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Special circumstances

Ability to sleep is often affected by the impact of dramatic life events, disability and illness. Get sleep information for life’s journey.

Illness and holidays

As much as possible, you want to maintain that good bedtime routine and encourage self-settling but sometimes it just doesn’t go that way. There will be blips along the away, but these can help you get back on track.

  • If you child is ill, layer in your help. Offer pain relief in necessary but try to give this to them in the bed or cot. If you child has been unwell during the day incorporate this into the bedtime routine.
  • Your child may need more TLC than normal but as much as possible try to get them into their bed awake, you can stay next to them if necessary.
  • Don’t return to offering milk in the night if this has been cut out. Water is always an option.
  • If you child has a sickness bug, have sheets and change of clothes out for the night. If they are ill in bed, the clean-up can be quick and less disruptive. You could double make the bed with waterproof sheet and fitted sheet put on twice. In the night just the top set gets pulled off with a new set underneath.
  • When sleeping in unfamiliar surroundings your child may be unsettled. If you use a scented sleep spray at bedtime at home, the same smell can be recreated in the new environment. A familiar sheet, toy and book can also help.
  • Decide what is manageable. If your child wakes up in the night, are you in an environment where you want them to make any noise? Have a plan on back up in case this does happen and feel confident that you can get everything back on track once you are home.
  • When back from holiday or over a period of illness, re-establish your normal bedtimes. It is normal for your child to need extra support if things have been different.

Sleep and additional needs

Research indicates that up to 86% of children with additional needs may have sleep problems.

Most children learn to sleep from prompts at bedtime, but for children with additional needs we need to accentuate these signals.

Make sure there are consistent cues for sleep and support positive bedtime associations.

Bedtime routine

Repeat the same schedule every night so that your child understands what is expected of them and what is happening next. Start with a quiet hour before bedtime, where you can dim lights, play relaxing sounds and include a healthy snack for supper. Include a bath only if your child doesn’t find it alerting. Move to the bathroom for teeth brushing and toilet and then into bed.


Wake at the same time every morning to entrench a positive sleep cycle.

Average sleep needs

Be realistic about how long your child is able to sleep. Some may need more than the average, but some need less. Plan your bedtime around the amount of sleep they can achieve.

Sleep association

Use the bed for sleeping only, so that the association for bed and sleep is strengthened. Avoid using electronics in the bedroom and as a calming technique before sleep time. The light from electronics such as tablets or phones can reduce melatonin, and therefore disrupt your child sleep onset. Teach your child to fall asleep alone, but if you are concerned you can use a video monitor to check they are ok.

Visual support

You can use PECs, Pictures or photos of the bedtime routine. Introduce using them in the day with daytime routines before bedtime to test if they help. You could also try now and next cards. A sunrise and sunset clock is suitable for those children who can’t tell time.

Sensory needs

If your child has sensory processing challenges, then include calming activities within the bedtime routine. Before your quiet hour use exercises that provide resistance such as carrying weighted objects around, wheelbarrow games, trampolines or gentle swinging. Wrap up in a tight blanket, lap pads, smells such as lavender and vanilla may support to calm down. Your child may like a bean bag, fidget toys or to sit in sensory tent with dim lights and soft cushions.


Make sure the bedroom is cool but not cold. Hot temperatures affect sleep. Check that bedding and mattress covers are made of breathable material. Bamboo sheets are cooling and those with a high cotton content.


Is your child able to tell your about any pain they may be experiencing?

Your child’s diagnosis

Bear in mind that some conditions could have an inherent sleep difficulties. However, even if your child has complex needs, there will be a behavioural element to their sleep disruption. See sleep strategies, rewards and early morning waking information.

Sleep during change and difficult circumstances

When difficult things happen, it can be a natural reaction to experience broken sleep.

This may take the form of difficulties falling to sleep, staying asleep or early waking. If this lasts for longer than 3 months it is useful to ask for advice as something can often be done to help.

  • Bedroom environment. Is it restful and reserved for sleep.
  • The hour before bed. Take time to relax to prepare for sleep.
  • Take time during the day to practice some relaxation like mindfulness, or paced breathing or progressive muscle relaxation. Even thinking about pleasant memories can help.
  • Plan out tasks during the day.
  • Try to complete difficult tasks in the daytime when you feel most alert but not before bed. So if this is keeping you awake you can be reassured that you have set aside time for this the next day.
  • Make sure that you eat and exercise healthily.
  • Get a dose of daylight when you wake and keep regular sleep patterns even over the weekend.

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