How Sensory Processing Impacts Sleep (for us but also maybe for you)
I want to start this post with two disclaimers.
1. I am not an occupational therapist and aside from two brief sections in my sleep consultant course, I do not have any formal training in sensory processing and how it impacts sleep.
2. If you do not have a sensory sensitive or sensory seeking kid, please do not read this post (or take it with a grain of salt). It provides a lot of sleep modifications for kids that need them, but if your kid doesn’t need them it can be an overload of information that can cause anxiety. Many kids do not need to go as far as I have to go with Landen to make sure his sleep environment is optimal. In fact, I don’t even do many of these things with my other two kids because they don’t need it. If your kid doesn’t need it, don’t do it.
However, I have 5.5 years of experience parenting a kid with sensory processing disorder so I will share my experience with that and what has helped him and me in terms of his sleep habits, plus a little bit about what I did learn from my course.
First of all, every kid is different. Every PERSON processes sensory input all day every day. Every person and every kid will be more or less sensitive to different inputs and this will impact a number of things throughout the day, one of which is sleep.
Everyone must be regulated to fall asleep…
The most important thing to know here is that a kid who is not regulated will not go to sleep easily. So the goal is to figure out what regulates your child and implement those strategies before bed or throughout the day.
There are 8 senses that can be regulated or dysregulated and different needs that are linked to each sense. I’m going to discuss what I know and have learned about all 8 and how you may be able to support sensory needs around each to help your child sleep better. But remember, I AM NOT AN OCCUPATIONAL THERAPIST. I DO NOT HAVE ANY FORMAL TRAINING. Ok I think I’ve said that enough times.
First, there’s the five senses we all know. Let start with the easy stuff.
Taste
It’s unlikely that the sense of taste will have a huge impact on bedtime, but I would definitely make sure your child is fed something that they are comfortable with and can fill up on before bed. Landen doesn’t eat a huge dinner if he’s dysregulated or if it’s not a favorite food simply because dinner is a hard time for him, and he eats more throughout the day so it’s his least hungry meal in general. He’s been overwhelmed all day and he’s at the end of his rope. When he’s already overwhelmed, food textures and new foods are triggering for him and he just won’t eat. So we work on new foods at other times and almost always have a banana and applesauce before bed so he doesn’t have to go to bed hungry. An easy boring bedtime snack may just do the trick for a hungry picky eater at bedtime.
Smell
This is also probably one of the least offensive senses when it comes to bedtime. That being said, there are some things that can definitely hurt or help. For example, if your child is sensitive to smell they may benefit from the diaper pail being in the hallway or bathroom, or at least not next to their crib or bed. On the other hand, if your child is sensitive to smell something they LIKE the smell of may help regulate them. For example, mom’s shirt! (If they’re old enough to sleep with it.)
Now for the fun stuff.
Touch
Touch sensitivities can present themselves in a lot of different ways and can seriously dysregulate kids and impact bedtime. First, there are a few “grooming” tasks that have to be completed before bedtime. This can include bath time, teeth brushing, hair brushing, etc. If these things are an issue before bed, then you’ll want to do them as quickly as possible and leave time afterwards to find a way to help regulate your child after they happen. I’ll talk about some specific regulating strategies below. You’ll also want to find strategies to help your child become more okay with these tasks over time. If it’s incredibly disruptive to the routine, you may want to consult an OT.
Other ways that touch sensitivities can impact your child are in what they’re wearing or what their beds feel like. This is one that I have a lot of experience with because Landen’s touch sensitivities (in general, not just around bedtime) are what initially led me to his very first OT evaluation over 2.5 years ago. He has always needed a very soft sheet and his blanket has always had to be tucked into the end of the crib so his feet were always covered. When he switched from a sleep sack to a blanket, he began wearing socks to sleep for this reason as well. And he has never, not one time in his entire life, slept in anything other than long sleeves and long pants. When he was tiny we had to change him into his pajamas for every nap in the summer or the nap just simply would not happen (that low sleep needs highly touch sensitive combo was killer).
He’s also incredibly sensitive to wet clothing. Getting dressed before he’s fully dry after the bath is not an option. If he spills water on himself before bed, even the tiniest bit, “it’ll dry” is not an acceptable response. He must change. These are small simple modifications that aren’t worth messing with.
These are the ways that my child is sensitive. It doesn’t mean yours will be the same. Maybe your kid is the opposite and can only sleep in short sleeves. Maybe they don’t like a blanket at all. Figure out what your kid needs as it may relate to touch sensitivities. These are easy accommodations and definitely an area that I’d recommend accommodating rather than trying to modify the behavior.
Sight and light sensitivities
If your kid is sensitive to lights the room should really be pitch black. I mean so dark that you cannot walk without tripping on things and walking into walls. You absolutely should not be able to see your hand in front of your face.
A pitch black room is helpful for any child or adult to get more restorative sleep. But it is NECESSARY for a sensory sensitive kid. So how do you achieve this pitch black environment? First, the windows. I don’t mean buy blackout shades. Light comes through the side of those. You need something that sticks to the window or wraps around the side, eliminating any tiny stream of light coming through. There are products that can do this, (blackoutez window shades is a favorite - here’s my affiliate link!) or you can use a garbage bag, black paper, tin foil, and any number of items just taped to the window.
But for some kids (my kid) this isn’t enough. For some kids, you may also have to cover the little lights on monitors or humidifiers or whatever else you have plugged in with a tiny piece of painters tape. In our house, we take it even one step farther. It’s impossible to block out all of the house lights when you have kids who are asleep before the sun. We also have these door blockers on the floor in front of each of their rooms to help block out that strip of light.
People ALWAYS ask me why they shouldn’t try to get their kids used to not sleeping in this pitch black environment so they can sleep in other places. I have two kids who sleep fine with a little light (Joey even requests a nightlight), so I get it. And for those two kids I don’t put tape on tiny lights or completely cover the windows with black paper.
But for some kids, it really is absolutely necessary. If you have a kid like this, you learn quickly that you’re better off accommodating for this at home and doing your best when you travel. I personally would rather sleep well every night at home than just sleep okay at home so we can also just sleep okay when we travel, which is likely going to happen regardless because traveling is hard (travel blog coming soon at the request of some friends!). You want the environment that you spend the most time in to be ideal and then you just do your best and prepare for more of a struggle when you’re not home.
For some kids with a light sensitivity, lights can be overstimulating even before sleep time making it harder to calm down before bed. Ever since Landen was very young, we have always done as much of his bedtime routine as possible in a dimmed or darker room. This really helps his body and brain prepare for sleep. I have a small tap light that I use to read to him, and the lights go out even before we start our books. Turning off overhead lights and using a lamp to read or do your routine could also be a great option to just start to unwind.
If your kid is even more sensitive to light and this isn’t enough, you may go as far as to dim the bathroom lights for bath time. This can be incredibly calming after an overwhelming day (every day is overwhelming for sensory sensitive kids).
Sound
A sound sensitivity can be one of the most difficult things to notice (at least it was for me - I didn’t notice it until literally this month) but when it comes to bedtime it’s one of the easiest things to fix. Two words: White Noise. This is something that should be implemented from birth for so many reasons, even if you don’t have a sensory sensitive kid, but for sound sensitivities it is essential. It blocks out noises from the house and noises from the room, and it helps sound sensitive kids turn off their brains for sleep. Sound can be INCREDIBLY distracting. So much so that a kid with sound sensitivities could be misdiagnosed with ADHD instead of sensory processing disorder (or this kid could have both like Landen likely does). There are noises that you may not even hear or think about. But I promise they are there.
Landen came to me in the middle of the night a few weeks ago and told me there was a clicking sound in his room that woke him up and I had to turn it off. I literally could not hear a thing. Couldn’t find the sound if I wanted to. The next day I was reading to him and heard a very faint clicking. The fan was moving around the fan string and it was clicking. I would not have heard this at all if he hadn’t previously mentioned it, but I certainly couldn’t find it over the sound machine. We now make sure the fan in his room is off before sleep.
The other 3 senses
There are also 3 senses that don’t get talked about as much unless you’re deep in the trenches of occupational therapy and sensory processing - Proprioception, Interoception, and Vestibular. I cannot give you a therapist's description of these senses, because I am not a therapist, but I can give you a google description because I know how to ask google questions.
Proprioception
Proprioception is body awareness. It is essentially the ability to understand where your body is and how your body moves in space as well as what exactly your body parts are doing. Kids like Landen whose proprioceptive senses are off don’t always know where their body is, so they seek input that tells their brains, sometimes even by running into things to feel what’s in their space.
For our situation specifically, I believe that this plays a huge role in Landen’s sensory seeking behaviors. This is his constant need to run or jump or touch other people. He is seeking proprioceptive input to help regulate his body.
So how does this relate to sleep? Well, as we discussed, if a kid (or anyone) is dysregulated it’s going to be much more difficult to sleep. Proprioceptive input will help calm the body to prepare for sleep. Without this input, sensory seekers (or really anyone) can become very aroused and seek a lot of movement which is obviously the opposite of what we want before bed.
So what type of input can help with this? First and foremost, heavy work. Pushing things, pulling things, squeezing things, or any type of activity that forces their bodies to “work”. This doesn’t have to look like work though. It can be something like crab walking to the bath instead of just walking. It could be climbing up a slide. It could be squeezing play doh. It could even be drinking from a straw (a smoothie is great) or chewing gum. Just google heavy work activities and you’ll get tons of incredibly calming activities that can help make bedtime a little easier.
Another type of proprioceptive input is touch. This is SO easy before bed and can seamlessly be incorporated right into your bedtime routine. How about a tight hug after pjs and then another one before the lights go out? What if you cuddle while reading books and maybe give some light arm or leg squeezes? Add it into your routine so it happens every night.
Vestibular
The Vestibular Sense is your balance sense. Vestibular issues can actually look pretty similar to proprioceptive issues. I sort of see this as just a different type of body awareness (probably because I’m not qualified to discuss this so I maybe don’t have a super clear understanding). How you treat it can be very different though. Heavy work is just about always calming for the proprioceptive sense. Vestibular may be a little more difficult to figure out though. For example, Landen has an under responsive vestibular sense. This means that he is constantly seeking movement and it never seems like enough.
Yes, I spoke about his seeking with Proprioception, but again, it’s different. He’s a seeker through and through, and his proprioceptive sense is seeking that heavy movement and deep touch. His vestibular sense seeks swinging, spinning, side lying, and inversion. He likes to be upside down on the couch. He likes to spin and could spin literally indefinitely without getting dizzy. He loves swings that move front and back, but also side to side or spinning. These things are all calming to him. When I see some of his seeking behaviors coming out before bedtime, I always tell him to spin x amount of times, or go on the spinning chair in his room.
Let me be very clear about this. These things are very calming to HIM. That doesn’t mean every kid would be calmed by these activities. In fact, you might notice the opposite. According to my BFF Laura the OT Butterfly, spinning is arousing for most kids, so this would have the opposite impact of what you’re looking for at bedtime, but front to back and side to side movement may work better.
You may also have a child who is over responsive to vestibular input. This may mean that any swinging or fast movement before bed will arouse their nervous system. If this is the case, you definitely want to aim for more calming activities before bed.
Interoception
The final sense is interoception. This is the one that I admittedly know the least about because Landen does not have any issues with this (thank god, I deserve at least ONE sense am I right?), and I am not a therapist. This is the sense that helps us understand what’s going on inside our bodies. It tells us when we’re hungry, thirsty, hot, or cold, or when you need the bathroom.
Without having specific experience with this myself, I began to think about what would help Landen if he DID have a hard time with his interoception sense. Immediately, I thought of his routine. If you can’t tell when you’re hungry or thirsty or when you have to go to the bathroom, a routine can be incredibly helpful. Having set (approximate) meal and snack times can be super helpful to ensure that your kids are full before bed.
The same goes for the bathroom. If you have a potty trained kid, I’d recommend having a bathroom stop be part of your routine regardless of their interoception sense, but it’s even more important if they have trouble with it. If the goal is to sleep all night without a pull up, bathroom should be the absolute last thing you do before going into the bedroom. Sometimes I even ask my kids again during their routine if they want to go once more.
A little more about routines…
I just want to talk a little bit more about routines in general for sensory kids. Bedtime is a tough time for so many reasons. After an entire day of being inundated with sensory input, it’s normal for any kid to be dysregulated, but especially a kid with sensory processing issues. They may associate bedtime with certain things that make them anxious, or they may just be completely overwhelmed from the day. Either way, knowing what’s coming next can be incredibly calming,
I think a bedtime routine is incredibly important for all kids. But I sort of view it as a requirement for sensory kids. Bonus if you incorporate some sensory strategies into the routine, but often just the routine itself is enough of a strategy as long as it remains the same each day. This is a slippery slope with anxiety and OCD, but that’s really a whole separate issue that I’d be happy to discuss at a later date if you’re interested.
What if you do it all and it still doesn’t work?
Finally, I also think it’s important to talk about what happens when all of these front loading strategies don’t work and you have an already dysregulated kid that you need to help calm.
It depends what that dysregulation looks like. If I notice that Landen is starting to spiral but isn’t totally in it yet, I tell him to do some jumping jacks or spin. He finds bath time to be incredibly calming, so on nights that seem like they might be hard I try to start earlier to let him sit in the bath for longer. I know these are things he loves and things that help him regulate himself. I’m not saying that this will work for you. I’m saying do some observing. Figure out what DOES help regulate your child and throw it at them when you see them starting to get overwhelmed. Maybe it’s deep breaths (Landen hates this and gets more dysregulated when I try to tell him to do it). Maybe it’s laying on the couch with heavy blankets and pillows on their bodies. Whatever it is, pull it out immediately and try to make it fun.
But I’m not going to sit here and say your child’s favorite regulating strategy is going to all of a sudden regulate them. It’s just a strategy, something to try when things are beginning to go south. Sometimes, the overwhelm will get out of control and turn into a meltdown. There’s two things I think can be done in these circumstances. One - sit with your child until he/she calms down, making sure everyone in the line of fire is safe, and then just move on with your bedtime routine once everyone is calm. For me, this is great when we have nowhere to be and nothing to do. However, I get very anxious around bedtime and it’s important for me to keep the schedule pretty much the same each night. When sitting with the meltdown will take too long (and this blog is about bedtime but this could also be when you have to get out of the house for something or you just don’t have 30+ min to sit and let your child scream), it’s ok to just move through the steps during the meltdown.
What do I mean by this? Let’s say you’re in the middle of a meltdown but you have to get bath time going. Your child is not going to walk himself to the bath and happily get in but you can pick him up and move him to where he needs to be while continuing to remind him that you’re there and you love him. (Believe me, I know this is easier said than done because my child is 52 pounds of screaming flailing meltdown and this is HARD.) I usually try to stay as calm as possible so I don't feed the fire and just move through the next steps of the routine or whatever has to be done. To be clear, this does not stop the meltdown. The screaming keeps happening but we also move through the steps that we need to get done in a timely manner. He calms down eventually and at least when that happens, we’re further along and we can get to bed a little bit quicker.
I’m going to be honest. I feel like this is all over the place but also I loved writing it because it consumes so much of my life. So maybe it will help one person with a kid with sensory needs, and that’s enough for me.