Introducing the board game that helps nurses promote healthy sleep in children

Sussex-based health visitor Ruth Silverman reveals how she developed a game to bolster healthcare professionals’ knowledge of sleep patterns and behaviour

Sussex-based health visitor Ruth Silverman reveals how she developed a game to bolster healthcare professionals’ knowledge of sleep patterns and behaviour 

The Sleep Game aims to promote good sleep

12-14 hours

Suggested time toddlers need to sleep per night, including daytime naps

Source: Royal College of Psychiatrists

The Sleep Game is the brainchild of at Ruth Silverman, specialist health visitor and locality manager for child development and disabilities at Sussex Community NHS Foundation Trust. It is a training board game for healthcare professionals working with children and families, including health visitors, school nurses, midwives, nursery nurses and children’s centre staff.

The game aims to help healthcare professionals improve their knowledge of children’s sleep patterns and can be used as part of continuing professional development as an update and/or refresher on sleep information. 

Ms Silverman has worked primarily with Focus Games to create this training resource. The company, which is based in Scotland, develop educational board games for use mostly in staff training in health and social care. 

Sleep clinics

‘During my time as a health visitor, I started running sleep clinics because there was such a demand,’ says Ms Silverman. ‘It is one of the most common problems that parents come to me with. Sleep has such a huge effect on children. It affects everything from their behaviour to their learning, attention and development.

11-12 hours

Suggested time preschoolers (three to five years) need to sleep per night

Source: Royal College of Psychiatrists

Ruth Silverman: ‘Sleep has such
a huge effect on children’

‘I became a specialist health visitor for children with neurodisability and found sleep is also a big issue for vulnerable children.

‘You do not get any particular training about sleep as a health visitor. So it became a passion of mine to find a way to address this training gap.’

In her specialist health visitor role, Ms Silverman attended two sleep training courses, including one run by Sleep Scotland. She found these offered an in-depth insight into the science of sleep, but the cost was prohibitive and it restricted the number of health visitors who could access this training. To address this, Ms Silverman ran a sleep awareness training course for around 40 local health visitors, nursery nurses and social care and family key workers.

‘However, the problem with this approach is it is not ongoing, I needed to offer something different where healthcare staff could learn on an ongoing basis,’ she says.

How to play the Sleep Game

The game is played in a similiar way to snakes and ladders, but with a sleep theme – players go up with the stars and down with the comets. The winner is the first to 100, or the first to 50 (for a shorter game). The rules of play are flexible – it can be played as a one-to-one game or as a team game.

Questions are split into blue (easier) and red (harder) and there are also trivia questions. An example of a blue question includes: suggest one pro and con of the gradual retreat technique to help a child self-settle; while an example of a red question can be: what is the circadian rhythm?


As part of her research, Ms Silverman surveyed healthcare professionals across the UK about their sleep training and found they lacked training around the subject of sleep to support families.

Topics covered by the Sleep Game include behavioural problems, monitoring sleep
patterns, the consequences of sleep deprivation and safer sleeping

Online training

To bridge this gap, she started offering online training through the Sussex Community NHS Foundation Trust’s learning gateway. Modules for this have been created and ratified by sleep experts and Ms Silverman hopes this will be available by the spring. 

During a conversation with a friend who is a burns specialist, Ms Silverman found out more about a game she had made with Focus Games. This gave her the idea of creating a board game all about sleep. Focus Games also felt this was something that would be beneficial for health and social care professionals.

Ms Silverman started by compiling initial questions around messages that she especially wanted to get across. For example, safe sleeping.

‘It is important that everyone who is working with young babies understands and promotes this,’ she stresses.

Topics covered by the game’s questions include:

  • Why sleep is important.
  • Sleep patterns and stages of sleep.
  • Recommendations on how to sleep.
  • Safer sleeping.
  • Monitoring sleep patterns.
  • Consequences of sleep deprivation. 
  • Techniques to encourage sleep.
  • Sleep problems for children with additional needs.

Relevant content

Ms Silverman kept in regular touch with Focus Games through the development to ensure the content was relevant. She also checked the content with a range of professionals.

9-10 hours

Suggested time teenagers need to sleep per night

Source: Royal College of Psychiatrists

‘I especially sought expert feedback on the breastfeeding, safe sleeping and sleep science content as this needed to be evidence-based,’ says Ms Silverman.

‘This included checking with a respiratory and sleep consultant at London’s Great Ormond Street Hospital and a renowned sleep expert who travels around the world lecturing on the topic.

‘I also consulted with an infant feeding specialist, a specialist paediatric nurse at Sussex Community NHS Foundation Trust, to check the accuracy on the sudden infant death content.’

Word of mouth is already spreading about the game in England and Scotland. Ms Silverman would also like to promote the game in Wales and has had some interest from the healthcare professionals in the United States.

In October 2018, Ms Silverman attended the Somnex Sleep Show in London and the Community Practitioners and Health Visitors Association’s Conference in Bournemouth to help increase professional awareness about the resource.

The game launched in July 2018 and retails at £60 plus VAT and postage and packing from Focus Games, and is also available in French and Spanish versions.

Three ways to help ensure young children sleep soundly

Ruth Silverman shares her top three tips for health visitors and school nurses:

1. Consistent bedtime routine – ‘It is important for children to have a regular rise time, even at weekends. This will help to strengthen the wake/sleep cycle’

2. Having an awareness of safer sleeping practices is vital – ‘Healthcare professionals should have an understanding of safer sleeping at every stage’

3. Accessing early support – ‘As soon as parents identify that their child is struggling to sleep in any way, they need to access support before it becomes an ingrained problem’

Further information

  • Follow the Sleep Game on Twitter and order the game here

This article is for subscribers only