Category Archives: Sleep

Teenagers and Being Mindful: A Contradiction?

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Hi again.  I’ve been on a blog hiatus, but happily, I’m baaaaaaack!  Hope your summer is continuing to be relaxing and enjoyable.

If you haven’t noticed, I see many children and adolescents in my private practice. I also see many of their parents or speak to them on the phone. I’ve also worked in public schools for 30 years and have had contact with my share of young people, teachers, and parents. Perhaps the most troubling aspect of this age group for teachers and parents is understanding their pre-teens and teenagers.

What is it about this population that is so puzzling? Perhaps it is their tendency toward moodiness. Or….. the constant challenging of your authority? Throw in their past adorable-ness and how they soooo needed you, but now want only to avoid your very presence. Sometimes there is the mix of  “I need you” and then, “I don’t need you,” all in the course of half an hour! Absolutely, I’m sure there are “perfect” teens out there (I haven’t seen one, but perhaps you have), but inevitably most experience changes at this juncture, including social, academic, hormonal, and emotional. A mindfulness practice can help.

What is mindfulness? It is the deliberate practice of paying attention to whatever you are doing, right now.  It is learning to be aware, or mindful, during difficult times in life. We become aware of our thoughts, feelings, behaviors, and physiological changes. We don’t try to change things; just become aware, fully focused. Breathing in and out helps us to stay in touch with this moment. Mindfulness requires practice on a consistent basis.  Perhaps parent and teen can learn this together!

That is exactly why I have become very interested in Mindfulness for teenagers. Recent research published in the British Journal of Psychiatry (June, 2013) revealed that mindfulness could reduce stress and lessen symptoms of depression among high school age students and increase their well-being.

Uh oh—another study. Just what we need!!!  But I liked this one A-Lot. The Universities of Exeter and Cambridge in England enrolled 522 students between the ages of 12 and 16 during their summer exam period. 256 of the students completed a 9-week introductory mindfulness course; the others did not participate in that specific training. It was found that the ones who completed the course reported lower stress levels, less depression, and overall greater well-being.

Over the nine weeks, the students enrolled in the mindfulness course learned a different mindfulness skill each week including: recognizing worry, harnessing the power of attention, dealing with unpleasant feelings, and distancing from thoughts and emotions.

One of the interesting findings was that mindfulness training can help with the psychological well being of all students, not just those who have symptoms associated with mental health problems.  Mindfulness practiced by adults has been more widely researched and has shown to have the effects of lowering stress levels, enhancing sleep, increasing compassion and self-knowledge, and other health benefits. Fewer studies have focused solely on children and adolescents.

I believe a large part of teenage “angst” can be approached with mindfulness techniques.  I have incorporated them into my therapy practice, even with some of the children I see.  The practice of breathing, being in the here and now, focusing, attending, and learning are all part of teaching children and teens to be okay with themselves, become grounded, and self-aware. Not bad stuff to learn on the road to a healthy life.

If you have any questions about mindfulness or any other topic, please contact me.  I am always eager to respond to any inquiries!  Happy day and BREATHE.

Bedtime Blues or Bliss–II

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My last post provided guidelines for establishing bedtime routines for your children, with an emphasis on consistency. Consistency is the key to helping ensure that everyone gets a good night’s sleep. When your child gets into a consistent sleep routine, he or she will be at less risk for emotional, behavioral, and learning problems. Additionally, you – the parent – will feel more refreshed during the day and enjoy a better overall family life.

What if my child has more serious sleep problems? Some children and teenagers suffer from sleep disruptions and have difficulty following a good sleep diet. These disorders may include:

  • Insomnia
  • Nightmares
  • Sleepwalking
  • Night Terrors
  • Other sleep disturbances caused by hormonal changes and stress in adolescence

Let’s explore these more serious sleep problems in greater detail.

Primary insomnia occurs when your child has difficulty falling or staying asleep without any known underlying medical condition. This may be due to poor sleep patterns or erratic sleep schedules. Usually the establishment of a good sleep routine is sufficient to reduce or eliminate primary insomnia. Emphasize calming activities in the hour or so before bedtime, avoid giving your child caffeinated food or drinks before bedtime, and provide for plenty of exercise during the day. If these techniques do not help, consult your child’s pediatrician to rule out any underlying medical conditions that my interfere with sleep. A mental health professional may be sought out as well.

Nightmares are disturbing and/or frightening dreams. As many as half of all children may suffer from nightmares; however, they are most common in preschool and elementary grade children and tend to lessen over time. Nightmares may begin around age 2, peak in the 4 to 6-age range, and then slowly diminish, although they can occur in all ages. What causes nightmares? Stress, traumatic events, scary TV programs, violent video games or movies, vivid imaginations, fear (such as fear of the dark), and even some medications can all trigger nightmares. When your child experiences a nightmare, calm her down and repeat a shortened version of her bedtime routine to help her back to sleep. A nightlight in the bedroom may help a frightened child, or a shared storybook for those who have frequent nightmares.

Sleepwalking occurs during deep sleep, often 1 to 2 hours after initially falling asleep. Episodes can range from simply sitting up in bed to actually getting up and walking around the house, down stairs, or even outside. It can be very difficult to wake a sleepwalking child. When awakened, he may seem confused and usually will have no memory of the event. Comfort your child after an episode of sleepwalking and then return him to his bed. Sleepwalking usually stops in late childhood, although a few continue to sleepwalk into adulthood.

Night Terrors are episodes during which the child screams, seems disoriented and anxious, does not recognize parents, but at the same time appears wide awake. They usually occur between ages 3 and 8, and often 3 hours into the sleep period. Night terrors typically end by age 12. I often refer to them as “Parent Terrors” because it can be very scary to be awakened by a screaming, anxious child who may not recognize you. While children who have night terrors seem to be awake, they are not consciously awake, and may fight the parent who is trying to calm them. When the night terror eventually ends, often after 10-15 minutes, the child will return to sleep and have no memory of this terrifying event. Although parents are usually frightened (and I have personally experienced this!), there is little or no impact on the child. Hold your child gently until the episode ends and then return him/her to bed. Night terrors are NOT a sign that your child is troubled or emotionally disturbed.

Teenagers usually outgrow nightmares, sleepwalking, and night terrors; however, other sleep disturbances caused by hormonal changes and stress in adolescence may crop up.  Changes in sleep cycles can be triggered by puberty, hormonal fluctuations typical to adolescents, and the stresses of growing up in a complex society. Most teens do NOT get enough sleep at night, nor do they fall asleep quickly when they lie down for the night. Teens begin their days with school early in the morning. Extracurricular activities, such as jobs, homework, athletics and other social events often work against teens, preventing them from getting an adequate number of hours of sleep. Parents can intervene by reducing stress, encouraging adequate exercise, eliminating caffeine and energy drinks in the evening and removing distractions from their bedrooms.

If you believe your child has any of these serious sleep issues, a sleep diary may be helpful. Record the number of hours your child sleeps, how many times he/she wakes during the night, what happened before the child fell asleep, and any parental intervention taken during the disruption. Your child’s pediatrician should be consulted for serious sleep problems. The sleep diary information will be a useful tool to determine if your child has a sleep disorder.

Does your child or teen have sleep disturbances?  Please share your interventions or frustrations. I’d love to hear from you.

Bedtime Blues or Bliss?

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One of the most frequent inquiries I get from parents involves children and bedtime issues. Even the best sleepers can go through a period of resistance to going to sleep. Why does this happen and what can you as a parent do to set up healthy sleep routines, or what I like to call a “sleep diet.”

Set bedtimes so your child gets the appropriate amount of sleep. Preschoolers generally require 11-13 hours/night, while school-aged children typically need about 10-11 hours.  Most children respond best to bedtime if a routine consisting of a set of activities that are the same EVERY night, including the weekends, is set up early in their lives. Activities may include a signal or warning that it is time to get ready for bed, readying for the next day (for older children), taking a bath, reading a book, conversing or maybe even singing a soothing song.

Still, some children refuse to go to sleep. Very young children may become fearful and experience separation anxiety (a general fear of something happening to their parent(s) while they are asleep). Children ages 4-6 may experience more specific fears, such as fear of monsters, darkness or fear of having a bad dream—all normal for this age group. In the 3-10 age range, disturbing dreams may occur, peaking at about age 10. And teenagers may suffer from disturbances in their sleep cycles due to puberty, hormonal imbalances or stressors such as growing up, college or career plans, relationships or other social concerns.

How parents handle the reasons for their child’s resistance or difficulty getting to bed will play an important part in outcomes. When the child’s resistance persists and becomes a learned behavior and parents give in to the child due to their own fatigue or other reasons, rules are relaxed and new behaviors pop up. The child learns that nagging, whining, crying, stalling, one more drink of water, etc. will put off going to bed.

You may be noticing a common theme in my posts—CONSISTENCY! As with time-out and grounding, consistency is the key. Inconsistency can turn good behaviors bad and make bad behaviors worse. When parents try to buckle down after rules have been loosened for a time, the child learns to push back harder to get what he/she wants. Riding this roller coaster may cause you and your child to lock horns in a battle over bedtime that nobody wants to endure.

So, as a parent, what can I do to attain bedtime bliss? Here are several suggestions:

  • Establish effective bedtime routines that include—the same bedtime each night, quiet time for one hour before bedtime, providing time cues for bedtime, story time, etc.  You set the routine however it works for your household, but once you’ve set it, keep it consistent!
  • Provide healthy daily routines for your child including good nutrition, physical activity during the day to promote sleep at night, and no violent video games or TV shows before bed.
  • One “get out of bed free” pass.  The child receives a ticket to be used ONCE per night to get a drink or ask a question of the parent. This ticket may not be used more than once per night. This technique may work for some as it feels like fun to your child and gives them a little leeway for any problem they may have getting to bed.
  • Planned ignoring is a technique in which the parent makes it clear that once the child is in bed and the routine is complete, no more interactions will occur.  If the child objects, then the parent ignores the child and provides no further attention.  That means NOT responding to questions, comments or statements from the child. If he gets out of bed, escort him back to bed with minimal interaction.  Expect an increase in negative behaviors for several nights, but the child will eventually learn to go to sleep without protest. This usually takes about three nights. Planned ignoring is often most difficult for parents; hence, set the routine early.

Next week, I will continue with this topic and focus on more serious sleep issues. Stay tuned, and as usual, send me a note and let me know what you think.  Any topics you want explored?