How-to-Manage-Sleep-Problems

Children With Trauma and Attachment Disorder: How to Manage Sleep Problems

How many of us have had bedtime become a big problem with our child who has trauma or Attachment Disorder? Even among adults, the number of individuals suffering with insomnia is rising, and we ourselves, may be struggling with good sleep. I know I was.  

After all, how could I sleep when my son would break windows in an attempt to run away? How could I sleep knowing that he has been sneaking out of his room to steal and hoard food at night? And how could I really sleep after he just calmly explained to me, earlier in the day, how he planned to kill me?

Both bedtime and sleep were a huge stress and it became something that turned into a re-traumatizing event for both my son and me night after night.  

I thought I was doing everything right to facilitate a smooth bedtime and good sleep for my child. I made sure he was very active during the day, then family time after dinner with singing and reading stories, we would have a prayer, and then he was supposed to calmly go to bed.  

It never worked out that way. Sometimes he would start to lose it during dinner, which caused family time to get skipped, because he was already in his room or we were having to do holding time in order to keep him and us safe.  

Sometimes, he would be great, engaged, and appeared relaxed, until prayer time, then as I closed my eyes during prayer time, he would reach out to punch me in the stomach. Ugh!!  

If he actually made it through dinner and family time, I would go with him to his room and tuck him in. We had a good night song I would sing after he was all tucked in, and for me, this was a really special moment that just the two of us shared, which caused me to feel very affectionate and motherly.  

Perhaps that was the problem. Because inevitably, he would hurt me. My face and eyes were usually the target. He would thrust the heel of his palm in my face, and either poke my eyes with his full force or shove my glasses back into my faces and eyes. What a way to kill the tender moment!!

More important, it was the fact that bedtime was obviously a time that his trauma was resurfacing, but we were in a horrible cycle of nervous system continuing to play out and reinforce this trauma response every night. However, I didn’t know how or what else to do for bedtime routine that would help him relax, but I knew that sleep was so important for his mood and behavior the next day. I had to do something, but what??

The first thing I resorted to was melatonin, a supplement known to promote sleep by increasing the levels of this sleep hormone made by the brain. Then I felt like I was an awful parent because I was told how melatonin blocks the brain’s production of growth hormone. Then I admit, I had the thought, “Well, maybe with this degree of violence and aggression, being shorter wouldn’t be bad.”  

Ugh. What an awful place to be. If you have been there or are there, know you are not alone! In this blog we are going to discuss what is safe to use for children, how to actually help them relax and sleep, and how to break the cycle of re-traumatization at bedtime.  

Why Is Bedtime and Sleep Such a Difficult Time?

Bedtime and sleep are times when children who have trauma and attachment issues become triggered and, thus go into survival response. Let’s look at the triggering from both a parts-work-perspective and a biological framework with the nervous system.  

From an Internal Family Systems, Perspective and parts-work-perspective, bedtime is a time when some parts come out stronger than at other times! Bedtime is usually a time of conflicting parts, when all parts are trying to make their voices heard, and the result is chaos.

Being asleep is a time of vulnerability for everyone. But for children who perceive threat everywhere in their environment, they do not allow themselves to become vulnerable, so they will do everything they can to fight off sleep and stay awake so that they can be vigilant of their surroundings.  

Another part of them that can come out at bedtime is the little child-part, who feels lonely and abandoned. They can feel that abandonment every night when you walk out and shut their bedroom door.  

There is another part of themselves that hates feeling that lonely and abandoned part, because of that they will desperately try to shut it down by demeaning it and pretending it doesn’t exist.  

What can result from this is this push and pull within themselves that will be carried out in their dynamic with you. Altogether and evernight there is the part of them that is hypervigilant and fights sleeping, because they can’t protect themselves; then there is the part of them that starts to feel the sadness and grief from feeling lonely and abandoned; yet, there is the part that would never let anybody else see that sad and lonely aspect of them so they turn it into anger or avoidance.

That is bedtime and sleep from a parts perspective!  

Now let’s look at sleep from the nervous system perspective:

Nervous System and Sleep

The nervous system has to relax, go into parasympathetic mode in order to fall asleep. For children and adults who have the freeze response wired into their nervous systems as a default survival response, falling asleep can have qualities similar to that of freeze.  The arms and legs should get heavy, the breathing slows down, the heart rate becomes slow and steady.  

Going into the freeze state is not comfortable, after all, it is a defenseless position. Rather than allowing our bodies to go into freeze, we usually fight it and become restless, agitated, or hyperactive. We do anything so that we do not feel that numbness and paralysis of the freeze come over our bodies.  

Therefore, children who have trauma or Attachment Disorder will fight the very relaxation process and get increasingly agitated the more tired they get. Ever experienced that? That was my son’s story every night!

In summary, bedtime and sleep is an extremely difficult time for children who have trauma and attachment issues, because of the different competing parts that are unbalanced. They easily get triggered by the relaxation, connection, tenderness, and also a fear of abandonment (whether you stay or go it will trigger them), which causes them to struggle even more with going to sleep.

Managing Bedtime For Children With Attachment Issues

By understanding that bedtime can be a trigger for children with trauma and attachment issues, as well as how their nervous system is fighting the freeze, can allow us to truly see what we can do to approach bedtime so that it no longer re-traumatizes them or us!

There are other factors to consider with bedtime that should also be mentioned:

We do not want to feed into any power struggles over control. We want to be strong, loving adults, because that is also how they feel safe enough to trust us: when we “say what we mean, we mean what we say,” which we say calmly and lovingly. No games, no begging, or manipulation to get their way with bedtime or anything else. We are teaching them healthy ways to communicate in relationships. Being a strong adult during bedtime will show them that they can trust you more to take care of them when they are asleep.

Not only do we want to get them to sleep, but also we want to maximize the amount of good sleep they will have. Knowing that their mood and mental health the next day depends on the quantity and quality of sleep they get, we want to maximize both.

Factors to Manage Bedtime and Maximize Restful Sleep

The following are the factors that you have control over and can use to help bedtime be calm, which can help to maximize their quality of sleep.  We will go over the first three, and the next three topics we will cover next week.  

  • Time
  • Light
  • Sounds
  • Activity
  • Touch
  • Supplements

Time

All bodies do best on a schedule, it’s called a circadian rhythm. Our biology and hormones get set to a rhythm so that it can perform best, especially when working with a child with trauma and attachment issues, a rhythm is really important. Meals and bedtime at the same time will really help their bodies heal and do the hard work of attaching. If you have never been on this kind of a rhythm before, I encourage you to try it. For 1 month, mealtimes and bedtime happen at the same time every single day, with no exceptions. If you are not convinced after 1 month that your child’s behavior is better with a rhythm, you are free to follow what works best for you!

Given how difficult transitions are for our kids, it also does not work well to get home and expect them to go straight to bed. Transitions are times of startle and hypervigilance for our kids, and so by cutting out extra activities and being home in the evenings will eliminate this contribution to poor bedtime and sleep management.

Light

Light plays a big role in our circadian rhythms and in the timing of the release of hormones, like that of melatonin, the sleep hormone.  

The science is very clear: no lights from screens/monitors for 1 hour prior to bedtime. These lights stimulate the receptors in your eyes to think it is middle of the day, and will delay the release of melatonin (1). This is specifically due to the blue light frequency.

Not only do you need to eliminate screen time of any kind in the last hour before bedtime, but also dim all the lights in the house two hours before bed stimulates the production of melatonin.  Steven Lockley, a Harvard sleep researcher, found light even from a reading light can reduce the melatonin production (2). Lights from candles do not have this effect on melatonin, so that could be a really fun way to optimize your sleep with low lighting and have a fun time. (This is obviously only if your child can be safe around fire and candles…. this is not for everybody!)

If your child is going to bed prior to the sun-setting, this can make for some creative ways to dim the lights, but for certain, don’t have any lights turned on in the house and just go with natural outdoor lighting as it gets dark.    

The body also needs complete darkness to do its best repair and rejuvenation at night (3). It is essential to make the bedroom as dark as possible. Many parents choose to do this, despite a child’s insistence they need a light on. To block out all light, especially the damaging light from outdoor city lights, I put a blanket over the window. If your child can resist touching the curtains, blackout curtains are also a good solution.  

If you choose to do a night light for your child, it needs to be a red or amber night light so as to minimize the disturbance to their sleep (4).  

There are also blue-light blocking glasses that you can buy. Obviously, this is not an option if your child would destroy them. If they would wear them, using them for an hour or two before bedtime would convince their brain it was dark and their production of melatonin would start. The site biohacker.com is one place to get blue-light blocking glasses (TrueDark) glasses to optimize sleep and melatonin production.

Just as important as it is to dim lights and block blue lights that you get from LED lights, it is important to start the day with direct sunshine. Being in the sunshine during the day will help your child’s circadian rhythm set itself to the light of the sun.

If a child has a fear about not having a light in their room that is because they feel like they need to protect themselves and so need to be able to see everything. I like to address this fear through other ways, like a walk around the bedroom and house using defensive orienting (looking and checking out everything) rather than using lights because I want them to get restful sleep.  

I also want to clearly give them the message that it is my job as the caring adult to protect them, and I show them the mechanisms I put in place to protect them. Click here to listen to a song that I love to play for them at bedtime. It is called Light in the Hallway, and it reinforces this idea that I am there to protect them, they don’t have to protect themselves. However, it is a metaphor since I choose to not leave a light on for them!

If you decide to leave their door ajar so that light is coming into their bedroom, I recommend that for their quality of sleep, you turn off all lights after they fall asleep.  

Sounds

Since the children are probably going to bed earlier than the adults, I found it helpful to put on meditations or sounds that would block out our noises. Otherwise, I found that it tempted them more to come out of their room, so they wouldn’t be alone or to not miss out on what we were doing.

Putting on relaxing sounds was really helpful for my son and other children with trauma and attachment issues who I have worked with! If it is something they like, it also worked as a motivation for them to stay in bed, because I explained it only got played if they stayed in bed. It only took one night of them getting out of bed and having the music turned off for the rest of the night for them to stay in bed!

Things I have found helpful:

Sleep Music

Choir Chants, “OM”

Guided Meditation by Jason Stephenson  

Again, for the most restful sleep, I would only have music playing for one hour to help them relax and fall asleep, not all night.

Binaural beats are the best way to enhance your brain going into delta waves for deep sleep, but it does require wearing headphones and at least in the early part of healing a child from trauma and attachment issues, they are not restrained enough to have headphones and not play with them when I left the room. If you would like to use this tool to help you get to sleep faster and get more restful sleep, this 90 minute cycle is what I would recommend: Binaural Beats.

Since this is an important time to actually have them relax and because we don’t know what exactly triggers them, at a different time other than bedtime, sit down with them and go through a few different options and let them choose which option feels the most calming to them. Because you are letting them choose, keep it limited to a few options that you are all okay with!

Feel free to share what you have done in your experience with a bedtime schedule and routine, and let me know if you have noticed lights or sounds make a difference for your child’s sleep.  

Sending You Encouragement ~

Dr. Aimie

Related:

Applying the Neuroscience of Safety

Attachment Disorder As A (Curable) Disease

 

 

References:

  1. Shanahan TL, Zeitzer JM, Czeisler CA. Resetting the Melatonin Rhythm With Light in Humans. J Biol Rhythms. 1997 Dec;12(6):556-67.
  2. Rahman SA, St Hilaire MA, Lockley SW.  The effects of spectral tuning of evening ambient light on melatonin suppression, alertness and sleep. Physiol Behav. 2017 Aug 1;177:221-229
  3. Asprey, David (2017). Head Strong: The Bulletproof Plan to Activate Untapped Brain Energy to Work Smarter and Think Faster – In Just Two Weeks.  HarperCollins Publishers, New York, NY
  4. Lucas RJ, et al. Measuring and Using Light in the Melanopsin Age.  Cell.  Jan 2014;37(1): 1-9

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