Showing posts with label relaxation. Show all posts
Showing posts with label relaxation. Show all posts

Friday, 6 January 2023

What’s really going on when a child is ‘overtired’ – and how to help them have a silent night in the New Year

Posted by Helen Ball, Professor of Anthropology, Director of the Durham Infancy & Sleep Centre (DISC), and Fuse Associate at Durham University

Anyone who’s cared for a young child will recognise the signs. They’ve had too little sleep or missed a nap, they’re cranky, tearful, and stroppy, and they can’t or won’t fall asleep. They are “overtired”. But is such a thing really possible – to be more tired than tired?

What we tend to call overtiredness happens when an emotional state, such as anxiety, distress or fear, blocks our ability to go to sleep even when we’re really tired. This is a survival response that helps us to stay awake when in danger, no matter how tired we are. It suggests overtiredness can be reframed to help us better respond to our child’s needs when it happens.

At the end of the day, the feeling we have of needing to sleep is called sleep pressure. The longer we stay awake the more sleep pressure rises. Typically, the higher it gets, the easier it is to fall asleep. If we stay awake for long enough, eventually we’ll fall asleep even if we are trying not to.

The sensation of sleep pressure is caused by the build-up of chemicals (called adenosines) in the brain. These are proteins that are removed from our brains while we sleep, and build up again while we are awake.

For adults, this process takes about 14-16 hours. When we delay sleep past this point the build-up of adenosines cannot go on unchecked. At some point, eventually, we must sleep.

Babies’ sleep pressure builds up more quickly than adults. Young babies often fall asleep after being awake for an hour or two. As children get older, sleep pressure builds more slowly. But it takes several years until a child is able to stay awake all day.

What stops us sleeping?

To fall asleep we must be calm, relaxed and able to switch off our brains so that the build up of sleep pressure can tip us into sleep. When something blocks the action of sleep pressure, such as fear, pain or racing thoughts, we may struggle with sleeplessness.

In the same way, sleep happens more easily for a baby or child when sleep pressure is high, they are in a calm relaxed state, and nothing is preventing sleep onset. But sometimes babies and children need help to become calm before sleep pressure can kick in and they can nod off.

When a baby or young child’s sleep pressure is high and the need to sleep is strong, but they are emotionally unable to calm themselves, or they are in a situation where they cannot relax – where there is noise, lights, or activity – we may label them as overtired. Emotional exhaustion, which is a form of stress, prevents both children and adults from sleeping and makes them cranky.

Some responses to overtiredness are heavy-handed. Ordering a child to their room, putting them to bed in the face of distress or punishing them for not falling asleep when told to do so will dial up the child further and push sleep further from reach. After all, none of us can fall asleep on command.

Helping babies to sleep

In this situation, we must remember that babies and young children need our help to manage their emotions. It is our job as parents to help them become calm, dial down, and relax in preparation for sleep.

We can do this in many ways. Physical contact such as cuddling, rocking, stroking or patting works for most children, although it must be remembered that some neurodivergent children can find touch irritating rather than calming.

Non-contact methods also work. The presence of a relaxed slow breathing adult can calm a child, as can listening to gentle talking, singing and humming. In the Czech Republic, there is a specific word for lying with and helping a child to relax so they can fall asleep: uspávání.

There is no name in English for the process of helping a child relax so that sleep pressure can tip them into slumber, so we often don’t discuss or acknowledge it. We can use it, though. And we can understand that what we have named “overtiredness” is the conflict between sleep pressure being high and something blocking the effect of that sleep pressure.

In this situation actively removing the blockage – fear, pain, anxiety – by helping babies and children to become calm is the quickest way to help them fall asleep.

Next time your baby is having a meltdown at bedtime, or your child is throwing a tantrum at the end of the day, hug them, cuddle them, talk gently to them and calm them. Let sleep pressure do its thing, and they’ll be snoozing in no time.


The Durham Infancy & Sleep Centre (formerly the Parent-Infant Sleep Lab) is a research centre of the Department of Anthropology. It is the home for a group of researchers examining various aspects of infant and child sleep and parenting behaviour since 1995. Its work with more than 5,000 parents and babies during the last 20+ years has substantially increased parents' understanding of babies' sleep, how best to care for babies during the night, and how best to keep them safe when asleep. 


This article is republished from The Conversation under a Creative Commons license. Read the original article.

Thursday, 9 April 2020

Working from home isn’t for everyone - here’s how to cope if you’re struggling

Posted by Annabel van Griethuysen, Floating Dietetic Clinical Specialist, Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV)

You may find yourself, as I have, being asked to work from home during the COVID-19 crisis. Although my work as a dietitian is vital to the NHS and to the care of patients, it is something which can be done remotely. Whilst those working from home may feel relieved in some ways to be able to socially distance, unlike our colleagues in front line services, this still comes with its own challenges.



Being isolated at home can be hard; it is easy to feel cut off from friends and co-workers, to feel out of the loop when it comes to work decisions and to feel stressed with how best to work when at home. Some people may find it frustrating that they cannot work as they did, and find performance dropping; others have told me that they are working over and beyond to almost prove that they are still being productive.

Working from home works for some people, and not for others. So what should we do if we are asked to work from home, and are struggling?

One thing which is key is to ensure that you keep a routine as much as possible. It is tempting to roll out of bed and turn on the laptop; no hair brushing, in pyjamas, no makeup. However, getting up and keeping a routine is very helpful to maintain mental health and structure. Getting up with enough time to relax before turning on the computer, to get dressed and to have breakfast, will help to separate relaxing time at home from work time at home. This also goes for the rest of the day - make time to do enjoyable activities, make sure you are getting enough sleep, and schedule breaks into your working day.

Ensuring you are eating and drinking well is also extremely important. Having time away from the computer for lunch and sitting in a different place to eat can help to break up the day and give you a much needed break. Generally, the British Dietetic Association has advised to continue to eat and drink normally throughout this pandemic, focussing on a balance of food groups. If we are struggling to shop regularly, they advise using fresh foods first, but also frozen, dried and tinned produce, for example vegetables, are still a valuable sources of nutrition. It is tempting to snack more when working from home; I know personally the lure of the biscuit tin is strong, but instead of reaching for a biscuit, try getting a hot drink, or having a wander to a different room for a 5 minute break. I’m lucky enough to have a garden to use to get a quick bit of exercise.

One thing to potentially consider is a supplement of vitamin D. This is usually the sunshine vitamin which, in the spring, we would be able to get from sunlight, but with limited exposure to the sun at the moment, a 10microgram supplement may be beneficial.

Having a completely separate space to work which is tidied or hidden away at the end of the day can help to establish structure and boundaries, and resist the temptation to work on into the night. Try to make sure that this space is appropriate as well, with a desk, supportive chair, and enough natural light and ventilation. It can also help to keep two or four legged ‘helpers’ at bay!

But finally, it is normal and understandable to feel anxious and stressed, especially at this time. So make sure you are talking if this is the case. Reach out to your social circles (I have somehow managed to teach my mother to use WhatsApp video calling!) and keep connected. Together we will be strong.

Some sources of support and information:

Annabel is a Floating Dietetic Clinical Specialist at Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV). Practitioner of Public Health, Faculty of Public Health, Trade Union Representative for the BDA (Association of UK Dietitians) and Staff and Dietetic Wellness Champion.

Photo attribution: