Sleep Issues In Children That Have Been Adopted & Children in Foster Care

June 25, 2013 Blog

When a family is preparing to deliver a biological child, they usually expect that their first few weeks, months, maybe even years will be filled with nights of interrupted sleep. Parents prepare to be sleep deprived and are not typically surprised by this once their child is in their arms. On the other hand, some adoptive and foster parents may be more willing to take on older children (ages 2 and up) because they believe those children will be “over” waking during the night. What some may not realize is that children in foster care or those being adopted will have a 50% chance of having sleep issues post-placement. For those who didn’t hear ahead of time, the experience can be frustrating and disorienting. Lack of sleep can cause a person to feel crazy!

So what can parents expect with older children, and how can these sleep issues be handled?

First, it is important to understand that much of what that child experienced early on may have caused their brain to bypass the development required for good sleep. Additionally, when a person is stressed out, their brain becomes bathed in neurochemicals that primes them for fight, flight, or freeze reactions and can lead to hyper-vigilance. Sleeping requires a great deal of vulnerability on the part of the child in order for them to relax enough to fall asleep. Once asleep, they may be easily woken up. While we know they are now safe, they do not yet know this in their core. Grief and loss also have the ability to disrupt sleep.

Realizing how our children began can help us to understand the factors that will most impact their sleeping patterns.

Three factors that all tend to impact a child’s sleep include their history, their temperament, and the parents’ expectations and education. At first, a child may sleep a great deal while things are in transition. Abrupt transitions, like foster care placements or quick adoptions, are the hardest on sleep. Any strange sleeping pattern is really not all that strange during times of transition, including refusal to sleep at all, refusal to sleep unless being held, refusal to take off clothing or shoes, desire to be left in a crib or bed, or sleeping perfectly. The important thing to remember is that none of these patterns are guaranteed to continue after the initial transition into the home. It has been estimated that 70% of children have problems with sleep during this time period. Additionally, sleep will change as attachment changes.

So how do parents attempt to handle such baffling and frustrating sleep patterns?

One of the most important characteristics is to exercise flexibility within structure. In other words, be flexible concerning where your child sleeps but provide consistency in approaching sleep developing routines that helps your child know what is coming next. Realize that the goals you have regarding sleep for your child are long term goals. In setting these goals, be sure to be realistic, meeting your child in the middle and being willing to give up expectations.

In the case of an internationally adopted child, when first bringing your child home, realize that jet lag can last up to two weeks. As a general rule, consider that it will take one day per each hour of time difference. To help your child adjust, start attempting to put your child to bed at midnight, and then move bed time up by a certain increment each night forward. For example, Monday night has bedtime at midnight, Tuesday night, bed time is 11:30pm, and so forth. This will help the sleep routine to evolve. Use natural rhythms to support healthy sleep. The morning sun is so helpful in this! Get outside in the morning. This can boost the natural circadian rhythm and boosts cortisol production. If additional help is needed, contact your doctor about the possible use of melatonin. When you first arrive home, limit the number of outings and visitors. Don’t be afraid to seek help from medical professionals.

When considering your child’s sleep patterns long term, there are a few facts to remember.

At times, children in adoption or foster care situations engage in self-stimulating behaviors. Typically, these behaviors will eventually fade away unless the child is older and the behaviors are more ingrained.  Additionally, it is not uncommon for children to experience either nightmares or night terrors. Nightmares occur when children can remember their dreams upon waking. In the case of night terrors, a child will have no memory of it when they wake up. If your child does co-sleep initially, do not attempt to force the transition to a room of their own too soon. Remember, while nightmares are scary and unpleasant for everyone, nightmares and co-sleeping can help to bond children to their parents quickly.

In society today, there seem to be a lot of negative perceptions of co-sleeping for various reasons. Realize that there are many different ways to co-sleep. For the situation to be effective over what  could potentially be a long period of time, it is important that everyone be comfortable and able to sleep. This could mean having a crib or mattress near your bed, or creating a pallet on the floor near the bed. Sometimes a twin bed can be placed next to a parent’s bed, but lowered by two or three inches to help keep the child from rolling onto or bumping the parent during the night. This is particularly useful for highly anxious children. Co-sleeping can help to calm brain chemistry down.  For some kids, placing a two-way monitor in their bedroom is sufficient. You can hear them, but they can also hear you.  Developing new sleep habits takes at least three months. Hang in there!

When you are exhausted and wondering if you will ever have a night of uninterrupted sleep again, remember that night time is a crucial time for building healthy attachment. View these late nights as valuable therapy time!

 Angela Mains, M.A., A.L.C., Crossings Counselor

References: Chambers, J. (2013). Sleep disturbances in the foster or adopted child, [online webinar]. University of Alabama, Birmingham. February 19, 2013.

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