The Importance of Sleep

Episode 2: The Importance of Sleep

Sleep can be hard for both the patient and family when a child is sick. Sleep problems are common in children with serious illnesses. Trouble sleeping could be caused by treatment, medicines, or the effects of illness. But getting sleep is very important for healing and recovery.

In this episode, Erica Sirrine and Valerie Crabtree talk with parents Andy and Caitlin about how they managed to get sleep when their son Max (now age 5) was going through treatment for Langerhans cell histiocytosis (LCH). Andy and Caitlin explain how they reached a compromise on sleeping arrangements at home. Valerie emphasizes that there is no playbook to figuring out sleep for your family. The group talks about the pressure to do things perfectly, and the joy of a simple nighttime song. Listeners will hear expert advice on routine, screen time, using melatonin as sleep aid, and co-sleeping.

A special thank you to our host, Erica Sirrine, director of social work at St. Jude; our expert Valerie Crabtree, vice president of Psychosocial Services at St. Jude and a pediatric psychologist who specializes in sleep; and parents Andy and Caitlin.

This episode was recorded April 24, 2025.

Learn more about Max’s diagnosis of Langerhans cell histiocytosis (LCH) on St. Jude Care & Treatment.

Read about one patient’s sleep success story on the Together blog.

St. Jude does not endorse any branded product or organization mentioned in this podcast.

Episode Transcript

Narrator (00:02) 
A child's diagnosis of cancer or another serious disease is difficult. Families, guardians, and loved ones experience a range of emotions and often need support related to their child's diagnosis and treatment. St. Jude Children's Research Hospital brings you Caregiver Share, a St. Jude podcast. SHARE stands for support, honor, advise, reflect, encourage. In this series, you'll hear stories and insights directly from the experiences of St. Jude families and care providers. 

Erica Sirrine (00:38) 
Sleep is important all the time, especially when a child is sick. But unfortunately, treatment can often disrupt sleep for a patient and their adult caregivers. I'm Erica Sirrine, the Director of Social Work at St. Jude Children's Research Hospital. I have the privilege of hosting this episode of Caregiver Share. 

Today, I'm talking with caregivers Caitlin and Andy about how they managed sleep problems while their son Max was undergoing treatment for a serious illness. We're also joined by sleep expert Dr. Valerie Crabtree. Valerie, can you tell our audience a little bit about yourself? 

Dr. Valerie Crabtree (01:14) 
Sure. I'm Valerie Crabtree. I am Vice President of Psychosocial Services at St. Jude and a pediatric psychologist who specializes in sleep. I'm really excited for us to be able to talk about sleep today. I think it is an under-recognized area that is so important, particularly for children who are ill. And I'm looking forward to us talking about how we can help children and their caregivers get better sleep. 

Caitlin and Andy, could you introduce yourselves and tell us a little bit about your journey? 

Andy (01:47) 
Hey, everybody. My name is Andy. 

Caitlin (01:49) 
And I'm Caitlin. 

Andy (01:51) 
And we have an awesome five-year-old son. His name is Max. 

Caitlin (01:55) 
Two years ago, when he was three, he was diagnosed with cancer called Langerhans cell histiocytosis, more commonly known as LCH. He was having headaches and we ended up discovering the cancer. The tumor was located in his head—not in his brain, but behind his eyes and his sphenoid sinus. 

It was putting pressure forward on his head, and he was able to have surgery and then he went through one year of treatment for his cancer, consisting of steroids and chemotherapy. And as of March 2024, he is in remission. 

Erica (02:32) 
Thank you. I'm so glad that you're both here today. Obviously, the topic of this episode is sleep. And so I think it might help us to start by just figuring out why sleep is so important. Valerie, can you tell us a little bit about that? Why does it matter? 

Dr. Crabtree (02:47) 
Sure. Well, sleep really matters for everyone. It underlies all aspects of our health, both physical and mental. And when we think about a child who is ill and the impact on their sleep—either because of treatments that they're receiving, being in the hospital, or feeling ill—we know that they are at increased risk of difficulty with their sleep. 

And when children are not sleeping well, it can impact their mood, their learning, their ability to manage the frustrations of the treatments they're undergoing, their behavior, as well as their physical health. It can impact their experience of pain, how well they recover from an illness, and what their immune function is like. 

We know that sleep impacts the quality of life not only for the child, but also for their caregivers. When children do not sleep well, their caregivers do not sleep well either. 

Erica (03:43) 
Right, and we're going to talk a little bit about that later because there's probably a lot of caregivers listening who are thinking, “Well, I came on here to learn about my child's sleep, but I actually am not sleeping myself.” So we'll talk a little bit and hear more about how the two of you managed that while Max was sick. 

But first, I'm thinking that when a child is receiving treatment for a serious illness, their sleep-related needs are not usually a priority, right? Their treatment is the priority, along with medical appointments and other concerns. So… Caitlin and Andy, can you just share a little bit about how your focus during treatment turned to Max's sleep, and maybe even some things that made sleep challenging for him while he was receiving treatment? 

Andy (04:26) 
So certainly there really was no anticipation of how deep this was going to go as far as the treatment. And when he went through his first couple of chemotherapy treatments with the steroids, he was not sleeping at all. 

Honestly, my sleep was not a concern. It really wasn't. It was about getting him well and getting him to sleep as best as he could. So we compromised as a parent couple, figuring out a plan to alternate sleep with him and by ourselves to get the rest we needed. 

And honestly, it worked out for a period of time. Like I said, my sleep was not a priority. It really wasn't. My priority was making sure that he was getting the rest that he needed. Our bodies need to sleep to heal. 

And honestly, that was my focus for him. I know how important sleep is for Caitlin, though. After about three or four months into things, it transitioned so Caitlin got more sleep while I stayed with Max. 

Caitlin (05:46) 
Right. We both slept in separate beds, and Max would alternate with us for probably the first four months. I did not know that there were resources to help us. Then we connected with Valerie, which helped us come up with a plan that worked out for all three of our needs—Max, Andy, and myself—because Andy and I have different sleep requirements. 

I unfortunately require more sleep. I cannot function on little sleep, and I'm not a good wife or mother when I am exhausted all the time. To be the most present mother for Max, I needed more sleep. 

With Valerie, we came up with a solution that worked out for all three of us: Max could sleep, Andy felt comfortable, and I was able to get the rest I needed to be present for my family. 

Erica (06:42) 
Caitlin, can you tell us a little bit about how you reached the plan for Max, and if you and Andy always agreed or had any concerns about his sleep during his treatment? 

Caitlin (06:54) 
Yes. So Andy and I did not agree on our sleeping arrangement. Andy felt very strongly about co-sleeping, and I felt very strongly about independent sleeping. 

So we saw Valerie. One thing I really want to impress on the listeners is that my biggest concern was that co-sleeping was not developmentally appropriate or healthy. When I asked Valerie about it, she told us that it is not harmful. 

That brought me such peace of mind—that this stigmatized sleeping habit of co-sleeping at four years old, at the time, was okay for us, and it was okay for Max. Knowing it was not harmful really gave me better sleep because I had peace of mind. 

I think it gave Andy peace of mind too, knowing that he could have this closeness in the evenings and at nighttime with Max, be physically there for him, and still have a successful sleeping schedule and habit. 

Erica (08:03) 
Yeah. Valerie, can you tell us a little bit about that? Because I think that's a question that comes up a lot for families, especially in a hospital setting. 

Dr. Crabtree (08:10) 
Yes. What I love about this example is that the two of you disagreed about it, but neither of you were wrong. That happens a lot in parenting—being able to come to a resolution when you don’t necessarily agree on the approach. That’s not easy or simple. 

In Max's case, he was four, so we didn’t have to worry about safe sleep. He was at home, not in the hospital. Sometimes, depending on hospital policies or the child’s treatment-related needs, caregivers can’t sleep in the bed with the child. 

But in this case, this was a decision you were making as a family. Different families make different choices. As long as it's healthy for the child, it can be the right thing to do. 

Erica (09:02) 
And so I wonder, Valerie, if you can share a little bit about the uniqueness of each family—and how what might work for one family doesn't necessarily work for another when it comes to sleep. 

Dr. Crabtree (09:13) 
Sure. Many times caregivers feel pressure to be the perfect parent. And when a child becomes ill, that pressure ramps up even more. But families differ in how they approach sleep. 

For infants under six months, they need to sleep on a surface by themselves, not share a bed with an adult—because it isn’t safe and increases risk for SIDS. But in older children, some families want them in the bed with them, others want them to sleep independently. Neither is right or wrong. It’s about what works best for that particular child and caregiver. 

It can become challenging if a caregiver wants the child to sleep independently, but the child is resistant, has a more challenging temperament, or is sick and needs nighttime care. That could mean medication, fever monitoring, or pain support. 

A caregiver may want to be physically present out of worry, or simply to share closeness and warmth with their child during a difficult time. 

Erica (10:58) 
I think a lot of times we hear that caregivers feel pressure to do it a certain way—like there is a “right” or “wrong” way. But you’ve told us that actually, a right or wrong way doesn’t exist. 

Caitlin and Andy, can you tell us what ended up working out best for your family to meet not only your own sleep needs, but Max's needs during treatment? 

Andy (11:18) 
Well, I think you're exactly right—there’s no playbook for this. So to the parents listening, you have to understand that you must use the plan that works for you. 

What’s working for us right now is that Max and I are sleeping together. For me, when we started sharing the same bed, it was partly guilt. I couldn’t believe that he was sick, and my way of coping was to stay close to him, hoping it would help him get better. 

And I actually sleep pretty well now, knowing that he’s right next to me and that he’s in remission. Ultimately, we hope to transition him to sleeping on his own, but for now, this works for me and for him. 

What’s really important is that Caitlin is getting her sleep away from this. There’s no “one-size-fits-all.” Do what works for you and your family—what lets everyone get the rest they need and keeps the child comfortable and happy. 

I even joked yesterday about how uplifting it is to wake up with Max poking my face or pinching my nose at six in the morning, even though I’d rather sleep until seven. It raises my spirits knowing he’s happy and right there with me. 

Caitlin (12:57) 
Yes, thank you, Andy. I think there’s stigma around family sleeping arrangements. 

Andy and I have been married 10 years. About a year before Max’s diagnosis, I realized I needed my own bed—I wasn’t sleeping well at all. I’m a very light sleeper, and even with earplugs and white noise, it wasn’t enough. 

Andy, on the other hand, feels extremely close and loves that closeness at night, while I cannot tolerate it for sleep because it wakes me up. 

So it happens to be a really good solution: Andy can have that closeness with our children, and I can get the rest I need. It works well for us as a couple and as parents. 

Dr. Crabtree (13:51) 
I’d like to add that many couples choose to sleep in separate beds. People often don’t talk about it because there’s a belief that all couples should sleep in the same bed together. But that doesn’t work for everyone. 

What’s really important is making the choice intentionally, not just as a reaction to challenges. I think the two of you have done that intentionally, recognizing what works for your family. 

This highlights how crucial open conversations and communication are—especially in the very difficult times of parenting a child who is ill. 

Erica (14:43) 
Yeah, it sounds like collaboration is key when you’re experiencing something like this. You all are a beautiful example of that—working together to meet your needs and Max’s needs during such a difficult time. 

I wonder, too: some people listening might be thinking, “Okay, but this solution wouldn’t work for me.” Are there other strategies? Valerie, are there practical strategies parents or caregivers can use with children to help them if they're having sleep difficulties? 

Dr. Crabtree (15:20) 
Absolutely. One thing we haven’t talked about is that you, Caitlin and Andy, could lean on each other. For single caregivers without a partner to trade off with, it’s really important to enlist the help of family or friends. Trusted adults can step in to give respite so that the caregiver can get some rest. 

Consistency is also very important, though challenging when a child is ill. There are changes in schedules, hospital stays, medications, pain, and side effects. But instilling as much consistency as possible can help promote healthier sleep. 

That can mean keeping a consistent bedtime, talking with doctors and nurses about timing of nighttime medications, maintaining the same sleep location whenever possible, and creating a bedtime routine—even a very short one—that’s consistent across settings. 

If a child sometimes sleeps at one parent’s home, sometimes at a grandparent’s, or in the hospital, the routine should still look the same. Maybe it’s getting a drink, having a short story, some snuggle time, and lights out. 

Another key point is helping a child distinguish day from night. When kids are sick, that’s harder because they aren’t in their normal routines. Caregivers can open blinds for natural light, let kids outside if possible, keep them active in the daytime, and then dim lights and quiet the house at night. 

In the hospital, this is even harder. Caregivers can work with nurses to “bundle care”—grouping vital checks, diaper changes, or other needs together to minimize nighttime interruptions. White noise machines can help mask sounds from hallways or nearby rooms. Even small things like adjusting when the trash is taken out can help protect a child’s nighttime sleep. 

Erica (19:03) 
As I’m hearing you talk about home versus hospital and consistency, I’m thinking about nighttime routines. Caitlin, you shared something with me earlier that I thought listeners might benefit from. Could you share what your nighttime routine with Max looked like? 

Caitlin (19:28) 
Sure. We don’t usually do a bath or reading at bedtime, which I know is typical. A bath excites my kids, and they don’t like reading at night because it delays bedtime. 

What they do love is to be rocked and sung to. So I would rock Max in a dark, cool room with the white noise machine on, and I made up a bedtime song to the tune of Twinkle, Twinkle, Little Star—all about Max. He started asking for that song every night. 

Even now at five years old, he still likes to be held like a baby, rocked, and sung to, even though he’s too big! We make it work, and it’s become our nighttime connection. 

Erica (20:38) 
Yeah, and it’s a beautiful way to connect with him. It sounds like each of you had unique ways to connect with Max during his illness and treatment—connections that continue today. 

Caitlin (20:52) 
Yes. When he’s in the hospital, he also requests that song. I’ll dim the lights, pull the curtains, turn on the little battery-powered white noise machine, and sing to him while rubbing his head. It keeps the same comforting routine even in the hospital. 

Erica (21:15) 
I love that—and it’s also a way to make the hospital feel safer and more comfortable for him. 

We haven’t touched on this yet, Valerie, but parents often ask about screens. Sometimes the tools we use to help kids sleep—like white noise apps—are on electronic devices. Can you talk about balancing screen time, especially when a child is sick, and how it might impact or aid sleep? 

Dr. Crabtree (21:51) 
I talk with many caregivers who had strict screen time limits before their child got sick. But once their child became ill, those rules often went out the window. Kids aren’t feeling well, they’re bored, they’re waiting around in hospitals without their usual routines. It’s natural for them to have more screen time. 

It can impact sleep, though. For a while, we thought the blue light was the main issue, but recent evidence shows it’s more about the type of activity. Many screen activities are highly addictive—like endless social media scrolling or engaging multiplayer video games. For sick children and teens, those games may also be their only way to connect with friends, so it’s not realistic to forbid them entirely. 

What caregivers can do is manage when and what screen activities happen. More stimulating activities should be earlier in the day. As bedtime approaches, it’s better to shift to something with a natural ending point, like watching one episode of a show, rather than something endless. When the episode ends, it’s easier to transition to bed. 

Another frequent question is about melatonin. Sometimes caregivers think: “Stay on screens and then just take melatonin to balance it out.” But melatonin isn’t like a sleep pill. It’s important to talk to the child’s medical team about safety, dosage, and timing. 

Also, melatonin isn’t FDA regulated. Two bottles both labeled “1 mg” could actually contain very different amounts—or even extra ingredients like CBD. If caregivers use melatonin, they should follow the medical team’s advice closely and check labels to ensure it’s only melatonin. 

Erica (25:46) 
I’m glad you brought that up. I imagine many caregivers listening are thinking, “This applies to me, too, not just my child.” The strategies you’ve suggested could benefit both kids and adults. 

Andy and Caitlin, you shared a bit earlier about your own sleep needs—Caitlin, how you needed more sleep, and Andy, how you were willing to sacrifice yours. Were there any other ways you cared for your own sleep needs during this time? 

Andy (26:33) 
What did we do before screens and video games to help kids sleep? I’m an older father—do you remember? Did we have a warm glass of milk, read a book, or sing a song? 

That’s how parents did it years ago, and maybe that’s why I still rub Max’s head to help him sleep. I may have developed that closeness with him from my own parents—when I was sick, they’d comfort me the same way. 

Caitlin (26:57) 
I loved going to bed as a child. I never had problems with sleep. 

Andy (27:03) 
Exactly. Back then, my parents would rub my head and that was it. Now I find myself doing the same thing with Max, especially after hospital procedures when we’d share a bed. Maybe that’s where my closeness with him at night comes from. 

It’s interesting—we’re talking about melatonin and screens, but what did we do before? 

Erica (27:53) 
Great questions. 

Caitlin (27:56) 
My dad sang to me—he even made up a song with my name in it. It only had three notes, but it worked. 

Andy (28:03) 
There you go—that’s how our song for Max was born. 

Erica (28:07) 
Carrying on the tradition. 

Dr. Crabtree (28:08) 
It’s multi-generational. 

Caitlin (28:10) 
Yes—except my kids don’t like to go to sleep, but I did. 

Andy (28:15) 
I’ve also learned to function with little sleep. Working in New York City, I’d get by on three or four hours a night. It’s catching up to me now, but I still don’t need much rest. If staying with Max or my other son helps them, I can put my sleep aside and catch up later. 

Erica (28:53) 
I appreciate that you’ve both shared today that there isn’t a specific playbook to follow. What works for one child or family might not work for another. 

It’s about collaboration, communication, and leaning on your circle of support to meet both your needs and your child’s needs. 

You also shared with me earlier that although Max is now in remission, the worries don’t just go away. Healing—both physical and emotional—takes time. As we close today, could each of you share something you’ve learned about yourself or your family through Max’s illness and treatment? Maybe one way you’ve found hope or joy, even when it felt like everything was falling apart? 

Andy (30:00) 
For me, the biggest solace is that this happened when Max was so young, and he probably won’t remember much of it. As he gets older, we’ll have that conversation with him, but for now, he can just focus on being a little boy—playing with friends, doing the things three-to-five-year-olds do. 

Knowing that he doesn’t fully understand what he went through gives me peace of mind. 

Erica (30:41) 
Thank you. 

Caitlin (30:43) 
Some advice I received right before Max started treatment was: “This is going to become your new normal.” I was scared, nervous, and unsure how we’d manage. But it did become our new normal—something we could achieve. 

Even now, life is different. Max is blind in one eye, and although he’s in remission, there are still therapies and treatments. But that advice has stayed with me: when I face future challenges, I know I can adapt, just like before. 

Life can still be beautiful, even though it’s more difficult. It’s our new normal, and we love our kids through it. 

Andy (31:45) 
I think you’re right. This all happened so fast that we just had to make it work as a family. We compromised, met the demands of treatment, and now—even though we’re out of the woods—we’re still in a healing period. 

We’re moving forward one day at a time. Inch by inch, we’re getting through. 

Caitlin (32:20) 
Well… life isn’t always a cinch, but yes, one step at a time. I also want to acknowledge that Andy and I had extreme privilege. We had resources to help our child. We had Valerie’s guidance on sleep. We lived only 30 minutes from the hospital. 

Not all families have that, and I don’t want to come across as if we “know it all.” I think our success comes from having access to resources, and I’m grateful for that. 

Erica (33:11) 
I appreciate your vulnerability and intention in sharing today. I know listeners will take pieces of your story and apply them to their own journeys. 

I’m grateful to have had you here, Caitlin and Andy, and you as well, Valerie. To our listeners, thank you for being with us. I hope today’s episode uplifted you and inspired hope. 

Even in those moments where it feels like, “There’s no way I can do this”—hear Caitlin and Andy’s story, and remember you can take it inch by inch, day by day. 

Narrator (34:13) 
Thank you for listening to Caregiver Share, a podcast lovingly brought to you by Patient Family Centered Care and Psychosocial Services at St. Jude Children’s Research Hospital. 

Please subscribe, leave a comment, and share this podcast with others who may benefit. Visit stjude.org/caregivers/share for show notes and educational links. 

This podcast is for informational purposes only and does not provide medical advice or services, nor establish a patient relationship with St. Jude. The opinions expressed belong to the caregivers. Your personal experience may differ. For health concerns or treatment options, please consult your child’s medical team. 

Season 3 Episodes