Sleep Hygiene and Bedtime Routine is Crucial for sleep

Home » Sleep » Safe Sleep » sleep hygiene and routine

Dr. Sandro Cantoni. Updated: 20 September 2021

Restful, regular sleep is critical to your child’s physical and mental well-being. 

Research shows that if your child is sleeping poorly or less than usual, he or she will have major problems. Irritability, impulsivity, memory and learning difficulties, mood and behavior problems.

Lack of sleep can also lead to physical diseases, such as obesity

Good sleep hygiene and a bedtime routine, are essential to getting and maintaining good sleep

Why is sleep hygiene so important?

Several research studies have shown that sleep hygiene works in helping children fall asleep and stay asleep. For several reasons.

Sleep hygiene practices reinforce the daily sleep-wake cycle, the night and day rhythm. They also cause behavioral conditioning. The child learns to associate certain activities and environments with sleep. In addition, proper sleep hygiene reduces stimulation and increases relaxation before bedtime. And this can reduce the child’s tension and anxiety.

For all these reasons, without good sleep hygiene, it is very likely that your child will have trouble at bedtime or during the night.

If the child has sleep problems, all interventions, whether behavioral or pharmacological, are ineffective unless there is also a good sleep hygiene.

For example, it is useless to try a medication such as melatonin, if the child watches television before sleeping. Because screens block the natural production of this hormone.

Your child should go to bed at the same time each day

Every day, even on weekends. This promotes your baby’s sleep. If your child falls asleep and wakes up late on the weekend, this can alter his sleep-wake rhythm. It takes many days to get back to a normal rhythm. 

Sleep and wake times should not vary more than one hour from day to day. This includes weekends. 

If your child maintains a regular rhythm, he may even stay up late on a particular day, such as a birthday. Then he will quickly return to his regular schedule.

Put the child to bed when he is sleepy. Otherwise, he will stay in bed moving around or doing something else. The child gets restless and will struggle to fall asleep.

If the bedtime is too late, gradually try to anticipate it.

Afternoon nap not too long

Don’t let your child sleep late in the afternoon. Then he will have trouble falling asleep in the evening. Anticipate naps and if he is still asleep at 4pm, wake him up.

In the evening, reduce activities and light 

The time before falling asleep, when there should be only calm and relaxing activities, is very important.  Decrease the light and noise. If the child falls asleep before sunset, close the windows and draw the curtains. This will help your child’s brain begin to produce melatonin, which is critical for promoting sleep.

In the evening, 1-2 hours before bedtime:

Avoid stimulating activities. Do quiet activities or games, such as reading a book, playing with dolls or cars, drawing.

Avoid sugary and heavy foods that are difficult to digest.

Your child should not watch television or play with electronic devices. 

If your child wakes up at night, turn on the low light of a bedside lamp.

Light in the morning and during the day

For the production of melatonin, the hormone that promotes sleep, the body needs a light-dark rhythm.

For this reason, during the day, try to keep the house well illuminated, opening the curtains in the morning.

Comfortable sleeping environment

The bed should be used only for sleeping. Therefore, your child should not be in bed when doing other activities. For example, watching television, using a tablet, or playing games. Or to do homework or study. Because in this way the child associates the bed with activities in which he/she must stay awake. Instead he should associate the bed only with sleep. 

The child’s room should have a comfortable temperature, from 18 to 20 ° C. 

The baby’s room should be a quiet place, away from noise. It is important that he does not hear noises such as your television while he falls asleep. Because it may happen that he wakes up when the television is turned off. 

The child’s bed must be safe. The mattress should be firm enough, not soft.

In the child’s room there should be no television, computer, tablet or smartphone. If there are, then it is difficult not to use them before bed, or during the night. Watching an electronic screen stimulates the brain rather than relaxing it. In addition, the light that these devices emit blocks the production of melatonin. 

The rooms where your child lives should be free of secondhand smoke. For his health and to promote his sleep.

A light scent, for example lavender, can be useful to create a relaxing environment.

The child must always fall asleep in the same bed

It often happens that the child falls asleep on the couch, or in the arms of a parent, then is taken to his bed. The child wakes up at night in a different environment. And this can disorient him and wake him up completely. If the child always falls asleep in this way, he is likely to develop a sleep disorder sooner or later.

Nutrition and physical activity

Avoid caffeine or other stimulants

Of course your child does not drink coffee. However, caffeine is present in many types of beverages, such as Coca-Cola or tea. Try to limit the intake of these drinks during the day. Because the effect can last up to 12 hours.  Caffeine is also present in chocolate. Better not to give it in the evening. For example, a good hot chocolate in the evening in winter does not help sleep. 

The evening meal should not be heavy

A large dinner makes it difficult to fall asleep. If your child goes to bed early, try to avoid eating dinner just before, but anticipate the meal by a couple of hours if possible. Some foods can promote falling asleep, such as warm milk. Afterwards, however, brush your child’s teeth to avoid milk caries. 

A balanced diet during the day, rich in fruits and vegetables, also promotes baby’s sleep.Meals should be at regular times every day. 

Physical activity every day

Children who do not move often have difficulty sleeping. Regular physical activity throughout the day is important. Especially outdoors. Even if your child doesn’t like sports, a walk or bike ride is enough.

The child uses up energy and gets tired, can relieve some stress. And this promotes falling asleep in the evening.

However, it is better to avoid sports or physical activity in the late afternoon or after dinner.

Why your baby or child should learn to fall asleep on his own

During the night we all wake up naturally, several times, for a few seconds. Maybe we change positions and fall asleep. In the morning, we don’t remember these awakenings. Kids and babies also wake up at night. 

If your child hasn’t learned to fall asleep on his own, he often can’t get back to sleep during these awakenings. He needs your help, just as at bedtime. Then he wakes up completely and calls you to help him sleep. This situation, if repeated several times a week, deeply disturbs you and his sleep. 

How to teach children to fall asleep on their own?

There is not a method that works for everyone. With the help of your pediatrician, you need to understand why your child can’t fall asleep on his or her own. And then find ways to improve the problem. These strategies are known as “sleep training.”

The Bedtime Routine. What is it?

A bedtime routine is a series of relaxing activities, always the same ones, to prepare your child for sleep. It is done about 30 minutes before the baby falls asleep. 

It is a kind of ritual that the baby and child learns to associate with the bedtime. In a positive atmosphere of calm, quiet, serenity. His brain begins to prepare for sleep and to produce melatonin, the essential hormone for a good night’s sleep. 

Research shows bedtime routines work. Especially if your child is having trouble sleeping. A repetitive bedtime routine gives your child a sense of security and serenity.  And it helps him fall asleep, even on his own. It also helps him to develop good habits that he will maintain over time. 

But the bedtime routine is not only important for sleep. 

Benefits of bedtime routine

In the evening, parents often arrive home. Or at least one of them in case one parent works in the evening or at night. 

Bedtime routine activities are very important not only for sleep, but for a child’s overall development. 

For example, reading a book every night helps him increase his vocabulary. To develop reading skills. And it increases the attachment relationship with the parent. Similar effects occur when the parent tells a story. 

During the bedtime routine there is often physical contact between parent and baby or child, e.g. with cuddles or massages. This has positive effects on the child’s emotional and behavioral development. 

Characteristics of a good bedtime routine.

Always the same, constant, repetitive, i.e., with activities always in the same order and done in the same way.

Daily. Bedtime routine activities should be done every night (except for a few special occasions)

Simple, with 3 or 4 activities at most. 

Activities should be relaxing and calm. With room lighting turned down.

Pleasant for you and for your baby or child. 

Not too long. It must last a fairly specific amount of time, usually 30 minutes.

If possible, both parents should participate. 

If the baby sleeps at the grandparents’, they should also do the same bedtime routine.

Bedtime routine should begin about 30 minutes before the child falls asleep. If the child falls asleep later than the desired time, gradually advance the bedtime routine. By 10 minutes every 3 to 4 days.

Examples of bedtime routines 

Activities change depending on your child’s age. And according to your habits.

The important thing is that the activities are relaxing. They must calm the baby or child. For example, usually a bath or shower tends to relax the baby.

However, some times the baby is excited in the bath and wants to play intensely.  In this case the bath hampers falling asleep and should not be included in the bedtime routine. 

Do not make a bedtime routine too complex or long. This can complicate falling asleep. And if there is little time, you will not be able to do it. 

If your child is falling asleep, keep the bedtime routine to a minimum, a few minutes.For example, teeth brushing then bedtime with a cuddle.

Bedtime routine for babies. 

Bedtime routine is usually established at around three months of age. 

An example might be this: 

  • A brief bath or diaper change.
  • Breast or bottle feeding.
  • Cuddling, massages, watching and reading a book.

Bedtime routine for toddler might look like this.

  • A glass of warm milk.
  • Bath with teeth brushing
  • Dressing for bed.
  • Reading a few pages of a book or telling a story.

Take home message

Good sleep hygiene, with a simple bedtime routine, is really easy to do. And it is essential to ensure a good sleep for your baby or kid. These are really enjoyable activities to do with your baby, and are helpful for his psychomotor development.

References

Darius A. Loghmanee et Jamie A. Cvengros. Promoting Healthy Sleep Practices. Principles and Practice of Pediatric Sleep Medicine, Chapter 8, 63-66

Erath SA, Tu KM, Buckhalt JA, El-Sheikh M. Associations between children’s intelligence and academic achievement: the role of sleep. J Sleep Res. 2015;24(5):510–3.

Taveras EM, Rifas-Shiman SL, Oken E, Gunderson EP, Gillman MW. Short sleep duration in infancy and risk of childhood overweight. Arch Pediatr Adolesc Med. 2008;162(4):305–11.

Mindell JA, Williamson AA. Benefits of a bedtime routine in young children: Sleep, development, and beyond. Sleep Med Rev. 2018;40:93-108. 

Allen SL, Howlett MD, Coulombe JA, Corkum PV. ABCs of SLEEPING: A review of the evidence behind pediatric sleep practice recommendations. Sleep Med Rev. 2016 Oct;29:1-14.

Kitsaras, G., Goodwin, M., Allan, J. et al. Bedtime routines child wellbeing & development. BMC Public Health 18, 386 (2018).


Related Articles

2 month milestones and signs of delay

4 month milestones and signs of delay.