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Sleep & Regulation Clinical Protocol

Deep Pressure Evening Routine

Time per day 10–15 minutes
Difficulty Easy
Ages 2–14
Materials 3 items

What this is for

A predictable sequence of deep-pressure input in the hour before bed, to help a seeking or restless body settle toward sleep. Deep pressure through muscles and joints is organizing input for many children, and delivering it at the same point in the evening builds a cue the nervous system can rely on.

What you’ll need

  • A firm cushion or couch pillows
  • A blanket your child likes
  • Optional: weighted blanket sized for your child

Step by step

1

Dim the room first

Lower the lights and turn off screens before you begin. The routine works best when the environment is already winding down.

2

Start with firm, slow pressure

With your child lying on their bed or the couch, press firmly and slowly down their back, arms, and legs with flat palms. Firm and slow — never tickly. Watch their face and body for what they enjoy.

3

Try the cushion sandwich

If your child enjoys it, let them lie between two couch cushions and apply gentle, steady pressure on top. Keep their head free at all times. Many children ask for this again — follow their lead.

4

Finish with a snug tuck-in

End with a firm tuck-in or, if you use one, a weighted blanket appropriate for your child’s size and age. Keep the sequence the same every night.

5

Keep the order identical

The power is in the predictability. Same order, same words, same ending, every night.

What to watch for

The right response is a settling body: slower movement, deeper breathing, easier stillness. If your child becomes more aroused, giggly, or seeks rougher input, reduce the intensity and slow your pace — you may be providing alerting input rather than calming input.

When to stop and call your practitioner

Stop and speak with your practitioner if your child consistently resists the routine, if pressure anywhere causes discomfort or pain, or if sleep does not improve after three weeks of consistent use. Never use a weighted blanket with an infant, and never one your child cannot remove independently.