Since becoming a certified sleep therapist I am now helping an OT client with their struggle to fall asleep. The child is taking stimulant medication as well as an anti-anxiety medication. Both drugs contributing to his difficultly falling asleep in the evening. The side effect profiles of these drugs are not surprising. The ASD diagnosis is also a factor. It makes him extra-intense when things go wrong. And not being able to sleep when tired is definitely the definition of “things are going wrong”.
This is not unusual, and not unexpected. These medications are known to negatively affect sleep, and sleep issues in ASD are also quite common. The answer from his prescriber, I hope, is not another medication.
Oh, I forgot to mention this client’s love of evening “screen time”. He finds it almost as much fun as LEGO construction. Screens are beginning to triumph over books and other manipulative toys as go-to choices during free play. Screen use is often used as a reward for participating in other activities and for being social. It is not helping him wind down in any way. He comes off the bus eager to play on a tablet.
Screen cravings aren’t the exclusive territory of children and teens. Adults often wake up and check their feed before their feet hit the floor. They might say that they need to see if their work team sent any messages, or if their boss has a new assignment for them. In truth, this is often the gateway to checking social media and news. There is no immediacy about seeing anything on their phone as soon as their eyes open.
This is a mistake for anyone’s mental and physical health.
And it isn’t ALL because of the blue light being emitted from the screen.
The cognitive effect of excitement and psychological reward from seeing the number of “likes” or other responses can be a strong neurologically alerting trigger. One that the brain is trained to expect. Sleep is harder once you give the brain a juicy dopamine reward, and the brain responds by lightening sleep in the wee hours because it is readying to receive the wake-up jolt from that phone.
OOPS.
While it is really challenging to move screen use to daylight hours when kids are over-scheduled, making a sincere effort here can help tremendously. I suggested house-wide lighting changes as well as altering any other kind of activity that gets him wired. All after-school time, all the way to bedtime, has to be more mellow. Weekends offer some flexibility that can be used to try out new ideas. His natural tendency to intense focus is always going to be a challenge. The attention issues that the stimulant is intended to address might need more non-pharmacological strategies.
Sleep is essential for children’s brain and body development. It isn’t incidental. It is fundamental.
Screen use isn’t evil, and it won’t go away. The future of work and higher education is on a screen. This requires all of us to be more mindful of their effects on our brains and bodies, and actively manage them. We cannot let them manage us.
