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Sleep and Teenagers By Kirsten Ellingsen, PhD

7/25/2019

Many teens are chronically sleep deprived. The recommended amount of sleep for adolescents is 8-10 hours a night to function at their best, yet most average only about 7-71/2 hours. An earlier high school start time, physiological changes, involvement in extracurricular activities, and demands related to completing academic work may contribute to less sleep. In addition, screen time (video games, phone and social media use) is another important contributor to reduced sleep and sleep problems for many teenagers. As described in a previous blog, getting less than the recommended amount of sleep will influence mood, behavior, learning and academic success. Teens may be more easily frustrated, have more difficulty regulating emotions, display increased risky behavior, exhibit memory and attention problems, and drive drowsy increasing their risk for car accidents.

Recommendations for improving sleep for adolescents:

Remove televisions from bedroom. Limit computer and phone use (*again, limit screen time at night and stop use at least 30 minutes before bedtime)

Talk with your teen about recommended number of hours and consequences, ask him or her to help problem solve and determine what time to get into bed to get minimum number of sleep hours.

Maintain / Encourage consistent bed times and schedule, even on the weekend.

Avoid afternoon/evening caffeine

A 15-20 minute early afternoon nap can help

Help your teenager keep a quiet, dark, and cool room

Encourage your teen to get out of bed and do something different if he or she cannot fall asleep after 30 minutes lying in bed (an activity not involving electronics)

If problems are ongoing and significantly affecting child (or parent) functioning please seek additional support to rule out medical issues or causes. Also, medications, stress, anxiety and depression can each influence the quality and amount of sleep and should be considered when evaluating the causes of problems and where to begin for support.

Resources and References:

https://www.sleepfoundation.org/articles/teens-and-sleep
https://childmind.org/article/help-teenagers-get-sleep/
https://kidshealth.org/en/parents/sleep.html#catbehavior
https://www.sleepfoundation.org/sleep-solutions/sleep-tools-tips
https://childmind.org/article/encouraging-good-sleep-habits/childmind.org/article/encouraging-good-sleep-habits/
https://www.nationwidechildrens.org/specialties/sleep-disorder-center/sleep-in-adolescents

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5 Tips to Communicating with your Partner By Rachel Funnell, LMFT

7/18/2019

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Learning how to communicate effectively with your partner is an important aspect of a relationship. This is what most people know. However, what people don’t always know is how to be a good communicator. Below are five tips to help you become more successful at communication.

Don’t sweep things under the carpet. This first tip maybe pretty obvious but in actuality, people often struggle the most with this. In order to be a good communicator you must be willing to talk about the problem. Keeping things in will only make them fester and eventually you will snap. It’s better to let things out a little at a time so that the pressure doesn’t build up. However, it’s important to keep in mind that this doesn’t mean talking to your partner about every little thing that bothers you but rather focusing on the important matters. It is still important to let some of the little things go.
Don’t put them on the defensive. It can be very easy to get caught up in the moment and give your partner a long list of what you think they are doing wrong. However, doing that will only put them on the defensive. Instead, I recommend using “I” Statements. Simply that means to talk in terms of how things make you feel. An example would be, “When I don’t get a call when you’re running late, I feel worried that something might have happened to you.” By putting the focus on yourself, you are taking responsibility for how you feel and helps your partner to not feel attacked.
Pick a place and time. It’s not just about what you say and how you say it, it’s also about where and when. At times, it can be beneficial to plan a time and place to have a discussion. This can help with allowing you to prepare what you are going to say and not be as reactive with your statements. It also, will allow you to give your full attention to the conversation without worrying about a time restriction.
Make time to talk AND listen. At times we get caught up in making sure that the other person understands us but it’s just as important that you understand what your partner is trying to communicate. A lot of times, people will only be listening to respond, rather than listening to understand. While your partner is talking, you are thinking of how you are going to respond rather than truly understanding what they are saying. To help you make sure you are understanding your partner, try repeating or summarizing what you just heard them say. This will allow you to fully understand them as well as keep you both from getting defensive.
Practice. It takes time and effort to become a better communicator. Practice with smaller topics and work your way up to more challenging ones. There will be times that you’re better at it than others but keep trying. You will become better at it.

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Mindfulness Apps for Kids and Teens by Sara Hofmann, PhD

7/5/2019

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The practice of mindfulness can help children improve their abilities to pay attention, to calm down when they are upset, and to make better decisions. In short, it helps with emotional regulation and cognitive focus. Help your child to start a mindfulness practice using one of the apps below. (All are free to try; some are entirely free and others are fee-based to access extra content).

Breathe, Think, Do (preschoolers)
This Sesame Street themed app helps preschoolers to work on problem-solving, self-control, planning, and task persistence using animated characters.

Calm (kids and teens with parent help; older kids and teens for independent use)
Calm provides a range of guided meditations and relaxing soundscapes in lengths of 3, 5, 10, 15, 20 or 25 minutes. It also includes several stories that parents can read to children to help them fall asleep.

DreamyKid (kids)
DreamyKid provides kid-friendly meditations, guided visualizations, and affirmations.

Headspace (everyone)
Headspace provides calming sounds and guided meditations suitable for all levels. Teens will likely prefer the adult version, but kids and tweens will probably prefer the kid version.

Insight Timer (everyone)
Insight Timer focuses on relaxation, stress management sleep, and concentration. Meditations and activities are available for kids and adults.

Relax Melodies (everyone)
Relax Melodies allows kids and teens to pick specific sounds and make their own relaxing mix.

Smiling Mind (everyone)
Smiling Mind has a wide variety of mindfulness activities aimed at different age groups and settings. Kids may need an adult’s help to discover and use all the options.

Stop Breathe & Think Kids (kids and teens)
This app turns mindfulness into a game, offering children a fun and easy way to identify and process their emotions. Kids pick up to three emotions they’re currently feeling, and the app will suggest a few relevant activities. From counting breaths to frog jumps, each completed activity brings fun rewards to keep kids engaged! For older teens, try the adult version.

Three Good Things (kids and teens)
This online gratitude journal helps kids and teens to focus on the positive and recognize what went well each day. It’s a great way to begin an individual or family gratitude practice.

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Sleep Blog 3a: Recommendations and Strategies to Help Children Get Sufficient Sleep By Kirsten Ellingsen, Ph.D.

7/1/2019

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There are many reasons that children and teenagers do not get enough sleep. Illness, medication side effects, anxiety, parent behavior and expectations, FOMO, an inconsistent sleep routine, and bedroom environment can each contribute to the amount and the quality of sleep for a child. The consequences of not getting adequate sleep were presented in an earlier blog about sleep along with the recommended number of hours of sleep by child age (see https://www.sleepfoundation.org/excessive-sleepiness/support/how-much-sleep-do-babies-and-kids-need). Below are some general recommendations to help foster sufficient sleep for children. A subsequent blog next month will outline recommendations for teenagers.

Sleep problems or issues for children are common. It is important to consider how child health, temperament, parent values and behavior, and setting might all influence sleep. *If problems are significant and longstanding it might be important to determine if your child has an underlying medical condition or sleep disorder that needs to be addressed.

Parent behavior matters. Parents can facilitate better sleep by establishing a calm and consistent bedtime routine. Start a bedtime routine early enough in the evening to facilitate sleep (an overtired child can make it harder to fall asleep; start the routine 30 minutes earlier if a child takes longer than 30 minutes to fall asleep). Create special bedtime rituals with your children. Also, discuss clear and reasonable expectations.

Sleep environments are also important. Dark, cool, and quiet rooms that have a comfortable bed (or crib) help facilitate and maintain sleep. Using a white noise machine also helps reduce distractions and night waking.

Age specific recommendations for increasing quality sleep are provided below.

Toddlers: Common problems include reluctance or resistance to go to sleep, night awakenings, fears, and trouble falling back to sleep after waking up.

Establish a consistent bedtime routine. Start with helping your child relax, consider quiet play without any television or loud noise for 60 minutes before bedtime. Reading stories. Give a bath. Listening to soft music. Routines only need to be 5-30 minutes, but should be consistent to help create positive sleep associations. Aim for the same bedtime every night.

Special stuffed animals, blankets, and pacifiers can help with sleep soothing to fall asleep independently or fall back asleep in the middle of the night.

Allow children to make some decision in the routine, picking books, deciding what pajamas to wear, selecting music or songs you sing.

End with a standard loving and comforting good night phrase.

Toddlers might have difficulty falling asleep or staying asleep if they are teething or having bad dreams. Offer comfort and stay until calm. Again, if a child is sick or in distress be sensitive to his or her needs, offer comfort, and address these important issues. Also, make sure the room is safe. Use a baby monitor if the child is in another room. Remove any potentially dangerous objects a child could reach (blinds, strings, framed pictures) and bumpers or large stuffed animals that can be used to help climb out of a crib.

Preschool Children: Common problems include resistance to go to sleep, night awakenings, sleepwalking, night terrors, and nighttime fears.

Continue to maintain a consistent bedtime routine with a similar start time each night. Include toileting, brushing teeth, bathing or washing. Read books. Proactively offer water. Use a nightlight if needed. Recommended practice is to leave your child’s room before he or she falls asleep and if your child gets up and comes to your room, help the child return to his or her bed and say good night again. Use minimal words. Keep the noise level low in the home so that TV or other sounds do not wake your child (particularly the first hour after he or she falls asleep). Preschool children may no longer nap during the day, but still benefit from rest and quiet time in the afternoon.

Explain expectations and limits clearly
Create a dark, cool, quiet room
Tell your child you will check on him or her
Make a chart with bed time routine and allow a “last request”
Use a reward chart to track sleep and measure progress
Use a clock to let the child know when he or she can come out of their bed in the morning (e.g., the Ok to Wake Clock).

Elementary School Age: Academic work, extracurricular activities, screen time, and worry can contribute to reduced sleep. Children might develop a fear of dark or concerns about being alone in the middle of the night.

The following recommendations are from www.nemours.org to help develop good sleep habits for school age children:

Provide a nightlight for your child within reach of bed to use
Use a white noise, quiet fan or humidifier to reduce noise outside the room
Give notice before bedtime and continue to implement a predictable and consistent schedule and routine
Talk with your child about healthy sleep habits and the importance of sleep
Keep computers and TVs out of the bedroom
Stop all screen time an hour before bedtime
Avoid caffeine

TIPS to address fears or anxiety:

If your child is still not able to sleep, ask what might be bothering them or what they are thinking about (e.g., nervous about a test, excited for a party, teasing at camp).

If prolonged talking about daily worries is a problem at bedtime it might be helpful to set up a designated time earlier the day to discuss these concerns.

If your child is afraid of sleeping in the dark, play games with flashlights to increase comfort.

Another good habit to start is ending the day on a “good note”. This might involve you as a parent writing down positive behaviors you observed during the day (being brave by trying something new, listening to your request, getting along well with a sibling) or asking your child to remember something positive they enjoyed or that was good that happened during the day (this can also be helpful for children who tend to be negative or think in absolutes).

If your child has ongoing or prolonged sleep challenges despite implementing these recommended practices, please talk with your pediatrician. If you need support identifying or implementing contact a therapist with experience supporting healthy sleep practices.

References and Resources:

https://kidshealth.org/en/parents/sleep.html#catbehavior
https://www.nemours.org/services/health/growuphealthy/sleep/families.html
https://my.clevelandclinic.org/health/articles/14302-sleep-in-toddlers--preschoolers
https://aasm.org/study-shows-that-children-sleep-better-when-they-have-a-nightly-bedtime-routine/
https://www.psychologytoday.com/us/blog/dont-worry-mom/201310/8-tips-improve-your-childs-sleep
https://my.clevelandclinic.org/health/articles/14302-sleep-in-toddlers--preschoolers

For safety considerations and more recommendations for infants and toddlers see:

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Photos from Marco Verch (CC BY 2.0), verchmarco, wriggly_toes, verchmarco

Sleep and Teenagers By Kirsten Ellingsen, PhD

5 Tips to Communicating with your Partner By Rachel Funnell, LMFT

Mindfulness Apps for Kids and Teens by Sara Hofmann, PhD

Sleep Blog 3a: Recommendations and Strategies to Help Children Get Sufficient Sleep By Kirsten Ellingsen, Ph.D.

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