Sleep Advice: Chronotherapy and Phased Advancement

15 April 2021

Sarah got in touch with our Sleep Service at a point when she felt that her family had run out of options to help their son Josh to get a good night’s sleep.

Sleep Advice: Chronotherapy and Phased Advancement

15 April 2021

Sarah got in touch with our Sleep Service at a point when she felt that her family had run out of options to help their son Josh to get a good night’s sleep.

Sleeping boy

Sarah got in touch with our Sleep Service at a point when she felt that her family had run out of options to help their son Josh to get a good night’s sleep. She explains how our Sleep Service helped them to try out new techniques and how it has opened doors to accessing further support.

Sarah told us that fifteen-year-old Josh has been struggling with his sleep for a couple of years. He finds it difficult to fall asleep at night. He often lies awake for 2-3 hours so he doesn’t fall asleep until the early hours of the morning, leaving him feeling very tired.

During lockdown this hadn’t been such an issue as he was able to lie in in the mornings and catch up on his sleep. But with a return to school this hasn’t been possible.

The family consulted their GP and school nurse and rigorously followed advice on sleep hygiene. Josh got plenty of fresh air and exercise and switched off electronic devices before bed, but nothing seemed to make any difference. Josh was also given medication including sedatives and anti-histamines, but again with no improvement.

Josh was becoming increasingly tired, anxious and frustrated. He was understandably cross that although he was trying everything suggested, it wasn’t making a difference. The lack of sleep and Josh’s mood was having a big impact on family life.

As Josh is on a pathway to an autism diagnosis his school nurse referred him to Cerebra’s Sleep Service – which he was able to access even though his diagnosis has not been confirmed. The family were put in touch with one of our Sleep Practitioners, Carwyn Tywyn, who worked closely with the family to try to find a solution.

Sarah told us: “Carwyn was fantastic. He had a really friendly approach and made sure that he fully involved Josh in the process, consulting him and explaining things clearly”.

With Carwyn’s support the family tried Chronotherapy. Carwyn explains “This involves shifting the child’s sleep time forward all the way around the 24-hour clock until the cycle comes around to appropriate evening sleep time. Chronotherapy is a demanding process both for child and parents alike, because it typically lasts for two weeks. For most of the first week, the child is awake during the night”.

Despite the toughness of the technique Josh rose to the challenge and followed the plan to the letter. The system did make a small difference – the time it took Josh to fall asleep reduced down to 1 and a 1/2 – 2 hours. This was largely due to the exhausting nature of the therapy. Since returning to school Josh’s sleep pattern has slipped back to the previous routine.

The second technique the family tried was Phased Advancement. Carwyn explains: “This involves bringing the child’s sleep routine very gradually earlier (typically 15 minutes at a time. Unfortunately, this had no effect at all.

Although Josh’s sleep is yet to improve, Sarah told us: “I view the whole experience of working with the Cerebra Sleep Service very positively. It allowed us to explore ideas we wouldn’t otherwise have come across and it has opened doors to further help. Because Josh has tried all of these options, he is now eligible for a paediatrician appointment as well as a referral to CAMHS to tackle underlying anxiety issues. We are hopeful that there is more that can be done to help him and we can also rely on Carwyn’s on-going support. I would absolutely recommend Cerebra’s Sleep Service to other families”.

If you would like support with your child’s sleep, take a look at how our Sleep Service can help.

 

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