By Kira MacKay, RN
Nursing Coordinator, Minot Campus
Imagine what it would be like if you couldn't go home at the end of a long day and crawl into your own safe, comfortable bed. That's what it has been like for many of the kids at Dakota Boys and Girls Ranch—their beds, and sleep in general, have not always been a safe, comfortable place. Some didn't have a bed and spent nights on the floor, on the couch, under the kitchen table...wherever they fell asleep. Others hopped from couch to couch with their families—never knowing where they would spend the night. Many see nighttime as scary because that is when bad things happened to them. They come to the Ranch and we expect them to sleep in an unfamiliar place surrounded by people they don't know.
Sleep is as vital to life as the air you breathe, the food you eat, and the water you drink. Adolescents ideally need 8-10 hours of sleep each night, and most have poor sleep habits—staying up late and sleeping in when they can. Ranch residents are no different—and their histories of trauma often impact their sleep even further.
Lack of sleep can have severe consequences, including limiting a child's ability to learn, listen, and concentrate. It can also lead to aggression or other inappropriate behaviors. Sleep difficulties can contribute to illness, unhealthy eating habits leading to weight gain, and make a child more prone to acne and other skin problems. Our residents already have many strikes against them and adding lack of sleep to the list makes it that much more difficult for them to be successful.
Teaching healthy sleep habits, and helping kids work through the trauma they associate with sleep, is an important part of the work we do at the Ranch. We make sleep a priority by helping residents develop sleep schedules and establish consistent bedtime routines. We teach our kids to avoid drinking, exercising, or screens before going to bed; and promote quiet, calm activities that signal to their bodies that it's time to sleep. A healthy bedtime routine might consist of turning the TV off, having a healthy snack, taking a warm shower, and reading a book.
In addition to teaching a healthy bedtime routine, we meet kids where they are at with their sleep habits. For some of our younger residents, this might mean we tuck them in and read a bedtime story. We offer them a night light to have in their rooms or a fan to provide white noise. Some residents enjoy listening to music or having their blankets warmed in the dryer before bed. If a resident is agitated prior to bedtime, we sit with them and help them find calming activities that work for them; such as breathing exercises, wrapping themselves in a weighted blanket, or snuggling with a favorite stuffed animal.
Many of our youth suffer from insomnia, a sleep disorder characterized by difficulty falling and/or staying asleep. In addition to working with Ranch nurses and youth care workers to develop bedtime routines that promote sleep, kids also talk about sleep with their therapist. They often have kids use a FitBit or complete a sleep log to track their sleep. Our mental health providers use this data to determine if sleep medications are appropriate.
With a combination of a consistent bedtime routine, therapy, and medication, the Ranch helps residents feel safe and comfortable in their beds so they can get the best sleep possible. Paying attention to every part of our kids' lives, 24 hours a day, is all part of helping them heal.
This article was originally published in Ranch Voice: Winter 2019.
Read more stories like this and explore other issues of Ranch Voice.