Make Good Dreams the solution to bad ones
“A YouGov survey found that almost a third of UK parents (32%) of five to 18 year olds have noticed negative changes in their children’s behaviour since lockdown. The poll for international children’s charity World Vision, shows that younger children are more likely to worry about catching coronavirus. They are also the most likely to tell parents they are lonely and missing friends and family. Children 5-11 years old are more likely than older children to become clingy, cry and have tantrums, disturbed sleep or nightmares.”
Before the Covid outbreak Zheng (Jane) Fan, MD, a children’s sleep expert and neurologist with the UNC Department of Neurology, says 50 percent of kids have problems sleeping at some point in their development.
Five of the most common child sleep / bedtime COVID related sleep issues are :-
They are outlined below in terms of who, why,when,what, how the end result and simple solutions.
There is usually no drug treatment required for most of these problems but “Relaxation and Image Rehearsal Therapy (in which the dreamer is taught to change the content of nightmares, into a form which is more pleasant) may be effective”. This basic Image Rehearsal Technique (IRT) is a common theme for resolving all of these sleep issues.
This basic Image Rehearsal Technique (IRT) is a common theme for resolving all of these sleep issues
(IRT is outlined in five simple steps).
Whilst “good” bedtime routine is one that is both relaxing and consistent. A “great” bedtime routine is one that your child looks forward to every night and willingly participates in.
At the best of times no amount of explaining the health and educational benefits of sleep will persuade an unwilling child to go to bed when they don’t want to. A stressed child having negative nighttime experiences needs something to turn this apprehension on its head.
Introducing the Image Rehearsal Technique into the bedtime wind down routine allows the child to not only feel in control of their fears but gives them the opportunity to transform negative thoughts into great dreams.
Five major COVID Related Bed Time Problems
(1) - SEPARATION ANXIETY
Selena's dream wish is to ride a unicorn over the rainbow bridge to see her Grandparents
WHO - When infants start to realise how dependent they are on the people who care for them it is normal for them to become anxious and this may continue for several years. Older children tend to suffer separation anxiety before school, if they become ill or with any other major change in their situation
The separation from close family members and friends during COVID 19 is already causing issues for children of all ages.
WHY - "Until as recently as 10,000 years ago we were all hunter-gatherers and any small child left alone in camp at night away from adults was vulnerable to predators. The monster under the bed was real! In older children anxiety about bullying, loneliness or anything else that they consider may pose a threat will often result in sleep-related problems”.
WHEN - This occurs if younger children feel either they or a primary caregiver is under threat. More general anxiety can last throughout childhood and so it is crucial to keep listening to your child to identify their concerns early.
WHAT - Separation anxiety is not just associated with parents, but also Grandparents, or other primary caregivers as well as friends.
HOW - With younger children crying and temper tantrums are often employed to get Mum or Dad to stay in the bedroom for longer until their power of reasoning and expression develop sufficiently. Once this happens most parents can testify that the range of excuses to keep you with them is endless.
RESULT - The fear a child experiencing separation anxiety feels is very real and they can become lonely, scared or stressed. This should not be dismissed as attention-seeking but an opportunity to try and find out what it is they are actually afraid of.
SOLUTION - It may be necessary to extend the bedtime routine (often there just isn’t enough time allocated to this critical transition period). Fill up their connection cup by listening to any concerns they have when offering a few wise words to help with their problem. Spend time allowing them to draw or write a creative dream solution to whatever is bothering them (one child who was being bullied at school drew himself inside a cloud which rained on all the bullies driving them away). Find their favourite cuddly toy and/or child pillow they use as a soothing/calming comforter and place their dream wish note inside a pocket so it remains close throughout the night.
LONG TERM - Although some adults can experience separation anxiety most children will grow out of it relatively early. Breaking the cycle very quickly and helping your child learn to fall asleep is a skill that will last a lifetime. This “nip it in the bud” approach also helps prevent low-level anxiety developing in a more serious mental health issue.
Ted and Rhu's Mum from Plymouth sent us this dream dinosaur (vi Rex) that ate Coronavirus so they could see all their friends and family again
Charlie (age seven and a half) dreams of attaching the virus to a firework rocket and sending it out of the Solar System
(2) - NIGHT TERRORS (or Sleep Terrors)
WHO - Night/sleep terrors generally start and end at a younger age than nightmares. They can begin in children as young as 2 but are most common between 3 and 8 years old.
WHY - Stress or anxiety are often considered to be the primary causes of these terrors where there is no underlying medical or mental health condition. They occur most frequently in families which have a history of sleepwalking and / or night terrors.
WHEN - Night terrors usually occur about 90 minutes after falling asleep. They are typically over after several minutes (but may last longer than 15) and sometimes occur more than once a night.
WHAT - This sudden arousal from non-dreaming sleep causes extreme panic and loud screams/movement as muscles have not relaxed significantly so early in the sleep cycle.
HOW - Night terrors tend to happen in the Non-Rapid Eye Movement (REM) stage. It will often start with a scream or shout. The child’s eyes may be open or shut they may be unresponsive and tend to be both confused and disorientated. There may be nonsense or indistinct speech and bed-wetting. The child may hit/throw objects or leave the bedroom.
RESULT - It is normal for children not to wake up from night terrors. If the parent wakens them the child is most unlikely to remember what caused their night terror. It is possible that they are more likely to be troubled by the reaction of the stressed out parent who has just been unable to help their highly distressed child.
SOLUTIONS - Initially a relaxing routine an hour before bedtime this should include drawing or writing a dream they would like to have as a way of reducing the causal stress. Anticipatory awakening - this involves waking the person who has sleep terrors about 15 minutes before he or she usually experiences the event. Then the person stays awake for a few minutes before falling asleep again.
LONG TERM - Most children grow out of them so there is normally no need for intervention with drugs. Medication is rarely used to treat sleep terrors, particularly for children. If there is the threat of injury or severe disruption, however, the use of benzodiazepines or certain antidepressants may be effective.
Alfie dreamt up this reassuring dream about Lego people social distancing and the NHS banishing Coronavirus
.
(3) - NIGHTMARES
WHO - Although 30% of children aged 3 to 6 experience nightmares that disturb their sleep they are most common in children aged 6 to 10 years old.
WHY - Nightmares in children can be caused by a frightening experience, such as watching a scary film, or by something that's worrying them.
WHEN - Nightmares usually occur later in the night when Rapid Eye Movement (REM) sleep is most prolonged.
WHAT - They are usually coherent visual dreams that seem real and get more disturbing as they unfold until they cause you to wake up.
HOW - Because Nightmares tend to happen in the REM stage (the last stage of the sleep cycle), when almost all muscles are totally relaxed, it is unusual for the child to shout or move. Activities so late in the sleep cycle cannot be physically expressed (unless dreams have a particularly aggressive content).
RESULT - A nightmare causes strong feelings of terror, fear, distress or anxiety. Unlike night terrors In most cases nightmares are remembered in detail. This may well result in difficulty getting a good night's sleep and this sleep loss can, in turn, lead to even more intense nightmares.
SOLUTION - Initially a relaxing routine an hour before bedtime. This should include the five steps of Image Rehearsal Therapy (IRT) which are fully described in section (5) below. This technique is used for treating nightmares and Post Traumatic Stress Disorder (PTSD) Worldwide (including in our own NHS)
LONG TERM - Once again most children grow out of nightmares so there is normally no need for professional treatment or intervention with drugs such as Prazosin.
Non-specific/general nightmares about COVID 19 can be displaced by many from the favourite dreams shown below......or tackled head-on with a dream wish like the bar of soap capturing Coronavirus and putting it in prison.
(4) - POST TRAUMATIC STRESS DISORDER (PTSD)
WHO - Initially identified as “shell shock” in World War One PTSD in children is more likely if they (or those closest to them) have been exposed to actual or threatened death, serious injury or other extremely stressful situation.
WHY - Learning of a traumatic event affecting a parent / Grandparent or other primary caregiving figure is one of the most common causes of PTSD in children.
WHEN - PTSD, is diagnosed after a person experiences symptoms for a minimum of one month following the traumatic event. It develops in response to the stress of a severe and/or abnormal nature.
WHAT - Recurrent distressing dreams related to the content and/or feeling of the traumatic event (Note: It may not be possible to ascertain that the frightening content is related to the traumatic event). Re-experiencing exactly the same vivid dream is common with PTSD.
HOW - Two of the main symptoms in primary school-age children are Re-experiencing their trauma! often through deeply upsetting nightmares. Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated or upset.
SOLUTION - Image Rehearsal Therapy (IRT) , outlined below, powerfully effective in reducing and eliminating most types of nightmares.
This Image Rehearsal Technique has been used with great success by psychologists with veterans of war and survivors of abuse and other traumatic events for decades. The five main steps which can often be completed without professional help are:-
I) - Write down what the child tells you about the nightmare as they wake up.
II) - During daytime ask to describe the final (most disturbing) part of their dream (in severe cases of PTSD this may be difficult and should not be attempted alone).
III) - Re-script the nightmare with a different, non-threatening ending. This requires imagination (which children have much more than most adults) and can be humorous or heroic (for inspiration consider stories from TV, films, books).
Note - The most effective dream rewriting often involves bizarre endings for example the child is saved by a superhero or even having their own superpower. More conventional endings may involve being an expert in martial arts or getting help from military or the police.
IV) - A daytime rehearsal of the re-scripted dream where the positive ending is recalled.
V) - The last part of the relaxing pre-bed routine write and/or draw the new non-threatening ending just before bedtime and put the new dream wish note inside their pillow or somewhere close at hand.
NOTE Steps 4 and 5 will need to be practiced a minimum of ten times (normally for two weeks) before the dreamer moves from the “re-experiencing” nightmare to fully ”re-dreaming” their positive dream.
LONG TERM - Although not a panacea for all the problems surrounding nightmares such as sevre PTSD or recent traumatic exposure, IRT has been generally recognised as one of the best non-drug related ways to manage nightmares for several decades. The Practise of imagery skills over time often improves the situation where the original nightmare is replaced entirely by totally different positive dreams.
Visit a GP if the child is still having problems four weeks after the PTSD symptoms start.
Sarah had a repetitive nightmare that she was in bed at night and COVID would come into her room and inject her with the virus.Using the Image Rehearsal Technique above this dream was rewritten so when the virus appeared an “NHS Avenger” flew between them and blew it away.
(5) - GENERAL BEDTIME / SLEEP RESISTANCE
WHO - Pre-adolescent children (generally the pre-high school age group). The problem with those in high school is more likely to be getting them out of the bed/bedroom!
WHY - Younger children tend to feel that the world is one huge playground full of adventure/experiences and can see no good reason for wanting to leave this excitement behind for their bed. Older children resent being forced to bed and they will frequently start to assert their desire for growing independence by challenging bedtime instructions. A child’s desire for some form of control starts to develop well before primary school age.
WHEN - In younger children, the resistance to bed often starts as soon as they recognize the first part of their bedtime routine (being called for their bath, etc). Parents of adolescents often find this the biggest single power struggle they have to contend with in the pre-high school years.
WHAT - This is not due to "Seperation Anxiety" or related to fear. It is just a devlopmental phase to be carefeully managed (not crushed or surrended to ).
HOW - Although the methods children use to avoid bed can be similar to those in separation anxiety it is important to talk to the child to confirm they are not afraid. Once it is established that this is control rather than a fear issue the solution changes.
RESULT - The bedtime battle is renowned for causing maximum stress between parents and their children at precisely the time a calming environment is needed.
SOLUTION - Create a bedtime routine that entices them in, one which they can look forward to and will want to participate in every night. Spend a little quality time talking to them about their hopes and fears. Once they understand that, with repetition, they can take some control of their dreams this appeals massively to most children of any age. A child’s mind is generally much more creative than that of most adults and they can have great fun just before bed drawing or writing out their own dream wish notes to go to sleep with every night.
Here are our faveourite dreams for helping children across the UK dream good dreams. Help others dream #GoodDreams ( and the chance to win one of seven Dreamimal prizes ) by telling us your favourite dreams
below or post it on Twitter, Facebook or Instagram
SWEETS EVERYWHERE- A land with Marsh mellow ground and plant lollypops or ice creams, palm trees bearing sweets instead of coconut, candy floss clouds and chocolate rainforests, rivers or mountains. Some would be given the keys to a sweet shop. Others have candy homes or baths where the water was skittles, chocolate or their favourite sweet. “I had Mr Tickle who would use his long arms to stretch all the way downstairs to grab sweets, biscuits and a drink for me”. Will from Rochester wants to dream about candy land where the sun melts the chocolate into a river!
@DreamPillowUK Twitter / @GoodDreamsUK Facebook / @dreampillowuk Instagram
1 - Zheng (Jane) Fan MD University of North Carolina Hospital - Why Won’t My Kids Sleep
3. You Gov survey April 2020 - Reporting negative changes in child behaviour since the UK lockdown.
4. Peter Grey Ph. D. - Why Young Children Protest Against Bedtime (Freedom To Learn).
5. NHS website Health A to Z - Nightmares and Night Terrors.
6. Mayo Clinic Hospital, Phoenix, Arizona - Sleep / Night Terrors, Diagnosis and Treatment.
7. Royal Papworth NHS Foundation Trust - Vivid Dreams or Nightmares.
8. Lancashire Care NHS Foundation Trust - Dealing With Nightmares.
9. Anxiety and Depression Association of America - PTSD Symptoms in Children Age Six and Younger.
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