Management includes good sleep practices mentioned earlier, specifically setting a fixed bedtime, reviewing sleep schedules (e.g. avoid late afternoon naps), and consistent parental limit-setting.
Parents should aim to establish a set bedtime that coincides with the child’s natural sleep time.
The method of ’bedtime fading’ may be practised, where the bedtime is initially set at the current bedtime, and brought forward gradually to the desired bedtime, to reduce struggles between bedtime and sleep onset.
Clear bedtime rules need to be set with the child (e.g. staying in bed, not calling out for parents), and ignoring complaints about bedtime (e.g. ‘I am not tired yet’).
Check on the child briefly if needed, provide reassurance and return the child to bed if he/she gets out of bed. A transient worsening of behaviour may occur in some children at the beginning. Caregivers are encouraged to be consistent and firm each time.
Positive reinforcement (e.g. sticker charts and small rewards) may help motivate the child.
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