A Good Night’s Sleep

Recently, a foster family came to see me about their nine-year-old son. *Michael had been with this family for about 6 months and the parents were at a loss as to how to help him sleep at night.  Every night, there seemed to be a mixture of reasons, excuses and behaviours that seemed to escalate every time they tried to put him to bed.  I laughed at his most recent humorous excuse – his pet turtle hadn’t finished having his bath.   In the routines of daily life neither parent could seem to reason enough, read enough books at bedtime or keep him asleep, if God willing, he did in fact, fall asleep. Through the night he was very restless, tossing and turning.  In the morning, waking Michael up was more than a chore and he was tired all day.  Michael was also overly reactive to what they felt like was – EVERYTHING.  These were devoted parents that implemented consistency but felt bewildered as to what to do as no amount of rigid scheduling, healthy eating or constant encouragement (kudos to them!) despite his many emotional outbursts, seemed to work.

Michael was also a smart, resilient, intelligent and ‘beyond his years in life experience’ kind of boy.  However, trauma and stress can affect a child’s nervous system which can result in sleep difficulties.  The larger question we had to address in our sessions was multi-layered – what is triggering the trauma, how do we effectively target this and how do we implement a strategy that is meaningful and effective?   I asked the parents a series of questions about Michael’s past and for the first time, the mom shared that she could almost put herself in Michael’s shoes and understand his challenges.   You see, he was the by-product of domestic violence and night time had been the most traumatizing for him in his early years of life. Though this foster home was safe from violence and a place of peace, this child was still suffering from the residual effects of toxic stress and his little body subconsciously stayed heightened in an over reactive stress mode. Michael was often unconsciously scanning his environment to better predict when “danger” was coming. We realized that this protective mechanism was going to take a lot of re-programming for there to be significant and measurable change (e.g. everyone sleeping better at night).  Simultaneously, the couple were trying to develop a healthy attachment with Michael but he consistently presented with the same dilemmas and insecurities each night.  The big “aha” moment was when we understood that Michael needed ‘to hear’ what was happening at night in order for his body to relax.

The parents shared (after the fact) that the plan we initially enacted seemed abstract and yet, over the next 3 months, they started to see a drastic difference in Michael’s ability to go to sleep quicker and his nights seemed to last longer.  Not only that, they were seeing a reduction in his emotional outbursts.  I believe that as we addressed his physiological and attachment needs with the principles we gained in the R.E.S.T. model that noticeable changes in Michael were being demonstrated.

A simple model that Complex Trauma Resources (CTR) therapists use in planning with some children uses the acronym (3) REST to frame bedtime strategies.  In short, the term REST refers to strategies that plan for predictable pre-bedtime Routines, modify the sleep Environment, minimize Stimulation and maintain structured Time strategies.

In our work we know that every traumatized child would need their own unique intervention plan to target their specific areas of assessed need.  For Michael, our first strategy was to place a fan in his bedroom each night. The “white” noise was intended to minimize his awareness of household sounds which was the cause of over-stimulating his stress response system.  Like all methodologies that need to be tried and tested, what seemed like a great idea was unsuccessful.  After a week, I called back to explore the strategy.  The difficulty the parents were encountering was that Michael didn’t want the fan in his room.   When he was asked about this, his reason was both surprising and yet, very natural. He reported that with the fan in his room, he couldn’t hear his foster parents at the other end of the house talking or watching TV.  Smart kid! We decided to modify the strategy and placed the fan at the end of the house where the mom and dad hung out when the kids were supposedly asleep. Over the next number of weeks, they gradually moved the fan closer to Michael’s bedroom. What they discovered was that over time, he was starting to get used to a quieter environment and the ‘white noise’ of the fan lent itself to a self-soothing rhythm for their foster son.   By the end of three months, Michael (and the rest of the family) was sleeping more fully during the night.  Mission success!

Let’s be honest, many children who have experienced complex trauma have difficulty with sleep.  I can’t hope to understand Michael’s unique circumstances that he has endured at such a young age but I do know that for even healthy families, we have kids that have unstructured and unpredictable bedtimes. For kids who have not experienced positive sleep routines, who have found that bed time is scary or who have experienced traumatizing experiences it is essential to teach them to feel safe at bedtime. Proper sleep allows our bodies to heal, rejuvenate, grow muscle, repair the broken bits and synthesize our hormones.  The brain is actually at work healing itself while we sleep.  Sleep is essential to growth and necessary for healthy development in children.  As caring adults, we need to be patient and establish patterned bed-time routines that will facilitate the needed rest a child’s body needs (and truth be told, adults also need this too in order to be the best caregivers they can be).

*This is an example of how the REST model can be incorporated to help traumatized children.  In this example, we shared how CTR incorporated one component of this model.

DISCLAIMER – At CCI, we respect everyone who comes to us for help – and many are working towards a process of integration and change in order to help those under their care. So while their stories are true, client names, ethnicity, location, images and variable factors may have been changed to protect their privacy. Thank you for your understanding.

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About the author

Dr. Kirk Austin, Ph.D., RCC, CCI Coach

Dr. Kirk Austin is a Registered Clinical Counsellor and member of our CTR Clinical team. To learn more about him click here.

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