As a result of the pain, grief, and stress coming from the horrific events of the past week, many people will experience sleep disruptions, including trouble falling asleep, staying asleep, waking early, or having nightmares. Children are particularly vulnerable to these problems. Lost sleep or excessive daytime sleepiness (EDS) contribute to feelings of adversity, can seem like one more 'loss of control,' and robs us of the opportunity to restore ourselves physically, emotionally, and even cognitively.
In order to help people address their need for sleep and sleep problems, and maximize the sleep they do get during these trying times, the National Sleep Foundation (NSF) offers the following information and tips:
Insomnia is characterized by difficulty falling asleep, waking up frequently during the night, waking up too early or feeling unrefreshed upon awakening. If these symptoms persist for more than a few days, seek help from a physician or other health care provider. Be cautious about self-treatments such as alcoholic beverages that may worsen the problem or not be effective.
Sleep experts recommend the following tips for good sleep:
- Engage in a relaxing, non-alerting activity at bedtime such as reading or listening to music. For some people, soaking in a warm bath can be helpful. Avoid activities that are mentally or physically stimulating.
- Do not eat or drink too much before bedtime.
- Only get into bed when you're tired. If you don't fall asleep within 15 minutes, get out of bed, go to another room and engage in a relaxing activity such as reading. Return to your bed when you're sleepy.
- Create a sleep-promoting environment that is quiet, dark, cool and comfortable.
During the day:
- Consume less or no caffeine.
- Avoid alcohol and nicotine, especially close to bedtime.
- Exercise, but not within 3 hours before bedtime.
Short naps (l5-45 minutes) are effective in relieving acute sleepiness and restoring alertness, but for people suffering from insomnia, they should be avoided.
Nightmares can increase during periods of great stress for all people, though they occur most frequently in children age 3-6. Avoid eating or taking high-dose vitamins before bed, which can increase brain activity and the onset of nightmares. Also avoid alcohol, caffeine and other stimulants. Exercise and relaxation techniques may be helpful.
Excessive Daytime Sleepiness (EDS) and Fatigue, with symptoms such as difficulty concentrating or dozing off while watching TV or reading, is best handled by stopping what you are doing and taking a nap, or retiring early and going to sleep. Be cautious about treating EDS with caffeine or over-the- counter stimulants as they temporarily mask sleep loss and can cause sleep disruption. If EDS persists for more than a few days, speak to a physician or other health care provider.
At times of acute stress or trauma, parents and guardians should expect children to experience sleep problems, regardless of their age. It may take a few weeks for them to get back to their normal routines, but if the problems continue beyond that time, consider seeking further help from your child's physician or other health care provider, the school psychologist, or the child's teacher.
There are things parents can do to help minimize the impact of these tragic events on their children, and help them get a restful night's sleep.
For all children:
- Your child's anxiety may affect falling asleep. Find out about his/her concerns and talk about them. While you should try to avoid these conversations at bedtime, don't shut off the conversation; talk briefly and offer to continue the conversation tomorrow.
- To avoid insomnia, try to maintain your child's usual bedtime and bedtime routines.
- Avoid foods and beverages containing caffeine at least four hours before bedtime, and exposure to news broadcasts at least an hour before bedtime.
Middle School and Younger Children
- If your child has trouble falling asleep alone, avoid a drastic response (e.g. everyone sleeping together). Stay near until the child falls asleep. Provide reassurance by telling him/her you will check in.
- Turn on a light in the hallway or next room, but not the bedroom. Music can provide some soothing noise. The presence of a family pet in the bedroom (even a goldfish!) is often reassuring.
- If your child has nightmares and wakes up in the middle of the night, don't have a long discussion about the dream; be reassuring and get the child back to sleep. In the morning, if they tell you about a bad dream, that's a good time to talk either about the dream or the events that may have precipitated it.
- If a child is significantly anxious at bedtime, relaxation techniques (tapes, deep breathing exercises) can be distracting and anxiety- reducing.
Teens may be more affected by these types of events than we realize and, therefore, at higher risk for sleep problems. Their greater understanding of the events can be accompanied by a greater degree of worrying, making them more at risk for insomnia than younger children.
- Show teens the extra support, doting, and soothing that is given to younger children.
- Teens may experience insomnia or phase delay ... going to bed later than usual because of talking on the phone, watching television, e-mailing friends, etc. Parents must set limits on how long this behavior can continue, and get their teen back to a bedtime routine as soon as possible.