Interview with psychologist and Dr. Erla Björnsdóttir a specialist in sleep problems
The psychologist Erla Björnsdóttir, who released a book about sleep this year, is a specialist in sleep problems. She has a Ph.D in medical sciences and spent years studying the effects of sleep deprivation and insomnia. She is the founder of the Icelandic company Betri Svefn, literally meaning better sleep that provides specialized cognitive behavioral treatments and education on how to improve sleep for all ages. Erla is also a mother of four and recognizes, like all of, us how it is to have children that do not want to sleep or have difficulties sleeping, at one time or the other. We ask Erla: What are the main symptoms of childhood sleep problems and are they different by age?
“Sleep is very different depending on age. For the youngest children they usually do not sleep through the night and wake up often or stir, which is quite normal during the first year of life. When the children grow older they can start fearing sleeping alone. Children get nightmares, are afraid of being alone or sleep walk. They can also have night terrors where they wake up terrified and remember nothing about it the next day. Some children simply have trouble falling asleep and take a long time to settle in the nights. Many children also wake up often at night and some even climb into their parents bed. There are a lot of different things that affect the quality of sleep for children, but in many cases these are things they automatically grow out of. Especially sleepwalking, night terrors and multiple wake ups during the night. Sometimes, however, they need a little help to sleep better. As an example, if they suffer from fear of sleeping alone or having trouble falling asleep in the evening" says Erla. The question is though: When do sleep problems stop being normal and become a problem that needs to be addressed?
Children show different symptoms than adults when tired
"The most important thing to consider is whether this affects the child's well being and behavior throughout the day. When children are tired they usually show different symptoms than adults. We get sleepy and tired, but children are more likely to be annoyed and restless. In some cases they can also show symptoms similar to ADHD behaviours. It is difficult to estimate when sleep problems are progressed outside of what would be considered not normal. You must take into account the impact this has on the child's daily life, as well as the family's" says Erla, adding that sleep problems can cause behavior in children that is usually just written off as misbehaviour.
"It's this effect on their mood that makes it hard for parents and the whole family. Moreover it can have a lot of impact on parents if the child can not sleep alone and always sleeps in bed with them. Children’s sleep problems can easily interfere with the parents' quality of sleep."
To promote a more quality sleep a routine is crucial
Erla however points out that there are various things that parents can do to promote a more quality sleep for their children. "Number one, two and three is establishing a routine for their sleep. Children should always go to bed at the same time and wake up at the same time. Preferably also on weekends. It is helpful to start settling them down to calmer activities one or two hours before bedtime. As an example, turn off smart devices and the television. Rather take a hot bath, read together or listen to quiet music to calm body and mind. Children are naturally very active. In the evening they may be watching cartoons that are colorful, or playing exciting video games, and it's not good to have that kind of stimulation just before they need to go to sleep. Then of course, the diet also has an affect on sleep. It is important that children eat healthy, eat regularly and do not ingest much sugar or drink caffeine. Some children and teens drink soda and energy drinks that can also negatively affect sleep" says Erla.
"Make your child's sleep environment cozy and comforting, so that the child is more likely to feel at ease when it is time to go to bed. Firstly, it is important that the lighting is comfortable and not too bright. It should be dark in the night, but if the child is afraid of the dark you can have a soothing and faint night light or give the child an item that makes them feel more secure, such as a comforting plush toy. Something that gives them a sense of security and comfort. It is also recommended to keep the bedroom in order. For adults it is recommended that the bedroom is only used for sleep. However, for children it is different as their bedroom is usually their play and study area. Just make sure there are no toys on the floor and not a lot of stimulus that can interrupt them. Electrical appliances should not be in the bedroom and it is not advisable to let the child fall asleep from the television. Rather, the sleep routine should be a quality moment, where a parent and child read together, sing songs, pray together, or do other activities that help them wind down. It's also good to encourage children to sleep in their own room when they are old enough. It's not a good solution to allow children to fall asleep in the parents' bed and then carry them to their own bed in the evening. As the child grows and becomes more independent you want the child to learn to sleep in their own room and feel comfortable sleeping in their room. However, what is most important is routine and a healthy lifestyle, that the child is exercising and is well nourished. This as we know applies to adults as well, but children have more of a need for routine than we do."
Erla says that young children rarely sleep in on weekends, even if they go to sleep later than usually the night before. Therefore, is is not advisable to allow them to stay up in the hopes of them sleeping longer the next morning. “In fact, they are usually up early in the weekends and end up being more grumpy and restless if they do not sleep well enough. The routine can often be irregular during weekends and children get sugary treats. It is therefore necessary to make sure that while you are enjoying the weekend, it is not necessarily the best for the child to go to sleep late. Of course, older children and teenagers can handle better staying up on weekends and are more likely to sleep in. I am rather referring to children in primary school and younger” Erla adds.
If all else fails, where can tired parents turn to if they can not turn around their children's sleep problems? "Here in Iceland Arna Skúladóttir, a nurse at The National University Hospital of Iceland, has been writing books and giving parents help with the youngest age group. If you suspect anxiety or other underlying problems with older children that may explain sleep troubles, you should talk to a child psychologist. It may very well be that anxiety is causing sleep problems, especially if the child is also experiencing anxiousness during the day. If the problem is physical, for example if the child snores a lot, I recommend taking the child to your GP" says Erla.
We here at RoRo would also like to add that when sleep has become a problem in the household we recommend to seek out advice with your pediatrician or sleep specialists. There are numerous sleep consultants online that provide great services and can also help recognizing situations where you need to seek medical or psychological assistance.
Sleep routine has improved with every child
Erla herself has four lively and energetic children of her own. We ask if getting her kids to bed has always been a smooth ride?
"No, not always" Erla confesses and laughs. "However, I think this has improved with every child, so to speak. I have learned a lot and matured since I had my first child when I was only 21 years old. At that time I was spending a lot of time getting my first to sleep. My youngest, who is three years old, has always gone to bed at 7.30 pm and fallen to sleep right away, just like clockwork. I think it has a lot to do with routine and us sticking with it. I also have older children and we are a little more relaxed with them. As an example during our summer vacation, my 11 and 13 year old were allowed to stay up longer and then they would sleep in longer. Of course, I try to keep all such irregularities to a minimum because I know how important this is. Especially that they get enough sleep. I try to adhere to these principles, but of course sometimes that does not always work, just like in all homes I think" says Erla.
Erla with her husband Hálfdan and their four beautiful children.
*Article originally published in Icelandic at: www.mbl.is