Sleep Disturbances of Children with Trauma

Sleep Disturbances Sleep disturbances

are among the most common problems for children after a disaster. Behaviors associated with sleep disturbances are likely to take the form of resistance to bedtime, wakefulness, unwillingness to sleep in their own rooms or beds, and refusal to sleep by themselves. Children will also express a desire to be in a parent’s bed or to sleep with a light on, insist that the parent stay in the room until they fall asleep, or may begin to rise at excessively early hours. Such behaviors are disruptive to a child’s well-being. Tey also increase stress for parents, who may themselves be experiencing some adult counterpart of their child’s disturbed sleep behavior. More persistent bedtime problems such as sleep terrors, nightmares, continued wakening at night, and refusal to fall asleep may point to deep-seated fears and anxieties that may require professional intervention.In working with families, exploring the family’s sleep arrangements may be helpful. Long-term adjustments in sleeping arrangements, such as allowing children to sleep routinely in the parent’s bed, will inhibit the child’s recovery pro-cess. However, temporary changes following a disaster may be in order. For very young children, it may be especially reassuring to have close contact with their parents during those times when disaster fears are most prominent. After a brief period of temporary changes, the parents should move toward the reinstatement of pre-disaster bedtime routines. Thus, the family may need to develop either new or familiar bedtime routines, such as reinstating a specific time for going to bed. Te family may find it helpful to plan calming, pre-bedtime activities to reduce chaos in the evening. Teenagers may need special consideration for bedtime privacy. Developing a quiet recreation in which the whole family participates is also helpful.

14Reactions of Children to Disasters Besides the above descriptions of fears, anxieties, and sleep disturbances, children’s reactions to a disaster can be expressed in many different forms. Below are some more common reactions. (For convenience, the reactions are presented for three age groups: preschool or early childhood, latency age, and pre-adolescence and adolescence.)

Preschool, Five Years Old and Younger  Most of the symptoms appearing in this young age group are nonverbal fears and anxieties expressed as the result of the disruption of the child’s secure world. These symptoms include: ■ crying in various forms, with whimpering, screaming, and explicit cries forhelp ■ becoming immobile, with trembling and frightened expressions ■ running either toward the adult or in aimless motion ■ excessive clinging Regressive behavior, that is, behavior considered acceptable at an earlier age and that the parent had regarded as past may reappear. This includes the following: ■ thumb sucking ■ bed-wetting ■ loss of bowel/bladder control ■ fear of darkness or animals ■ fear of being left alone or of crowds or strangers ■ inability to dress or eat without assistance Symptoms indicative of fears and anxieties include: ■ sleep terrors (i.e., child abruptly sits up in bed screaming or crying witha frightened expression and autonomic signs of intense anxiety. The child is unresponsive to the efforts of others to awaken or comfort him/her. If awakened, the child is confused and disoriented for several minutes and recounts a vague sense of terror usually without dream content.) ■ nightmares (i.e., frightening or anxiety producing dreams) ■ inability to sleep without a light on or someone else present ■ inability to sleep through the night

15Reactions of Children to Disasters ■ marked sensitivity to loud noises ■  weather fears – lightning, rain, high winds ■ irritability ■ confusion ■ sadness, especially over loss of persons or prized possessions ■ speech difficulties ■ eating problems The symptoms listed above may appear immediately after the disaster or after the passage of days or weeks. Most often they are transient and soon disappear.Parents can help diminish the above symptoms in their children through under-standing the basis for the behaviors and giving extra attention and caring. If the symptoms persist for longer than a month, parents should recognize that a more serious emotional problem has developed and seek professional mental health counseling