As part of the Jamie’s Farm experience, check-ins – where our visiting young people rate how they are feeling on a scale of one to ten – are a regular part of every day, allowing young people to reflect on their experiences and share these with the group. Quality of sleep is a recurrent theme during check-ins – the comment above was from a young person with a diagnosis of ADHD after their first night spent on the farm, they take medication for sleep difficulties and is testimony to the importance of sleep for well-being.
As an Occupational Therapist and Sleep Practitioner, I have become acutely aware of the importance of sleep for the well-being of not only the children I have worked with, but also how this can affect the health and functioning of the wider family. However, parents have often commented to me that sleep, particularly for older children, is rarely discussed, or only after other factors have been ruled out, or “dealt with first” – for example medical, educational and psychological needs, rather than considering sleep as part of a person-centred approach.
But why, when sleep is such a huge part of our lives? We spend more time engaged in the occupation of sleep than any other – about one third of our lives are spent asleep, or more for children and adolescents. Broadly speaking, primary school aged children (5-11 years) require 10-11 hours’ sleep per night, and secondary school aged children (11-16 years) 9-10 hours’ per night (www.nhs.uk). However, children in western populations are estimated to sleep on average one hour less per night than 100 years ago, and up to 25% of all children will have a sleep problem at some time (Mindell & Owens, 2003).
The detrimental effects of sleep deprivation are significant. Sleep duration and quality in school aged children is directly associated with school performance, cognitive function and behaviour. Studies of typically developing children have shown deterioration in memory and visual attention (Sadeh et al, 2003), as well as poor emotional lability and restless-impulsive behaviour scores (Gruber et al, 2012) in response to restriction of sleep duration.
So why are children sleeping less? Poor diet, more sedentary lifestyles, and use of electronic media in the bedroom are all factors which contribute to sleep problems in childhood. Further to this, regular routines and a safe and suitable sleep environment are not available to many children. Many of the young people visiting Jamie’s Farm tell us about some of these difficulties, with comments such as “I go to my bedroom at 10pm, but I play my X-Box and go to sleep at 3.30am”, “I go to bed whenever I want”, or in a recent conversation, one young person spoke of feeling afraid to go to sleep in a quiet room, as at home he watches YouTube until falling asleep.
It is however unhelpful to attribute blame when working with children who struggle to sleep – children’s sleep is a hugely emotive topic which many parents struggle to address, and can consequently feel that they have “failed” their child. This can have long term implications for family health and well-being, and childhood sleep disturbance is known to impact upon maternal stress and fatigue. Unsurprisingly, by the time a child reaches adolescence, improving sleep can feel like an insurmountable task for parents.
A more pragmatic approach to sleep promotion should first acknowledge that sleep is something which must be learnt. During a visit to Jamie’s Farm, young people are immediately immersed in routines which promote sleep, in the evenings and throughout the waking day. Diet and exercise are an essential component; caffeinated drinks and processed foods are not allowed on the farm, but homemade meals and snacks are planned to provide slow release energy and combat “dips” in energy. The daily routine and jobs around the farm are typically physical and outdoors – this type of activity provides input to the muscles and joints which in turn sends calming and organising messages to the brain; put simply, young people are truly tired at the end of the day!
The afternoon and evening routines on the farm are also carefully planned; following a late afternoon walk, young people return for a shower, evening meal, a final check-in meeting and activities such as games or a bonfire. Each part of the evening serves a purpose; a hot shower is relaxing, and taking this at least an hour before bedtime ensures that the body temperature rises and then falls, which subsequently helps to induce sleep; the check-in meeting allows for the opportunity to debrief, reflect upon the day and share any worries which could adversely affect sleep; and evening group games and activities are not centred around electronic media. The adjustment to a new sleep routine can be difficult for some, however farm staff will also support young people to feel safe and relaxed through storytelling and guided relaxation at bedtime, if needed.
Within the peaceful, rural settings of the Jamie’s Farm sites, the impact of improved sleep patterns can be profound. And while short term sleep promotion can be observed during residential stays, this is just one part of a holistic approach that leads to a sustained change in behaviours; children who are less sleep deprived are able to develop more positive relationships with others, be more able to attend at school, and, simply, feel healthier and happier. This highlights the diverse ways in which Jamie’s farm initiates a cycle of positive change over time, and our impact measurement demonstrates this change.
I think I’m going to change my sleeping habits…. I’m going to go to bed at 10pm and get up at 7am” (Hartshill School pupil, April 2017).
- Back in March, BBC Panorama delved deeper into the problems associated with sleep deprivation in children. Catch up on it here: http://www.bbc.co.uk/programmes/b08hymf3
- ‘Western society is chronically sleep deprived’: the importance of the body’s clock by the Hannan Delvin in The Guardian, October 6th 2017: https://www.theguardian.com/science/2017/oct/06/western-society-is-chronically-sleep-deprived-the-importance-of-the-bodys-clock?CMP=fb_gu
Written by Beth Walker, Therapeutic Coordinator at Jamie’s Farm Monmouth
Beth joined Jamie’s Farm in September 2017 as a member of our new team for our new farm near Monmouth. Like the rest of the team, Beth is spending her first few months at Jamie’s Farm Bath and Hereford for her induction. When the Monmouth farm launches, Beth will lead group meetings and have personalised therapeutic conversations with all visiting young people. Beth graduated from Cardiff University with a degree in Occupational Therapy, has completed a postgraduate certificate in Sensory Integration, and trained as a Sleep Practitioner. She has worked as a therapist in schools with children and young people with autism, language and communication difficulties, and most recently within a children and adolescent mental health service supporting children with learning disabilities and behaviours that challenge.