by M. Ranard, M.Ed.
580 words
Why is it that your five-year-old’s fever, congestion, and pain suddenly worsen at nightfall when the pediatrician’s office is closed?
Is it simply a matter of your weary child noticing their symptoms while lying quiet in bed? Maybe. But there are also real changes occurring late in the evening and during sleep which may contribute to increased severity in their illness symptoms. Here are some tips on how to respond to those changes.
1. Emotional Factors
Things seem scarier at night. At bedtime, your sick child’s anxiety may grow simply because of the dark or imagined monsters under the bed. Isolation and silence at nighttime may also contribute to how they perceive or cope with discomfort.
Make things less scary. Reading their favorite storybook or playing soft music as they drift off may lower their anxiety. Also don’t underestimate the power of a gentle shoulder, back, or foot massage. Your own anxiety will affect them so be sure to speak softly and calmly in your bedtime ritual.
2. Physical Changes
Symptoms really are worse. During sleep, a child’s symptoms may grow more severe. For example, with an ear infection, lying down is painful because of the increase in the collection of fluid in the ear canal (which places pressure on inflamed ear tissue). This explains earaches (and crying from pain) flaring in the middle of the night. Also, fever burns in the evening, and prevalent health conditions such as asthma worsen at night.
Asthma affects 20 million Americans and involves a narrowing and clogging of the bronchi tubes in the lungs. At night bronchi narrow in everyone, increasing resistance to air flow. Not a problem for kids without asthma, but in asthmatics such constriction at night may bring on an attack.
Ask the doctor. Find out what sleeping position would be best for your child’s presenting symptoms (elevated pillow, etc.). Also, check up on them while they are sleeping to be sure their position is not making it hard to breathe.
3. Chronobiology
We are different chemically at night. Chronobiology relates to circadian rhythms and how internal timing mechanisms affect our biology. At night, two important internal hormones which relax the airway, cortisol (a steroid) and epinephrine (adrenaline), taper off. In fact, since both hormones have an anti-asthma effect on the body, synthetic versions are administered to break severe asthma attacks.
Help your child understand. Your 4-year-old doesn’t need a lecture about steroids, but you can encourage her by explaining that her symptoms feel worse because they are worse at night and that things will feel better in the morning.
4. Allergens in Bedroom
Their bedroom may make things worse. Unfortunately the air children breathe at night in their rooms may host common allergens including pet dander and dust mites which can set off a reaction.
Learn more about allergies. Ask your doctor what you can do to minimize the chance of setting off a reaction. Ask about humidifiers. Make sure you dust and vaccum (without them in the room) to clear out the mites.
Comfort Ideas for Nighttime
In addition to your pediatrician on speed dial, it may be possible to ease your child’s pain and illness at night by keeping these items close at hand.
*Compassion, patience, and lullabies
*Rocking chair, ice pack, and soft music
*Children’s antihistamine
*Children’s pain reliever
*Humidifier
*Ear drops
*Popsicles
*Thermometer
*Saline nose spray
*cheerful storybooks
*hot water bottle
Good luck, and remember your children will forget much of their childhood but never those times you were there tenderly caring for them when they felt miserable.
M. Ranard has a husband, two children, and a master’s in counseling. Visit her at hellolovelychild.blogspot.com
Resources:
Asthma and Allergy Foundation of America
www.aafa.org/
American Association of Chronobiology
www.aamcc.net/
