Setting the Stage for Healthy Sleep

Sleep.  As parents, we sometimes feel we can never get enough of it.  We birth a child and suddenly we come to understand why sleep deprivation is used on prisoners of war.  We stop longing for those Saturday mornings when we could sleep until 10 a.m., and instead pray for at least 6 consecutive hours of uninterrupted dreamy bliss. 

Why is sleep so important to us?

Well, for one thing, we feel better when we're rested.  When we're not rested, we're more likely to feel depressed (Ross, Murray, & Steiner, 2005).  We're less optimistic in our outlook.  We may isolate ourselves as our desire for social interaction declines.  We may feel more bodily aches and pains (Hack & Mullington, 2005).  And, our decision-making and communication abilities are compromised (Harrison & Home, 2000).

Some of you may be thinking that these are just some of the necessary sacrifices we must make as parents.  We can't ignore our children when they're awake at night.  It is our job to tend to them and make them feel secure.  If that means giving up uninterrupted sleep, then so be it.

This is true.  But prolonged uninterrupted sleep can actually compromise our ability to care for our children.  When sleep-deprived, it's very difficult to maintain patience for a bundle of energy 1-year-old.  It may also be difficult to maintain the self-sacrificial attitude for more than a few months.  For some, resentment may rear its ugly head.  The point is, sleep is important for parents.

But it's also important for children.  Very important.

For children, the very development of their brains may be adversely affected.  For this reason -- and I'm going to show my bias here -- sleep should be a priority equal to feeding.  Not only can cognitive functioning be somewhat inhibited as the brain is unable to make necessary neuronal connections due to a lack of sleep, but later behavioral problems have also been linked to sleep deprivation in the first year of life (Sher & Zuckerman, 2005).  Not to mention that fact that a well-rested child is simply much more pleasant to be around!

But sleep is such a natural state.  Children will sleep when they're tired.  Right? 

Not necessarily.  Turns out that children love to be with us so much, and are so excited about being awake and alive, that they'll fight sleep.  This is why they may need our help in developing good sleep habits.  In fact, children whose parents pro-actively assist them with developing good sleep habits have better sleeping patterns than infants whose parents are not proactive (Wolfson, Lacks, & Futterman, 1992).

However, it's pretty obvious we can't force our children to sleep.  But what can we do to set the stage for good sleep habits?  Here's a little list compiled from many different parenting books I've read over the years.  If you have more, please add them in the comments!

Recognize when your child is starting to get drowsy.  Signs include red eyes, rubbing eyes, yawning (dead giveaway!), a glassy look in their eyes, drooping eyelids, less intense sucking (if breast or bottle feeding), a slow-down in activity, or even a red forehead (which was always a sign Tod-lar was feeling tired!).

Put your child down for sleep when you see the drowsy signals.  This is how you let the child determine the sleeping schedule.  If you wait too long after this period to put them down, they become hyperactive if a toddler, or cry inconsolably if an infant. 

(I have a friend whose 3-year-old wouldn't nap.  He went to bed at 8 p.m. and was up at 6 a.m. everyday.  My friend had a very hard time putting him down for bed.  When I asked her about drowsy signals, she watched for them and told me they occurred around 6:30 p.m.  I told her to put him to bed at that time.  She thought I was crazy.  After sleeping that night from 6:30 p.m. to 6:30 a.m. without any trouble putting him down or any night waking, that became his new schedule! And let me tell you, his disposition became much more pleasant all around in the afternoon!)

Don't bottle-feed or nurse them to sleep.  What?!  That's crazy!  A lot of books suggest this, and here's my take on it:  It's okay to do this in the beginning.  BUT, if this habit goes on for too long, well, then you may be nursing your kid to sleep every day and night for years.  No kidding.  I have friends who are doing this now.  One loves it.  The other doesn't, and now she feels "trapped" and doesn't know how to get her 3-year-old to sleep without it. 

Decide for yourself how long you want this habit to go on, keeping in mind that the longer it does, the harder it will be break!

Establish a bedtime routine.  The environmental signals of bathing, story-time, whatever, really help them to "know" it's time for sleep.  You may find them showing even more drowsy signals at this time.  And, routines can be established for even young infants. 

Put them down when awake.  Don't try to rock them to sleep and then put them down.  This rarely works anyway!  Let them learn how to put themselves to sleep.

Don't use a binky.  Again, you may want to use one in the first few months of life, but try putting them down without it, because eventually a) they'll have to give it up anyway, and b) you'll find yourself waking in the night to put it back in their mouths!  Again, let them learn how to put themselves asleep.

Don't respond to every little grunt or cry.  This was actually a mistake I made when my son was only two months old.  I responded to every noise he made until I realized I was waking him up!  Even if they are momentarily awake, give them a minute or two (or more if they're older) to see if they can put themselves back to sleep. 

If you have any other suggestions for developing good sleep habits, please share them!

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Haack, M., Mullinton, J.M.  (2005).  Sustained sleep restriction reduced emotional and physical well-being.  Pain, Vol. 119(1-3), 56-64.

Harrison, Y., Home, J. A. (2000). The impact of sleep deprivation on decision-making: A review.  Journal of Experimental Psychology: Applied, 6, 236-49.

Ross, L.E., Murray, B.J., Steiner, M. (2005).  Sleep and perinatal mood disorders: A critical review. Journal of Psychiatry & Neuroscience, Vol 30(4), Jul 2005. pp. 247-256. 

Wolfson, A., Lacks, P., Futterman, A. (1992).  Effects of parent training on infant sleeping patterns, parents' stress, and perceived parental competence.  Journal of Consulting and Clinical Psychology, Vol 60(1), Feb 1992. pp. 41-48.

Comments

[Kat O+]

I'm not a routine follower as a rule but bedtime is one of the few times in our house where we stick to a routine. It's like magic - one minute my son's refusing to say goodnight to Thomas (the Tank Engine), and the next minute he's closing his bedtime book early so he can get to bed. One thing I learned about the routine is to alternate between Mum and Dad. That way, you're not trapped into being the only person who can help your child to bed. This is especially important if you travel for work and may need to be away overnight. Also, it's a wonderful bonding experience that all parents should enjoy.

I have a question, too. My child sleeps from 9pm to 7:30am (give or take half an hour) with a midday nap of between 1.5-3 hours. Is this sufficient? We have great difficulty following a routine where he sleeps before 8:30pm simply because of the time it takes to feed him, feed ourselves, play with him and bathe him (we get home from work no earlier than 7pm).

[Laura S.]

Kat -- you are so right! Both parents should definitely be involved in the night routine so one parent isn't always "trapped" into doing it. Thanks for that reminder!

Regarding your son, sounds like he's getting at least 12 hours of sleep per 24-hour period, which is good. Kids around this age generally sleep around 13 hours in a 24-hour period (your son is 2 right?). I guess the question is, do you notice a difference in his behavior when he gets 13 as opposed to 12 hours of sleep? If you don't notice a difference (he's not cranky or overly whiny on 12 hours), then he's probably getting enough sleep. If he is more cranky, then he may be better off with 13 on a more regular basis.

To us, it seems like 1 hour shouldn't make a difference, but to these little guys it can!

[Kat O+]

Phew! Thanks, Laura. :-)

[shiso mama]

sleep was a really huge issue for us, because our baby seemed to have difficulty falling asleep from day one. he's been sleeping really well for some time now, but it was a tough battle to get here.

i don't have anything new to add to your list, but just wanted to mention that for us, the most difficult component of sleep training was getting our baby to fall asleep on his own -he rarely if ever drifted off to sleep without a long bout of crying, even in the days right after birth, so it didn't feel possible to ever just set him down awake. maybe it would be helpful to others to hear some advice on how to teach babies to fall asleep on their own?

[Laura S.]

Shiso Mama, you bring up a really good point! We'll be covering that with our next couple of installments on this sleep series.

[Krista]

I have heard that since babies have no way of communicating their stress, that a period of crying can be helpful at the end of the day. THIS IS NOT LETTING THEM CRY IT OUT. YOU ARE NOT LEAVING THE CHILD ALONE IN THEIR ROOM. After attending to the baby and making sure that all their needs are met, full tummy, dry bottom, etc. sit and hold them in the rocking chair in a dimly lit room. Rock and hold them close, but do not have any music playing. They may cry for a little while (I know, even one minute is an eternity when your child is crying) but eventually will "talk" about their stress and calm down. Then you can transition them to bed, or for one last feeding, etc. I haven't had the chance to try this since I learned about it after our son was already a toddler. Of course not all babies will need this, but some seem to feel the stresses of their day more deeply than others.

[hazela]

The only other comment i would make is that swaddling and shsshing eased my 11 week old into sleeping on his own at around 6 weeks, and we put him in the crib for his night sleep almost from day one (mainly becuase he was almost too big for the bassinette!), with two rolled blankets below his arms so he wouldn't move around and wake himself up.
I used the 'Baby Wisperer' book a lot for working out how to read the signs (PIP was not around then :>))
I know I found the lactation consultants excellent at helping with breast feeding, but what the world needs now is 'sleep consultants'

[Kate]

My mommy friends and I have been pondering this -- what are the reasons why child should give up a pacifier? Is there any downside to just waiting until they lose interest? (Assuming they don't use when awake and so it isn't getting in the way of language development.) Thanks!

[Laura S.]

Kate, this is a good question. I used a pacifier with my first son. The problem I ran into was that when it fell out in the middle of the night, he'd cry if he couldn't find it, and more often than not, he couldn't. I even tried clipping the dang thing to his pajamas, but it'd still get lost in his crib! So, in the end, I had to just take the thing away from him.

Also, more likely than not, it may be a loonnnnngggg time before they actually lose interest in it -- especially if they're using it to fall asleep.

[Kristen]

These were great - I used the majority with my kids and I can attest to the fact that they definitely work.

I was intrigued about your friend with the three-year-old going to bed at 6:30 p.m. - we're having some issues with Quinn, and this makes me wonder if I should try moving his bedtime up dramatically (currently 8 p.m. to 6 a.m., with a 1.5-hour nap most days).

On the pacifier, I WISH we had had the wherewithal to remove it from our youngest when he was a baby - unfortunately at the time we were sort of in survival mode since we had a high strung 18-month - two-year-old living among us. But now, our youngest is 3 1/2, and has not yet decided he's tired of the pacifier. He never has it during the day, but he ALWAYS sleeps with it. Argh.