The Importance of Sleep in Supporting Sensory Modulation and Emotional Regulation

By Maude Le Roux, OTR/L, SIPT, RCTC, DIR® Expert Trainer at A Total Approach

For most children, sensory modulation develops during the course of ordinary childhood activities. If this process is somehow disrupted, a child may develop sensory modulation disorders (SMD) that interfere with their behavior, learning ability, social skills and self-esteem. They will also have trouble with emotional regulation.

The inconsistent responses of a child with SMD to sensory stimuli are less about willful behavior and more about how their system adapts and the coping strategies available to them at any given moment.

An important influence for a SMD child’s inconsistent performance is how they are sleeping. 

Adequate amounts of restful sleep give us the foundation for our best participation and engagement in daily life. When we work with children who exhibit developmental delays, first we explore the impact of sleep habits on the child and the family to determine their ability to function effectively during the day. 

Definition of Sleep

Physician Robert MacNish, who wrote The Philosophy of Sleep in 1830, describes sleep as a “suspension of sensorial power”, an altered state with a natural lessening of conscious awareness of the external world. The sleep state is transient, periodic and physiological, characterized by reduced responsiveness to environmental stimuli. It is also reversible, meaning people awake from sleep, which differentiates it from death or coma. 

Sleep is regulated by a homeostatic process and a circadian process that interact to determine sleepiness and alertness. These two processes are described scientifically as follows: 

A homeostatic sleep debt process refers to the drive for sleep that increases as a saturating exponential when we stay awake and decreases exponentially when we sleep, and a circadian process refers to the internal oscillatory rhythm that runs about 24 hours and can be reset by the environmental light.

Theories On Why We Need Sleep

Philosophers and scientists have been studying why people sleep since the dawn of medicine. Adaptive and instinctive, sleep:

• restores and repairs our bodies, creating metabolic homeostasis
• conserves our energy
• strengthens the integrity of our synaptic and neuronal network
• clears our minds of extraneous thoughts and consolidates our memories
• regulates our body temperature
• improves endocrine regulation of our immune systems

The Impact of Sleep Deprivation

Sleep also affects our emotions. Research shows people who sleep poorly or aren’t sleeping enough find it more difficult to recognize expressions of emotion like anger or happiness. Lack of sleep can also limit their social skills. 

Sleep deprivation is so prevalent in our society, it’s become an unmet public health problem. According to a report funded by the National Institutes of Health, an estimated 70 million Americans chronically suffer from a sleep disorder that hinders daily function and adversely affects health and longevity. 

When children are sleep deprived, it manifests through emotional and behavioral symptoms that include aggressive or delinquent behavior, reduced attention spans and a variety of social difficulties. Children can also experience sleep disorders associated more with adults such as insomnia, narcolepsy, sleep apnea and others. 

When a child comes to us with a sensory modulation difficulty, our first course of action that initiates any intervention program is to explore their sleep habits. Using sleep questionnaires, we help families make systematic changes in bedtime routines and suggest calming activities and other routines to facilitate sleep that do not burden the family and can be carried out consistently.

Tips To Create a Bedtime Routine That Promotes Healthy Sleep

• Select a specific bedtime for each child based on their age and schedule.
• Get your child relaxed and ready for bed with a predictable, regular sequence of events.
• Reinforce the bedtime routine with your child by explaining the routine step-by-step, then remind them of what’s coming, like, “First we eat dinner, then we play, then we’ll take a bath and put on our pajamas. Then we read a story and then get into bed to go to sleep.”
• Begin the relax-and-ready routine about a half hour before bedtime.
• If your child wants a drink, try a glass of warm milk, which is scientifically linked to improved sleep.
• Avoid having your child drink too much liquid before bedtime, however.
• Offer your child a light snack of foods high in tryptophan, such as bananas and cheese, to help them feel drowsy.
• Encourage your child to be part of the process. Ask them what step of the routine comes next, for example.
• Have your child pick up and put away toys.
• Turn off the TV and play soothing music during the bedtime routine.
• Prepare your child’s bedroom for healthy sleep. Keep the lights low and the temperature cool.
• Have your child take a warm bath, adding lavender or Epsom Salts to the bathwater.
• Offer your child choices of books to read and music to listen to or songs to sing.
• Suggest that your child take a favorite doll or stuffed animal or a favorite blanket to bed with them.
• Be consistent with bedtimes during the week, on weekends and even during vacations.

Tips for Increasing Your Child’s Comfort at Bedtime

• Check your child’s sensory experiences at bedtime. Are their pajamas or bed blankets itchy? Do the fabrics breathe? Is the room too warm? Too cool? Do the window coverings let in too much light?
• If your child expresses a fear of the dark, help them overcome the fear in a safe, supported environment. Make statements such as: “I believe in you,” or “I know you can do it”.
• Incorporate supportive actions into the bedroom routine, like checking the closet or under the bed for danger.
• Switching on a nightlight in your child’s room can help reduce their fear of the dark. Avoid lights with a blue or green cast as they inhibit the production of melatonin in the brain and can prevent your child from feeling drowsy at bedtime.

Learn More About Sensory Integration Therapy

If you’d like to learn more about the different methods we use for sensory modulation and emotional regulation, such as Tomatis sound therapy, Interactive Metronome therapy and others, I recommend scheduling a free phone consultation with one of our therapists who can give specific insight about you and your child’s situation.