Bedtime struggles are some of the most common complaints made to pediatricians and reasons for prescribing psychotropic medications to young children. Whether it’s fighting the bedtime routine, refusing to go to bed, getting out of bed, or trouble falling asleep, all cause parents undue stress.

There are some simple actions you can take on a day to day basis to help improve issues surrounding bedtime routines and improve quality of sleep for your child.

Things to do during the day to promote better sleep:

• Make sure your child is getting lots of activity and exercise during the day.
• If your child or teenager consumes caffeine, consider limiting, especially in the afternoon/evening.
• Consider getting rid of a late afternoon nap if your young child is struggling to sleep at night.
• Close to bedtime, limit access to electronic devices (e.g. video games, television, phones).
• If you have a teenager or child with a phone, consider having them charge their phone in a common area of the house overnight. This will limit possible distractions when your child should be sleeping.

Improving your child’s bedtime routine:

• Pick a bedtime and stick to it as much as possible.
• Create a consistent bedtime routine.

• Example: Bath, pajamas, brush teeth, stories, tuck-in, and say goodnight.

• Use of electronics should be avoided during your child’s bedtime routine.
• If compliance with the bedtime routine is a struggle, make sure you are providing reinforcement for completing the routine.  

• Example: If your child completes their bedtime routine within a specific amount of time or without tantrums or protests, they earn an extra story or song before being tucked in.

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Considerations for creating a bedroom environment that promotes sleep:

• Lighting in the bedroom should be dimmed prior to bedtime and dark for sleep. Consider using blackout curtains to keep the room dark and lighting consistent throughout the night.
• Bedroom temperature should be cool and remain consistent throughout the night.
• Create sleep dependencies that are available all night such as a white noise machine. Using a white noise machine will also help block out any noises that occur throughout the night that could disrupt sleep.
• Stay away from using devices on a sleep timer, such as the television or music that turn off during the night.
• Your child’s bed should be reserved for sleeping. Try not to let your child play in their bed during the day or before bedtime.  
• Before bedtime, remove all electronic gadgets and preferred toys from the bedroom or put them away out of sight.  

If your child struggles with calling out, getting out of bed, or leaving the bedroom after being tucked in you might consider implementing a bedtime pass. To implement this procedure, you will provide your child with a tangible bedtime pass (e.g. note card or small piece of paper with their name on it). Feel free to be creative when making the bedtime pass. Explain to your child that the bedtime pass can be exchanged once for an item or action they want (e.g. glass or water, hug from mom, trip to the bathroom). Tell your child they may also choose to stay in their bed and hold onto their bedtime pass in order to exchange it for a reward in the morning (e.g. choice of breakfast, later bedtime that day, 10 minutes on the iPad). Once the bedtime pass has been exchanged you will need to ignore call-outs and return your child to their bedroom with minimal to no interaction if needed.

Free printable Bedtime Pass:

https://www.boystown.org/parenting/Pages/bedtime-pass.aspx

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If you have tried some simple sleep solutions and your child is still struggling it is time to take a closer look at what is going on an AnswersNow clinician can help assess and develop an individualized plan for better sleep. Visit getanswersnow.com to learn more

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References

Freeman, K.A. (2006), TREATING BEDTIME RESISTANCE WITH THE BEDTIME PASS: A SYSTEMATIC REPLICATION AND COMPONENT ANALYSIS WITH 3‐YEAR‐OLDS. Journal of Applied Behavior Analysis, 39: 423-428. doi:10.1901/jaba.2006.34-05

Jin, C.S., Hanley, G.P. and Beaulieu, L. (2013), AN INDIVIDUALIZED AND COMPREHENSIVE APPROACH TO TREATING SLEEP PROBLEMS IN YOUNG CHILDREN. Journal of Applied Behavior Analysis, 46: 161-180. doi:10.1002/jaba.16

Friman PC, Hoff KE, Schnoes C, Freeman KA, Woods DW, Blum N. The Bedtime Pass: An Approach to Bedtime Crying and Leaving the Room. Arch Pediatr Adolesc Med. 1999;153(10):1027–1029. doi:10.1001/archpedi.153.10.1027