Sleep issues in children and teens may feel complex and never-ending, especially to bewildered and exhausted parents at the end of their tether. But in my experience, problems with sleep have proved to be one of the most straightforward issues to solve and put right.
By the time parents usually come to see me, they've typically been heroically battling their child's sleep issues for months and sometimes years. When children struggle to get to sleep by themselves, it can put a huge strain on Mum and Dad at a time when they're also trying to cope with other daily demands: work, looking after other children, and caring for elderly or sick parents. In most cases, parents are often in need of a good night's sleep themselves.
Using a combination of hypnotherapy (Rapid Transformational Therapy) and practical coaching techniques, the first step to solving a child's sleep issues is always to find out where, when, how and why they first started experiencing difficulties either getting to sleep or staying asleep. My next step is using hypnotherapy to help foster a strong belief in the child that they can sleep easily and effortlessly all by themselves. In most cases, children have convinced themselves (and their parents) that they can't. I like to compare the process to deleting old, unwanted apps (negative beliefs) on your mobile phone and installing upgraded Better Sleep software (positive beliefs, thoughts and actions) instead!
Lastly, I work with parents to reintroduce good sleep hygiene alongside setting new boundaries around bedtime to make better sleep a lifelong habit.
Some common childhood sleep issues I see in my practice:
Frequent nightmares or night terrors,
Not being able to go to their bedroom by themselves,
Needing a parent to sit with them or stay in their bedroom until they fall asleep,
Waking up in the middle of the night and needing a parent to help them get back off to sleep,
Not being able to sleep in their own room.
Of course, not getting enough sleep has a knock-on effect on every part of a child's life, and can lead to poor engagement and concentration at school and being moodier and less co-operative at home. The link between sleep and mental health is very closely tied. Almost every child I see in my practice, who is experiencing anxiety or depression, also has poor sleep or sleep issues.
Sleep problems can also affect friendships. I know many children who turn down invitations for sleepovers or refuse to have friends over to sleep, because it means letting on that they need Mum or Dad to sit with them every night.
Normal evenings become a thing of the past as Mum or Dad, or both, take it in turns to sit with their child until they fall asleep. Evenings out become impossible as parents become locked in the bedtime routine and find it difficult to ask a babysitter to look after the children while they're out.
Until sleep issues are sorted out, normal family life is put on hold. Everyone is tired and everyone suffers.
How sleep issues in children and teens start
We are all born with the perfect natural ability to fall asleep, and usually to sleep soundly for around 6 to 10 hours. Our bodies are designed to sleep and, at their most fundamental level, know how to sleep without any interference from us.
At some point as we get older however, our minds start to hijack the sleep process. If we have a couple of difficult nights getting to sleep, we may start to create a belief in ourselves that we have insomnia or some other sleeping disorder.
We may start to say things like "I can't get to sleep", "I've tried everything but I just can't sleep", or "I'm not a good sleeper".
This line of thinking however creates a feeling of anxiety around bedtime and sleeping, which then of course interferes even further with the sleep process. Believing we can't sleep becomes a self-fulfilling prophecy, and going to bed becomes something we dread rather then look forward to.
Our bodies may be crying out for sleep, but our minds keep us awake.
This same thought process is true for our children too.
In general, at the root of every child's sleep issue is a feeling of worry or fear:
Worry. A child may lie awake worrying about what happened during the daytime or worrying about what might happen in the future. Worrying may take the form of going over events that went badly and wondering if they could have done things differently or, worrying about things that might happen such as failing exams, getting in to trouble, parents getting a divorce or being bullied at school.
Worrying is our mind's way of trying to put things right. By going over past events our minds are scouring our memories for clues that we were somehow not at fault, that we weren't to blame. By worrying about future events, our minds are rehearsing worst case scenarios in an attempt to try to be prepared for any threat of pain.
Fear. It is not uncommon for children to be afraid of the dark. I think most adults can relate. The dark, especially when it's associated with sleeping, is when we are most vulnerable. Children may fight sleep as they are afraid of what might happen while they are asleep and so feel they have to stay awake and be vigilant. They might be worried about waking up in the middle of the night and no one being there to help them. They may also fight sleep because they are worried about having nightmares. Sleep issues caused by fear are often triggered by watching a scary movie or seeing something scary on the news or in social media.
Jake: A Scary Movie Story
I've recently been seeing a lot of children in my practice, all around the age of 11 or 12, who tell me their sleep issues started because of one particular movie: It.
In most cases the children have never even seen the film. Some have accidentally caught a glimpse of the movie trailer while they've been on social media. Or they've seen the posters showing Pennywise, or have been told gruesome details about the more gory scenes by older brothers and sisters who have seen the film. It seems just the image of Pennywise the clown is enough to terrorise younger children (and some adults I know) and start off a downward cycle of fear of the dark and disrupted sleep. This was definitely true of Jake, who had accidentally seen a trailer for the film while innocently watching YouTube videos. From that point on he downright refused to go upstairs to bed by himself and insisted on Mum sitting on the bed with him until he went to sleep, which could often take hours. Poor Mum - what should have been evenings spent relaxing and chatting with her husband after a day at work, were now spent in a dark room, trying to get Jake to sleep. Even when she did go to bed, Jake would wake up most nights and call for her. Not knowing what else to do, and worrying he would be too tired for school the next day, she would go to his room and once again sit with him till he fell asleep.
Mum came to see me after this had been going on for nearly a year.My hypnotherapy session with Jake involved helping desensitise the trigger (Pennywise's face) but most importantly "re-installing" the brain's original "sleep software" and the absolute belief that he could go to sleep all by himself without Mum's help,. The emphasis was on building confidence that sleep would come naturally, easily and effortlessly.
I also worked with Mum, giving her key techniques, including suggestions she could use to help embed the belief in sleep in Jake's mind.
After just one session of RTT, Jake started to go up to bed by himself. Mum changed her usual habit of sitting on the bed, and began just popping in to his bedroom to say Goodnight. Jake felt comfortable letting her leave the room and falling asleep by himself, which Mum said he started doing in minutes instead of hours.
Jake continues to make huge progress and bedtime now feels normal and under control. Mum and Dad are back to enjoying their evenings, something they had given up hope of ever happening.
Crucially, Jake's progress was about allowing him to take his own time, and for any changes to come from him. This is true of all the RTT work I do with children and teenagers. The pace of change is dictated by the child - not the parent, no matter how much the parent wants (or desperately needs) change to happen as soon.
How one or two sleepless nights turn into a sleep issue
While most sleep issues start because of worry or fear (a feeling), they become embedded through habit (an action).
This habit or action is the immediate response to the sleep issue and is often reinforced because at some point it becomes easier for poor Mum and Dad to "give in" to their child's sleep issues than tough them out. And that's not in any way a judgment. Having dealt with my own kids' sleep issues, I know there will always be times when it's simply easier to crawl into bed with your child to help them sleep (and go to sleep yourself) because you're too exhausted for another battle. There will be times when your child is sick and you might be worried about leaving them on their own. There will be times when you sit on your child's bed every night until they go to sleep because you just don't know what else will work. Having tried all options sometimes it's just easier and less exhausting to take the path of least resistance. We have all been there!
While no one is saying don't ever comfort your child at night, the danger is that this parental reassurance becomes a pattern. If a parent sits with a child until they go to sleep on a regular basis, the child's subconscious belief becomes: "I need Mum and Dad to sit with me because I can't get to sleep by myself".
Or, the shorthand version: I can't get to sleep by myself.
Once this belief is there, no amount of practical action is likely to be very effective, You can change the bedtime routine, use sleep aids like night lights and white noise, read bedtime stories till the cows come home... the belief will dominate the child's behaviour, and then that of the whole family dynamic.
While your child may have the belief that they can't go to sleep by themselves, our job as parents - and mine as a hypnotherapist - is to help them believe that they can.
Things to try before you seek help for your child's sleep issue
If you're not doing these already, the following steps are a good place to start to help get your child's sleep back on track.
Good Sleep Hygiene and Bedtime Routines:
Make bedtime a set time every night - no matter what time your child eventually falls asleep.
Try to get into the routine of waking your child every morning at the same time, regardless of what time they got to sleep the night before
Limit screen time before bed – no screens at least one hour before bedtime and keep devices out of the bedroom (no tablets or phones on charge).
It seems obvious, but limit sugar and caffeinated drinks and also strenuous exercise or activities for two to three hours before bedtime.
The Power of Suggestion When our children struggle to sleep they will often use words and phrases like:
I can’t get to sleep, I’ll never get to sleep, or I’m trying to get to sleep but I can’t…
As a parent or caregiver, your words can have a powerful effect on your child’s belief in their ability to sleep, and their own sleep confidence. By using and repeating key phrases and suggestions consistently throughout the day you can help build your child’s belief in their own ability to get to sleep by themselves.
One phrase I hear parents say a lot (and I was guilty of using it myself when my children were younger), is: Try and get to sleep.
There are three words in this phrase which will be a barrier to your child's belief in being able to sleep: "try" and "get to":
The word "try" implies that something is hard. We don't want our children believing that going to sleep is hard. Similarly, the words "get to" implies that sleep is something your child needs to work at rather than something that will come naturally of its own accord.
A better, more powerful suggestion is: Sleep will come really easily.
This takes all the hard work out of going to sleep. Sleep will come all on its own. It's about allowing it, not working at it.
*Sarah came to see me in the grip of terrible anxiety which she had suffered for as long as she could remember.
In Sarah’s case her anxiety was very specific. She had a debilitating fear of not being able to find a toilet when she was away from home. If she needed to leave the house, even for short trips, she would plan her route around the locations of the nearest public toilets.
Even before she left the house she would start to feel a sense of panic and dread about not being near a toilet. She would go through a routine of making sure she used the bathroom before she left the house even if she didn’t really need to, and having an emergency kit with her at all times, consisting of toilet paper and an empty bottle “just in case”.
While short journeys were somewhat manageable, long journeys in the car or on a plane or having days out with the family were incredibly difficult. Consumed by anxious thoughts of not being able to find a toilet, Sarah could never relax and enjoy herself. Long trips were punctuated by frequent stops at public restrooms. Traffic delays, getting lost or delayed sent Sarah into a panic, so much so that she would sometimes ask whoever was driving to stop suddenly so she could dash out to find a place to go to the toilet wherever she was.
Needless to say anxiety was ruining her life. She couldn’t enjoy days out with her husband and children. She felt limited by her anxiety to the extent that it was controlling her and her entire life. There was also a deep sense of shame about the anxiety and it was not something she felt safe talking about to many people.
The first thing I knew I needed to do was find out how Sarah’s mind was trying to help her by keeping her in a constant state of anxiety about needing to be near a toilet.
It sounds bizarre to suggest that Sarah’s anxiety may have been trying to help her. But one of the absolute rules of the mind is that our minds are always trying to protect us from harm – but sometimes they do this in really odd and unhelpful ways.
I suspected the roots of Sarah’s issue lay in childhood, most likely related to an incident where she was made to feel shame or guilt about natural bodily functions. So Sarah agreed to have a Rapid Transformational Therapy session with me to see if we could help her break free from the toilet anxiety once and for all.
Even though Sarah was keen to have RTT she was also sceptical. The only incident she could remember regarding being anxious about needing to use the toilet was in her late teens in the car with her boyfriend , when she had to ask him to pull over urgently so she could find somewhere to use the toilet. She remembered a feeling of blind panic and dread crashing down on her. But that was her only memory,
During her RTT session, however, she started to remember scenes from her childhood where she had experienced terrible shame about herself associated with needing to go to the toilet.
The most significant of these was as a four-year old girl, waking up in the middle of the night and needing to use the toilet. To get to the bathroom however she had to walk through a dark house, down a series of corridors, through several doors, past the kitchen. The corridors were dark and, to a four-old’s mind, very scary. She was terrified.
So instead, her little four year old mind came up with a solution. She shared a bedroom with her two younger sisters, one of whom had a potty which sat in the corner of the bedroom. She could use that. Problem solved.
The next day when her mum found that she had used her sister’s potty, she was angry. She screamed: “Why did you do this? That’s disgusting. You dirty girl. I’m so disappointed with you”.
It’s worth stating at this point that Sarah never felt loved by her mother. Her mother was often angry and took it out on Sarah. In a situation where Sarah should have been treated with love and compassion, she was made to feel dirty, disgusting and worthless.
From these scenes it was clear that there was already fear and anxiety associated with using the toilet (having to walk through dark and scary corridors to get to the toilet); and then, added to this, the shame at being called dirty and disgusting about not being able to get to a toilet, but using her sister’s potty instead.
In that moment, Sarah’s mind made a decision, to never put herself in a position where she was made to feel those same terrible feelings of shame and self-disgust ever again. Her mind decided in no uncertain terms: “You have to protect yourself, Sarah. So make sure you are near a toilet at all times. Never let yourself get caught out .”
Now that we knew where the root of the issue was, I helped Sarah change her belief about herself and to see that little four-year old girl through adult eyes. Rather than being dirty and disgusting, she was just a scared little girl, but also incredibly smart and resourceful to find a way to protect herself from being scared of going to the toilet.
We talked about how children have toilet accidents all the time – it’s part of growing up. And how if that had happened to one of her own children she would have responded in a completely different way to her own mother – she would have been understanding and loving. I worked with Sarah to help her feel incredible love and compassion for that little four-year old – and to understand that the event was not her fault.
We changed the belief Sarah had about herself. She is not dirty, nor disgusting, No one would ever tell her so, even if she did have a toilet accident. I also encouraged her to see that unless there is a physical condition present, adults are pretty good at being able to control their bladders. I helped her realise that she is in control of her body including her bladder at all times.
Following the session Sarah listened to her transformation recording for 21 days as instructed. During this time I coached her in specific techniquesto develop new ways of coping with anxious thoughts so that they became less and less troubling.
One week later, I checked in with her to see how she was getting on. There were already signs of improvement. When she was out with her children she felt more relaxed and was no longer thinking about where the nearest toilet was.
Then came a long car journey when the family went on holiday, after which I checked in with her again. And this is what she wrote:
“I never ever thought I would get to this stage! You have truly helped give me a new lease of life. I have broken free from those chains. I was so sceptical about RTT, thinking that it’s something that works for other people but not for me. How I smile at this not being the case. I’ve learnt also to trust in the process. I can’t thank you enough for providing such a safe, non judgemental space for me to dig deep and be totally honest and open about some of my darkest experiences and memories. Not worrying every time I walk out of the door is so refreshing and I know things will only get better and improve even more as time goes by.
What a miracle you have worked on me Dawn. This is something I never thought I would be free of. I can’t thank you enough”.
It can be hard to keep calm and positive in the midst of our current Coronavirus pandemic. If you are struggling with worry and stress, know that there are steps you can take to feel calmer and more resilient through this stressful time...
In difficult times, such as the ones we are all currently experiencing, one of the hardest challenges can be dealing with uncertainty and the sudden lack of control over our own lives and events.
Some of us may be worried about catching Coronavirus - or Covid-19 - while at the same time trying to work out what we'll do to keep our children entertained and busy if schools close (if they haven't already). We may be concerned about how we are going to survive financially, especially if we are self-employed or run our own businesses. Or we may be feeling upset about having to cancel holidays or special events like weddings and other family celebrations.
It is hard to manage these worries at the best of times, not least without having to deal with a global pandemic.
The advice may be to Keep Calm and Carry On but how do we actually achieve that? Telling yourself to stay calm is like accidentally cutting yourself on a sharp object and telling yourself not to bleed.
The simple truth is, life will always throw challenges our way; this is something we will never have control over, however much we feel we do. What we can control, however, and what can help us stay calm and more resilient, is how we choose to respond.
Reaction Versus Response
When we're in the grip of a powerful emotion like fear or anger, it may feel as if we have no choice or control over our thoughts and feelings whatsoever. But we do.
How people have responded to the Coronavirus pandemic is a case in point. On one hand we see people rushing to the supermarkets and panic buying toilet roll and soap. On the other there are people rallying together to form community groups to look after the elderly and vulnerable in our society. Two very different ways of dealing with potential threat.
A completely natural response to perceived danger is the stress response - fight, flight or freeze. Our bodies and brains are hardwired that way and, for the survival of the species, have to be. However, our brains have a difficult time deciding what is real and what is perceived threat - danger is danger to the brain. It's black and white.
But whereas panic may be our brain's first automatic response, what comes next is completely within our control, however much it doesn't feel like it. And that is: we can choose how we act.
How to stay calm when all around us feels overwhelming
Every day we face a constant barrage of external stimuli - from people, situations, the news, the weather, our environments, the list goes on. Without us even being conscious of it, these external stimuli trigger a thought, which leads to a feeling which leads to an action, This is called a Looping Thought pattern - the diagram below shows how it works.
By understanding our own Looping Thought patterns, we can break the negative cycle of fear, stress and anxiety.
When we pause to examine our thoughts, feelings and actions, we can re-wire our own ingrained responses to stressful situations and choose better, more positive thoughts and feelings which lead to healthier actions. This results in a positive feedback loop, as calmer actions then calm the body's stress response leading to calmer thoughts and feelings. Instantly, this creates greater resilience and stronger coping mechanisms.
If you are struggling to stay calm in times of panic, uncertainty and stress, try this simple exercise.
A Calmer Response Exercise
1. Trigger: Take a piece of paper and write down what has happened - the event/person/situation - to cause you to feel stressed or anxious. eg: reading an alarming headline about the spread of coronavirus.
2. Thought:Then write down the thought this trigger had created. eg: What if we all have to self-isolate. What if the shops run out of supplies? What if my business suffers?
3. Feeling: Write down the feeling that follows this thought. eg: fear, anxiety - include the physical symptoms that accompany these feelings.
4. Action: Then make a list of what you usually do next after you've had this thought and feeling. eg: Start to panic, google Coronavirus symptoms, and read more news articles looking for reassurance but which only makes me feel worse.
5. How can I respond differently? Now think of a more positive action you can take following the thought and feeling. eg: Informing yourself (getting the right information from official sources so you are prepared instead of feeling panic); distracting yourself (reading, listening to music, doing some exercise); comforting yourself (making a cup of herbal tea, chatting with a friend); or being proactive (thinking of positive ways to respond to the situation).
Once you have thought about more positive actions you can choose to take in response to events or situations that usually cause anxiety or stress, visualise yourself taking these actions. Close your eyes and rehearse how you will act differently, what you will say that's different to what you usually say, and what steps you will take to stop the negative thoughts and feelings in their tracks.
This takes practise. Changing old habits of behaviour is just like changing or stopping any habit. Practise, be patient and be kind to yourself.
If anxiety or panic is becoming an issue for you and interfering with your daily life, please get in touch to discuss how Rapid Transformational Therapy can help.
Banish the stresses of the day and unlock inner calm and balance. This 15-minute guided meditation is designed to calm frayed nerves and soothe the body’s stress response, allowing you to slip into your own personal inner oasis of peace and calm.
During moments of stress, anxiety and even panic attacks, the common advice tends to be to "take deep breaths. "But that advice is now being seen as outdated, and in some cases might make stress and anxiety worse.
About a year ago, I learnt of a breathing technique that really does nix moments of stress, not just in the short-term but also long-term, and relatively quickly too. It worked for me (I'll show you a fascinating little self-experiment in a mo), and it has also worked for my clients, so much so that this is the only breathing exercise I teach, and I teach it to all my clients for general wellbeing regardless of whether they're suffering from anxiety or not.
Coherent or resonant breathing is a technique that helps bring both emotional and physiological systems in the body into balance in order to boost overall health and wellbeing. The idea is to make breathing slower and more rhythmic by making sure every exhalation is the same length as every inhalation.
I've read a couple of different accounts of how and why this works. The creator of the trademarked Coherent Breathing method, Stephen Elliott proposes the theory that moving the diaphragm in a rhythmic manner stimulates the phrenic nerve thereby promoting optimal circulation, better brain function and "nourishing every cell in the body in a positive feedback loop".
Other research shows that coherent or resonant breathing helps bring Heart Rate Variability (HRV) into a smoother, more even pattern which promotes the better functioning of every organ in the body, most importantly the brain.
HRV, by the way, is the measurement of the gaps between heart beats - and is now recognised as a far better way of measuring overall health and fitness, compared to just measuring heart rate. If you're intrigued by HRV there is excellent information over on the HeartMath website.
First, a bit of science Our Autonomic Nervous System is the part of our nervous system that governs automatic bodily functions like breathing, digestion and our heart beat, The ANS is in turn divided into two parts: the sympathetic nervous system and the parasympathetic nervous system. Both regulate the same bodily functions but have opposite jobs. The sympathetic nervous system prepares the body for intense physical activity (fight or flight); while the parasympathetic nervous system prepares the body for relaxation and rest.
While we are awake, our optimal state is when both the sympathetic and parasympathetic nervous systems are in balance. When brain function, heart rate and breathing are all in balance, we cope with stress better, we are more sociable and positive, and tend to be more resilient.
When we are stressed, however, our bodies stay in high alert, with our sympathetic nervous systems constantly firing. Although still evolving, research into HRV and coherence is showing a link between lower coherence and disease and aging.
Coherent or resonant breathing works by hacking the ANS to bring both sympathetic and parasympathetic systems back into balance almost instantly.
You can find a number of apps that help you track your own personal coherence index and HRV. I use WellTory. The results below show my body before and after 5 minutes of Coherent Breathing.
A measure of wellbeing before coherent breathing (using WellTory app)
The coherence index is very low.
and after coherent breathing. The coherence index has more than doubled.
How to Practise Coherent Breathing
Relax and find a quiet spot where you won't be disturbed. Breathe in for 6 seconds. Then breathe out for 6 seconds. If 6 seconds feels too long, start with 4 seconds and build up to 6 seconds. Make sure both your inhalation and exhalation are the same length.
Start with a minute or two then build up gradually to however long feels comfortable. Some recommend a daily practise of 20 minutes, but I tend to follow the principle of "little and often" as a guide,
You can find a number of apps that help guide you through a timed breathing technique. Calm's Breathe setting allows you to set the timings for your breath and plays a different note for inhales and exhales (so you can practise with your eyes closed.).
The Breathing App by Deepak Chopra and Eddie Stern (with music by Moby) allows you to choose from a pre-selected format of breathing patterns with five different screens.