Your child used to fall asleep at a regular time in the evening and wake up every morning at the same time. Suddenly, this changes abruptly, it becomes difficult to settle him to sleep, and, when he or she is finally asleep, this child seems restless, turns in his or her bed, and wakes up crying in the middle of the night, maybe two or three times per night. He or she wakes up much earlier in a very bad mood, the whole family’s schedule is disturbed, everyone is tired, and you wonder what could cause this sudden change.
A sudden change in sleep patterns which have previously been in place for several months is a signal that something needs attention and you need to find out the cause. Hoping that time and endurance will make everything better sometimes works, but it is wiser to act immediately if the problem persists for more than three days.
What are the physiological causes for sleep disturbances?
1. Hunger
Let’s look first at the simplest cause which is also the simplest to solve: hunger.
Children grow in spurts and the child who used to be full after a cup of soup, a slice of toast and a yogurt may now have a much bigger appetite. If your child is non-verbal or has communication issues of other forms, such as in PDD where the child can speak but cannot express himself, this child will not come to you and say,
“I am still hungry, can I have some scrambled eggs and toast?”
In a dream world which does not exist, children, or adults for that matter, know exactly the amount of calories and the type of minerals or nutrients their body needs. In the real world, a child is not really aware of hunger and will try to fall asleep while discomfort rises and the brain remains alert, sending messages such as:
“Feed me now!”
Because it is such a simple problem, you may not need to run a battery of tests and measurements. Try adding an extra portion of food to your child’s dinner, or give them an evening snack. Chances are that if your child eats the extra food, it is because there was a need. If sleep returns to normal, you have solved the problem.
2. Aches and pains
Some aches are more intense or more noticeable when laying down, such as a headache, toothache, gut pain, or growing pains. Again, a non-communicative child will not come to your room and ask for a pain relief pill.
If hunger is not the issue, then you can investigate whether the child has any symptoms of aches and pains. Check their teeth, the warmth of their forehead, the redness of the ears, and the tenderness of the belly and the joints.
Does your child relax if you gently massage of his legs, calves, knees and ankles?
First, take the measures that do not involve medication. A massage may be the solution to a particular type of pain.
If this does not help, you can try giving your child the recommended dose of a child’s pain relief medicine that you have already given them in the past. Growing teeth are extremely painful but may not show in the mouth.
An otherwise healthy child won’t suffer side effects with a child’s dose of pain relief, and it would be terrible if the cause for the sleep disturbance is a pain that can be managed while the problem gradually disappears, such a the growth of the tooth, or an unusual headache caused by a change of weather.
Many of the children on the spectrum are extremely sensitive to changes in atmospheric pressure and will suffer headaches which they can’t explain in words. We recommend having a barometer in the house to verify atmospheric pressure changes. Wind is a precursor of headaches, and changes in the amount of daylight are also a factor.
Children with neurological disorders can start a long term headache with one trigger. A headache can remain after the trigger is passed.
3. Digestive problems
Children can develop allergies or digestive issues as they grow and can become sensitive to a food which did not cause a problem before. You can verify this by simply changing the kind of food you offer for dinner. If your child is happy with the change, then you may have identified the problem. However, this is rarely the case, unfortunately.
4. Noises that only he can hear?
Because your child is certainly more sensitive to sounds than the rest of the family, he or she may be disturbed by a new bus route in the neighborhood, the start of a baseball season three blocks away, or a new puppy barking frequently down the street.
A change in the environment that can cause sleep disturbances is certainly a problem that you can’t solve easily. You may need to stay up at night and listen to the outside sounds when your child wakes up. It may be faint and distant, but if you notice the correlation, you have something to work with.
The solution is to bring a small white-noise device into your child’s bedroom. You may also need to leave it on during the day so that the white noise does not become a nuisance in itself. You can start by putting it in the hallway at night to see how comfortable you child is with it. A small table fan can also work if you position it in a way that it won’t blow on the child.
5. Night seizures
Night seizures are certainly the most serious cause for sleep disturbances and not one that you want to ignore.
Children on the spectrum often develop seizure activity. The seizure can be extremely short but can wake the child and cause a headache.
The only way to know, besides running a 24-hour EEG, which is hard to obtain from the neurologist and hard to implement, is to sleep in your child’s bed and observe:
- a sudden jerk, similar to the jerk everyone has when the brain starts its sleep process;
- a sudden stiffness and rigid posture;
- a change in breathing pace – accelerated for a few seconds;
- a repetitive motion of one hand, arm, leg or foot;
- an unusual sound (moaning, heaving, mumbling, etc) seeming to be coming from a dream.
If the event is short and medical assistance is not fast and easy to reach immediately, we promote the use of a strawberry scent and the application of ice protocol when you feel you are witnessing a seizure. Of course, after this short, helpful protocol, you need to wrap your child in a blanket and drive to the emergency care unit closest to your home. If the event is short, it is reasonable to think that you do not need an ambulance but can safely drive yourself and your child to the doctor. If the event lasts more than one minute, you need to call 911. Make sure that you note down all of your observations as precisely as possible as the doctor may not be able to verify any seizure activity once you arrive. Your comments will be indispensable to help the doctor take the appropriate measures.
Nightmares do disturb typical sleep and are part of normal development, even in a child on the spectrum. It is hard to differentiate reactions to a nightmare, such as waking up panting, in tears, from a seizure which could sometimes lead to the same reaction.
The main difference is that nightmares do not occur systematically, and they seldom occur at the same time of the night.
In conclusion, when sleep is disturbed, take action, for yourself as well as for your child. Be vigilant and try to make objective observations that you can share with medical professionals.
6. One final tip: Smelling while you sleep
Put a drop of his favorite smell on his pillow before he goes to sleep. It can be a drop of lavender essential oil, or anything he or she loves. Whatever the reason for poor sleep, this simple technique is bound to help both you and your child to sleep much more soundly and feel much more refreshed in the morning.
A fragrance diffuser will not work as well as putting a drop on the pillowcase because the diffuser sends fragrance into the air evenly and constantly. What you want is intermittent stimulation of the olfactory bulb and this is achieved when your child turns his head to the spot on the pillow with the scent.