Steps in Planning a Sleep Programme
There are five key steps in creating a sleep support plan. Where possible, these should be completed with your child, as well as other family members, to ensure everyone is on the same page. To assist with your planning, we have provided you with a template below.
1. Set sleep goal(s)
Once you have explored the multi-faceted nature of your child’s sleep difficulties, you can set goals related to these. These may be focused on changes to the general environment or routines, while others may focus more specifically on aspects of your child’s sleep (e.g., taking a long time to fall asleep, night waking, early morning waking).
As part of this step, it is important to consider why you want to make these changes. If the reason(s) relate to conforming to a specific norm of how certain behaviours ‘should’ look, it may be beneficial to reconsider. For instance, are you seeking independent sleep because it is a societal expectation, or because your child’s sleep patterns are causing disruption to their daily life? If the reason(s) relates to enhancing your child and family’s well-being while respecting the individual needs and preferences within the family, you will be more likely achieve success.
2. Select strategies
Next, you will need to select the strategies that you would like to try to achieve your goal(s). Here, it is important to consider those factors that you’ve identified as contributing to your child’s sleep difficulties, as these are generally what will need to be modified. Then consider what might be the least disruptive strategies (e.g., sensory and visual supports, sleep scheduling, sleep hygiene) for you and your child to achieve your goal(s). Keep in mind that as strategies are tried, you may gain a greater understanding of your child’s sleep-related needs and decide to try alternative strategies – this is very appropriate and should be done as required. Below is a table with links to relevant content in this website. Further details regarding varying strategies are provided in these modules.
Contributing factors | Website module(s) to refer to | Relevant strategies within the module(s) |
Distracting or non-conducive sleep environment (e.g., too much light). | – Creating Optimum Conditions for Sleep (Module 3). – Teaching Children New Skills (Module 5). | – Modify the environment e.g., ensuring bedroom is dark, quiet and warm, removing distracting items such as device and toys, or adding appropriate visual cues. |
Sensory and/or emotional overwhelm. | – Creating Optimum Conditions for Sleep (Module 3). – Relaxation (Module 4). | – Modify the sensory environment to suit your child. – Provide relaxation supports. |
Inconsistent bedtime routine. | – Creating Optimum Conditions for Sleep (Module 3). – Teaching Children New Skills (Module 5). | – Establish consistent steps in the bedtime routine. – Carefully select bedtime activities to promote calmness. |
Inconsistent bed and/or waketimes. | – Sleep Scheduling (Module 2). | – Temporarily adjust the sleep-wake schedule to ensure your child is biologically ready for sleep. |
Items or environmental features associated with sleep (i.e., things that are only available during sleep onset, such as sleep setting, parental presence) are not available during night wakings. | – Creating Optimum Conditions for Sleep (Module 3). – Promoting Sleep-Conducive Behaviour (Module 6). | – Gradually eliminate or replace items that are not consistently available throughout the night. |
Certain responses to sleep-interfering behaviour (e.g., access to a device, a delayed transition to bed). | – Teaching Children New Skills (Module 5). – Promoting Sleep-Conducive Behaviour (Module 6). | – Use rewards for positive sleep-related behaviours (e.g., putting effort into the bedtime routine). – Alter your responses to sleep-interfering behaviour (e.g., fade responding to calling out). – Scheduled access to activities or ‘special time’ before bed (e.g., time with parent before bed). |
3. Ensure there is a plan to address each goal
It is not uncommon for children to have more than one sleep difficulty (e.g., taking a long time to fall asleep, waking in the night and/or waking early in the morning for the day), and in turn for families to have more than one goal. If that is the case, it is important to come up with a plan that covers all bases, as the factors that might be contributing to one difficulty (e.g., transition to bed) are not always the same as those that contribute toward others (e.g., night waking). This does not mean that you have to address everything all at once/apply all strategies at once, but it is helpful to think about all potential options.
4. Consider the practicality of the plan
Next, it is important to consider the timing for implementation of the plan to increase your chances of it being effective. Keep in mind changes should be gradual and flexible depending on your and your child’s day to day capacity and needs. Below is a list of important practical considerations to look into and plan around before commencing a programme.
Is now a good time for a sleep programme?
If you, your child or family is experiencing other difficulties (e.g., a period of illness, mental health difficulties, another transition, Autistic burnout) it may be better to start a sleep programme at a time where you all have more capacity. If now seems a good time, do think about if you can ensure a settled and consistent period over the next weeks and months (e.g., due to family holidays).
When will you start?
Choosing when to start should be done with your child and family. Usually, parents begin programme changes on a night when they are best able to manage a bit more disruption to their own routine. For some parents, this may mean starting a programme on a Friday night to minimise disruption to weekday activities and routines. However, it is also important to consider your and your child’s emotional capacity on the chosen night and whether your child has had adequate time to process the upcoming change (e.g., consider a programme calendar). If either of you are feeling particularly stressed or exhausted, it may be better to start on another day.
What will you start with?
Choosing what to start with should be done with your child and family. We recommend for every sleep difficulty first consider sensory and/or emotional factors. Once these have been attended to, then try sleep scheduling (Module 2), sleep hygiene (Module 3) and/or teaching aides (Module 4). These are often the most straightforward options and can ensure your child has sufficient sleep pressure (i.e., drive for sleep), helpful cues for sleep, and understands the sleep routines. Allow time to try and adapt these strategies to meet the needs of your child and family. You may ask your child why they do not think something is working or what they think would be more helpful. If your child is still having difficulty sleeping, then you may consider other changes (e.g., Module 6).
Do you have the resources or support to try the chosen approaches?
In families where multiple adults share caregiving responsibilities, the adults need to think through how they can support each other by forming a ‘tag-team’. Based on each adults’ strengths and capacity, this may mean splitting tasks, nights or weeks to ensure you all get a few good night’s sleep. If you are the sole primary caregiver or have majority of the childcare responsibilities you may need to ask a friend or relative to help at times, to ensure that you are getting sufficient sleep. This might involve directly helping with the sleep plan or other tasks such as having them care for your other children, prepare meals, household chores etc.
Is everyone in agreement about trying the programme now?
Make sure all caregivers are prepared to implement the plan. If there are disagreements about the plan, do make sure these are discussed and resolved where possible. Ideally, the plan would be developed with the child and other important family members.
Are there other family members who may be impacted by sound and movement in the household overnight?
Make sure other children understand what is happening “we are helping Kiri to stay in bed all night and will be moving around at night for a while to help her do this”. If your child is receiving a reward for making progress with their sleep perhaps other children could receive a small reward for helping by sleeping through as well, or a reward for good progress could even be a family celebration such as a movie night.
What if my child gets sick, burnt out or experiences difficulties with their mental health?
If your child gets sick, burnt out (e.g., has frequent meltdowns or shutdowns) or experiences difficulties with their mental health during the programme, temporarily pause the programme until they build more capacity. When reintroducing strategies, consider a gradual approach. You may also consider going back to earlier steps in the programme and re-build from there.
How long will it take for progress to occur?
It can take weeks to months for a sleep programme to take effect (i.e., goals are met), depending on the chosen strategies and individual adaptations. You may see small changes within a few days of starting each step, but it is important to allow your child time to fully process and adjust to the change before moving to the next step. It is important to note, that sometimes the child’s sleep can get a bit worse for a few nights or fluctuate, before settling down, as your child and family adjusts to the new routine or supports.
5. Start the plan!
Select a night that suits you, your family, and your child to take the first step.