness. 
  • Think about co-sleeping.
    • Co-sleeping, or sleeping in the same bed as your children, has pros and cons. 
    • This may be a way you and your child can get more restful sleep, or it may lead to your child being dependent on you for sleep. 
    • This is a personal choice for every family.
  • Give your child some control over the task.
    • This can help give them more buy-in as well as curtail any negative behaviors. 
    • Let them pick out what pajamas they’d like to wear or a story they’d like to read. 
Also, make sure there’s not a cat literally IN your bed when you make it
  • Model the same behavior.
    • Try to practice what you preach and demonstrate healthy sleep habits. Talk about them with your child.
  • Practice!
    • It almost goes without saying, but the key to becoming proficient in these skills is practicing them and making them part of daily routines. 

I hope these strategies were helpful for building healthy sleep habits with older children! As a school-based OT, you can have a role in developing healthy sleep habits and helping students and families understand the impact of sleep hygiene on school performance. Do you have any other strategies to share?

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