Introduction A child’s activities during the hour before bedtime forms the basis of the assessment for behavioural change interventions for children’s insomnia. The aim of this observational study was to identify patterns of behaviour around bedtime in a cohort of children with severe sleep difficulties and to explore deviations in behaviour from The Sleep Charity’s standard bedtime routine advice.
Methods Data were collected by research staff using a questionnaire during a baseline face-to-face visit to the child’s home prior to sleep practitioner support as part of the Sheffield Children’s Sleeping Well study. Children were aged 2-17 years with a diagnosis of ADHD or were identified as a looked-after child. Data was input into NVivo where it was coded to identify common or recurring keywords or phrases in the responses.
Results 51 parents were interviewed. Table 1 presents the coded responses to questions relating to sleep behaviours. For 32 children, bedtime routines lasted 30 mins-2 hours; 17 had no routine. Only 13 children were reported to have actively had technology removed within the hour before bedtime. 32 had no planned snack. of the 17 that did, snacks were usually cereal, toast, biscuit, warm milk although some snacks included chocolate, hot chocolate, crisps, burger and chips. Only10 children engaged in calming activities in the hour before bedtime such as reading, colouring, lego and crafts. 28 children were left to self-settle and 22 had a parent laying or sitting next to them in their bedroom in order to fall asleep.
Conclusion There was marked variation from the recommended bedtime routine in children with severe behavioural sleep difficulties, accepting that in some, socially desirable responses may have been given to the research staff during the assessment. Further work to explore the important factors in helping a child to self-settle is ongoing.
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