Health services for children and young people

Quality sleep is essential for children’s growth and development. A good night’s sleep may help children concentrate better at school, have a better memory, learn more effectively and solve problems.

Good sleep is also good for health as they may catch fewer get colds and other minor illnesses. Overall, they will feel much better and be happier!

Sleep deprivation can increased activity levels and may lead to challenging behaviours. 

If your child seems to be waking up at night and snoring, this can really affect the quality of their sleep. Some children have large tonsils or adenoids that need monitoring by their GP and may need removing. If your child's tonsils or adenoids are causing them alot of problems with sleep and comfort, your GP may refer you to an Ear Nose and Throat Specialist. 

Some children find it difficult to settle, and may be worried about being alone. Common issues that stop good sleep are:

• Day time napping
• changes in routine or worries, 
• bedwetting, or worries about bed wetting, can stop children falling asleep or wake them up (please also see our continence pages).
• Children may be sensitive to noise, 
• feeling too hot or cold, 
•  they may not like the smell of the bed or the room!

It is important to try and find out if that is the case for your child. If your child does say they feel anxious they might want to talk to someone about their worries. 

Kooth is an online counselling service for older children, aged 10 years old to 18 years old who can talk through any worries they might have that are keeping them awake. 

If you think your child is worried about something you can find way to help on the ‘getting help’ page in the social and emotional support section of the Local Offer

• Take some time to plan your routine and write it down. Work out what time it will start - this should be an hour before your child goes to sleep. For younger children 30 minutes would be enough to start with.
• Make sure everyone knows about the new routine. You could stick the routine on the fridge or on a bedroom door. Use pictures to help your child see what the routine looks like. You can also make a social story about the routine. 
• Do the same thing at the same time each day, including having a set wake up time each morning. This can be difficult at the weekend and during school holidays, but it is important to have these set times to help your child’s body clock.
• Turn off all screens like iPad/television and phone at the start of the routine. They may suppress the body’s production of melatonin, the sleep hormone, and make it more difficult to get to sleep.
• Think about a small snack in the routine. Visit The Sleep Charity’s advice about ‘sleepy food’. 
• Dim the lights in the hour before bed to start the production of melatonin, this will help children feel sleepy.
• Some children may like a ‘bedtime box’, filled with a selection of activities to carry out during the routine. Hand eye co-ordination activities such as jigsaws, colouring and threading are great or even playing with things that feel nice to the child, for example sensory toys. Some children may prefer to read, or play a board game
• A bath 30 minutes before bed can help sleep, the drop in body temperature after a bath can help us to sleep off more easily.
• Once in bed sharing a story is a great way to end the day, or older children may prefer to read independently.

You can find out more from The Sleep Charity and Cerebra Sleep Tips

Sometimes sleep hygiene methods, such as avoiding phones and screens before bed, do not always work for neuro-divergent young people. 

Sleep hygiene advice works to try and increase melatonin and reduce stress so if children are stressed by the withdrawal of screens, or they have tried to avoid screen use and it does not work, then it is more about reducing stress at bedtime. 

Reducing stress will increase melatonin, so it is better to focus on stress reducing strategies for some children, and find a compromise that increases melatonin just enough, while also reducing stress enough to make sleep easier. 

It would be helpful to fill in a sleep diary for two weeks, as it will help pinpoint any difficulties. 

View the sleep diary (PDF)

• Fill it in as honestly as you can
• Use extra sheets if necessary. Get as much information down as you can
• If your child sleeps elsewhere during the time you are keeping a sleep diary, for example grandparents, child minder, respite centre, make sure you get the child’s carer to fill in the sleep diary and record where they have slept.
• Check with your child’s school or nursery to see if they nap in the day (if applicable)
• If your child uses school transport check with the escort/driver to see if they fall asleep / nap on the journey home
• Keep the diary by the bed/in the child’s room so that you can fill it in immediately rather than trying to remember what happened later
• Keep the diary for at least TWO weeks to see if you can find a pattern to your child’s sleeping behaviour

• If you want to talk to someone about your child’s difficulties with sleep, you can email your school nurse or health visitor or call them on: 0300 033 6200
• Seek advice through the Family Hubs Best Start in Life 0 to 5 years 
• There are parent courses on our parent support page that cover different challenges parents may be having, including sleep
• You can ask a professional for a referral to a Waltham Forest sleep specialist. You can also refer yourself through the short breaks self-referral form, and ask for sleep support.
• If you are a member of the Waltham Forest Parent's Forum you can email  Waltham Forest Parent Forum with your queries and they will find someone to help you

Sometimes children might need further referrals if they have more severe sleep difficulties. Severe sleep difficulties could mean they rarely sleep for more than a few hours, or going for long periods of time with little or no sleep. They may have medical problems that are preventing them getting a good night’s sleep such as Asthma, blocked nose or hay fever, constipation, heart burn or even another medical condition disturbing your child’s sleep.  

You can approach your GP for a health check to rule out any other factors. If there are no other obvious reasons for your child’s sleep difficulties, you may need a referral to a Consultant Paediatrician or Child and Adolescent Mental Health Services.

At you appointment, you will be asked what strategies you have tried and how long you have tried it for. Referrals will only be accepted if you have tried different strategies for three to six months. It will be helpful if you can show the professionals your child's sleep diary. 

Remember, sometimes things get worse before they get better! 

At the specialist appointment you will be asked what you have already tried, so remember to bring some notes about what did and did not help. 

Sometimes children may be prescribed medication to help with sleep. Medication is only given as a last resort. It will be monitored carefully through the prescriber and your child’s GP.

If your child has physical disabilities remember to ask your Physiotherapist or Occupational Therapist for advice on positioning your child so they are comfortable at night. 

The therapists may give you stretching exercises that will help, in addition to the above sleep routine advice. They may want to show you different positions for your child at night, to make sure they are comfortable. Some children with severe cerebral palsy may be assessed for and prescribed a ‘sleep system’. This is a way of making sure your child is well positioned in their bed through a series of support cushions that are velcroed in place. These are only appropriate for children with severe physical disabilities. 

In severe sleep cases such as sleep apnoea, you may be referred to a specialist sleep clinic.