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14 November
NO 1243
Sleep
A restful night's sleep is known to have pronounced and positive effects on emotional and physical well-being. Children's sleep is significantly influenced by many factors including parenting style, the quality of the attachment relationship, as well as through the immediate sleep environment (Meijer, Habekothe and Van Den Wittenboer, 2001). Behaviours and internal constructions regarding the meaning and purpose of sleep are established very early in the infant's life and continue through adolescence to adulthood. A sensitive and attuned caregiver will initiate interaction and be responsive to the infant's needs. It is within this relationship that the child learns to regulate his or her own feelings and behaviours (Sadeh, 2001). Sleep behaviours are, in many ways, the external representation of the young child's internal working model. Howe, Brandon, Hinings and Schofield (1999) describe the internal working model as a set of expectations and beliefs about the behaviour of self and others, self-worthiness as well as the emotional availability of others.
Children and young people in residential care are likely to have suffered early life disruptions, stress and trauma (Berridge and Brodie, 1998). It is therefore likely that this particular group may suffer from sleep disturbance. Stores and Wiggs (2002) outline some of the sleep problems and disorders which are experienced by children and young people who may be anxious, depressed or traumatised. These include such issues as insomnia, failure to settle, nightmares and a tendency toward easy disturbance through the night. Blatt (1992) also reported that an intense level of residual distress may be expressed by children in residential care around sleep and pre-sleep activities. The resultant sleep deprivation can have major effects on life through the day. Sadeh and Gruber (2002) report outcomes such as reduced educational attainment, inability to concentrate and deficits in social skills in adolescents under stress who have disturbed sleep.
The relationship between physical care and the benefit of healthy sleeping patterns is becoming popularly recognised amongst the public. Wolfson and Carskadon (1998) reported that adolescents who sleep six hours or less are more likely to experience depressed mood than adolescents who sleep eight hours or more. Equally, daytime behaviours are likely to have a significant negative impact on sleep quality and the stability of bedtime routines. These daytime behaviours may include the use of alcohol and or drugs; lack of age appropriate intellectual stimulation (such as attendance at school), and lack of physical exercise or activity. Healthy sleeping patterns can also be hindered by chronic and enduring lack of bedtime routine as well as in daytime routine overall. Given the nature of the issues which have faced children and young people prior to their reception into care, it is likely that staff in children's units will have to deal with sleep disturbances and their consequences. The most likely group of staff who may deal with this are the night care staff.
This article demonstrates the complexities involved in supporting young people to adopt positive sleep routines in the residential care setting. It is based on a period of consultancy with a team of night care staff and describes two care scenarios, involving bedtime and pre-bedtime activities implemented by four female staff members. Contextual factors such as the psychological needs of the young people are considered, alongside the capacity for skilful and sensitive caring from night staff. The focus of the analysis is to demonstrate practice that promotes healthy sleeping patterns for vulnerable young people in the residential setting.
MARGARET CONLON
Conlon, M. (2005). Creating a safe place to sleep: an analysis of night care staff interventions to reduce evening and night-time disturbance in a residential care unit. Scottish Journal of Residential Child Care, 4, 2. 2005. pp.1-2.
References
Berridge, D. & Brodie, I. (1998). Children's homes revisited. London. Jessica Kingsley.
Blatt, E.R. (1992). Factors associated with child abuse and neglect in residential care settings. Children and Youth Services Review, 16, 6. pp. 493-517.
Howe, D., Brandon, M., Hinings, D. & Schofield, G. (1999). Attachment theory, child maltreatment and family support: a practice and assessment model. London. Macmillan Press.
Meijer, A.M., Habekothe, RT & Van Den Wittenboer, G.L.H. (2001). Mental health, parental rules and sleep in pre-adolescents. Journal of Sleep Research, 10, 4. pp. 297-302.
Sadeh, A. (2001). Sleeping like a baby. Massachusetts. Yale University Press.
Sadeh, A. & Gruber, R. (2002). Stress and sleep in adolescence. In M.A. Carskadon (Ed.), Adolescent sleep patterns: biological, social and psychological influences. Cambridge. Cambridge University Press.
Stores, G. & Wiggs, L. (2002). Sleep disturbances in children and adolescents with disorders of development. Cambridge. Cambridge University Press.
Wolfson, A.R. & Carskadon M.A. (1998). Sleep schedules and daytime functioning in adolescents. Child Development, 69, 4. pp. 875-887.
