Count up the hours that your child currently sleeps. This might be trickier than you think.

Here are three methods you can use:

Counting Method:

Each morning, make a note your child’s wake-up time.

Each evening, make a note your child’s fall-asleep time.

Each afternoon, note the time spent napping (most kids do not need naps, but some do).

Count up all of the hours that your child sleeps for each 24 hours. Do this for seven days and average your numbers.

Estimation Method:

Reflect on how your child slept for the past three nights or the past week. Try to come up with an ‘average’ number of hours of sleep per 24 hours that your child needs.

Guessing method.

Use the information below, and choose the number that matches your child's needs.

The amount of sleep needed varies by age. Guess how many yours your child is sleeping. Here’s a general guide:

• Infants: 14 to 16 hours

• Toddlers: 12 to 14 hours

• Preschool-aged children: 11 to 13 hours

• School-aged children: 10 to 11 hours

• Older school-aged children: 9 to 10 hours

If you’re worried about your child’s sleep, you need to know how many hours they are currently sleeping. If you are not sure how to do this, consult your child’s pediatric care provider.

Understand Sleep-Onset Associations

Sleep-onset associations are objects and rituals that signal to the brain that it’s time to fall asleep. Your child needs to choose one or two objects and one or two rituals that will help them to fall asleep.

Choose a Sleep-Onset Object

Your child should select a toy, blanket, pillow, or other item. This item will serve as a cue that it’s time for sleep.

Choose a sleep-onset Ritual

In addition to the sleep-onset item, your child should also establish a sleep-onset ritual. The ritual could be a short conversation with you, a prayer, or some reading. These steps are effective for both young children and older children with developmental delays.

The entire sleep-onset ritual should take approximately 10 minutes.

Other strategies to help with sleep-onset.

The environment is important. the room should be dim or dark. The temperature should be cool. The room should be quiet.

Sleep-onset objects and rituals that are not allowed.

The sleep-onset objects and rituals do not include food, drink, or screens. Food, drink, and screens are allowed earlier in the evening. They should be removed about one hour before the sleep-onset routines and rituals.

The sleeping schedule is super-important.

Choose and fix the wake-up time

It might surprise you, but the wake up time is more important than the bedtime. Wake your child or adolescent up at the same time each morning. This is the best strategy for all children and youth, regardless of age. Choose the wake up time that works best for your child and your family. This is one choice that you get to make- not your child.

No sleeping in

During the training period, keep things very consistent. Wake your child up at the same time every morning for 2 to 4 weeks. Don’t allow your child to sleep in. Usually, this also means no napping. Sleeping in makes it harder for your child’s brain to master good sleeping habits.

The Role of Naps

Most kids do not need a nap. If your child does need a nap, keep it short. A nap should be less than 1 or 2 hours. If you let your child nap, make sure they nap every day at the same time. Don’t allow a nap just because they slept poorly the night before. Most children 5 years or older do not need a nap

Gradual Reduction of Daytime Sleep

If your child does a lot of daytime napping or if they sleep in late every morning, you may need to reduce the daytime sleeping gradually.

Here are some examples:

Put a limit on the nap- let’s say you will first limit your child’s nap to two hours. Allow your child to sleep for 2 hours maximum. After a while, reduce the nap to 1.5 hours. Then, go down to one hour. Probably, you can eliminate the nap. If your child only needs, say, 10 or 11 hours sleep per night, the nap should not be needed.

Reduce and stop teenager daytime sleeping.

Daytime sleep should be reduced and then eliminated for most elementary school students and those who are older. It does not matter what kind of disability your child may have. Be sure that your teenager’s teaching staff at school know that sleeping during the day is not allowed. Reduce day time sleeping gradually. Start by offering, say, 2 hours of sleep. Then, a few days later, reduce it to 1.5 hours. Then a few days later reduce to 1 hour, until your teenager has stopped napping.

Choose your child’s bedtime.

Now, you are ready to choose your child’s bedtime. First, do steps one and two. See above. Fix the wake up time and keep it consistent. Reduce the nap or stop it all together. Then, figure out what the bedtime should be. Repeat: Don’t choose the bedtime until after your child has a controlled nap or no nap, and has woken up at the right time every day.

The best bedtime depends on two things:

How many hours of sleep your child needs See the table under Objective #1

For most children, the bedtime should occur 9 to 11 hours before the wake up time.

• If your child needs ten hours of sleep, and the best wake up time is 6:00 am, then they should be in bed by about 8:00 pm.

• If the best wake up time for your child is 7:00 am, then they should be in bed at about 9:00.

• If your child’s best wake up time is 6:00 and they need 9 hours of sleep, then the bedtime should be 9:00 pm.

Use mild Sleep Deprivation to train your child’s brain to fall asleep faster.

If you want, you can teach your child to sleep better by using a little bit of sleep deprivation. This strategy is good for kids who take a long time to settle down at bedtime. Start the bedtime routine a bit too late. For example, you can put your child to bed one hour or so after the time you think they should go to bed. If you start the bedtime routine late, your child will be more tired and more ready for bed. This strategy works well for children who struggle to fall asleep. If they are already tired, they fall asleep more quickly after you’ve put them to bed. That way, they’ll only get 9 hours of sleep (depending on the timing you choose), when really they need 10 hours. Or, they’ll get 8 hours of sleep when really they need 9 hours.

It will take a few days before you see the effect. Just get them to bed a bit late, and keep the wake up time fixed. After 5 to 7 days, their brain will be ‘trained’ to fall asleep more quickly once they are in bed.

Co-Sleeping: Children who co-sleep rely on a co-sleeper as a sleep-onset association. They need a co-sleeper to fall asleep, and also to stay asleep.

Co-sleeping is common and usually not a problem for children. But, co-sleeping is a problem when the parent is the child’s co-sleeper.

Co-Sleeping with Parents: Children who need to sleep with their parents are using them as a sleep-onset association. They can learn to use other sleep-onset associations and not rely on their parents.

Parents’ Preference: Most parents prefer to sleep separately from their children for better rest. Children can be taught to sleep independently at any age, ideally before the age of eight.

Preparation for Independent Sleeping: Teaching a child to sleep independently requires preparation and discussion with your child- and with your child's other parent(s). Children who co-sleep are often resistant when their parents tell them they have to sleep on their own. Both the child and parent will lose sleep initially. But, each night you practice will get you closer and closer to independent sleeping.

Training Methods:

Quick method: Training can be done quickly by removing all support at once. The parent who is the co-sleeper no longer joins the child in their bed. Your child has to fall asleep on their own.

Slow method. Training can also occur slowly, by gradually reducing the co-sleeper's presence and interaction. Your child's co-sleeper first stops lying with your child, and instead sits next to your child. Then, they place their seat a few feet away from your child's bed. Then, they sit near the door of your child's bedroom. After that, they disappear from view all together- even if they maintain some verbal contact. Only at the end of training does all contact (including talking) stop. This process can take 1 to 3 weeks. .

Confidence and Success: . Your child's fussing and crying might make you feel like you are failing your child. Actually, your child’s fussing and crying is part of their learning. the golden moment of learning occurs when, finally, your child falls asleep from extreme fatigue. It could take a few hours. But, they need that chance to fall asleep when you are not in the room with them. Each time they succeed in falling asleep on their own, they will take less time fussing and crying the following night.

Each time your child eventually settles down celebrate the fact that they calmed themselves down on their own. Celebrate the fact that they fell asleep- even if it took a long time. The next moring, tell them how excited you are about their successes.

Special strategies to remember

When training your child to sleep independently, they will lose sleep. Their sleep loss will help them the following night- they’ll be too tired to fuss for long, and they will fall asleep sooner.

Keep the schedule consistent. Just because your child took so long to fall asleep does not mean that they can sleep in longer the next day. It also does not mean that they can have a nap! Your child will probably be very tired the next evening. That will make it so much easier to keep doing the training.

Expect improvement in 3 to 5 nights.

Recognize learning successes and convey a sense of success to your child. If you feel insecure, and the whole experience is just too stressful, wait until a later date. Try the process again over winter Break or summer vacation, or another time when you can dedicate your time and our energy to teaching.

The above suggestions apply o most children- but not all of them. If you plan on doing a sleep training for your child, you should let your child’s pediatric care provider know.

Understanding the Role of Medication

Pre-Medication Considerations

Don’t think of using a medication until after you’ve learned about sleep hygiene. You need to understand your child’s current sleeping habits before you’ll know if they truly need a medication. You need to know:

• How many hours your child currently sleeps

• How many hours your child should be sleeping

• Where your child sleeps

• What the sleep-onset objects and rituals are

• Whether or not they are co-sleeping

The Need for Medication

Children do sleep. Parents are often surprised to learn that their child actually does not have a sleeping problem, even though they thought there was a problem. You will not know if your child actually has a sleeping problem until after you’ve gathered the information listed above. A medication may not be necessary.

The Training Process

Before considering medication, encourage your child to be a good sleeper, even if it means co-sleeping with you for a while longer. Get your child sleeping on a consistent schedule and reduce day time sleep if it’s no longer needed. Once your child’s sleep is established, you can figure out if a medication is needed.

The Role of Medical Conditions

At times, a medical condition may prevent your child from sleeping properly. children sometimes do not sleep well because of snoring, because of medical conditions such as seizures, or because of discomfort or pain. Whenever your child is not sleeping well, be sure to review your child’s sleep habits with their pediatric care provider. .

When Your Child is Already on Medication

If your child is already taking medication for sleep, create a plan to remove the medication, especially if your child is now sleeping successfully. Speak with your child’s pediatric care provider to learn about how you can stop the medication, especially if it’s no longer needed.

Tapering Off Medication

Once your child (and you) are both sleeping well, you can gradually taper the medication to a lower dose and then remove it.

Managing Medication Withdrawal

When a medication is removed, it’s common to hit a rough patch. Your child’s sleep can get disrupted as the medication is removed. Follow the steps described above and be sure to speak with your child’s pediatric care provider.