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Friday
Jun212013

"Sleeping Through the Night"

One of the most difficult sleep issues facing young parents is babies and children waking in the night.  For most of the first 4 months of life, babies have not developed the mature sleep rhythms which allow them to sustain sleep for a long period at night.  After six months of age, however, it is reasonable for parents to expect that their babies would be able to stay asleep for most of the night.   Unfortunately, sustaining sleep at night is a learned behavior, and most babies need their parents’ help to develop this skill.  Let’s look closer at this very common but trying dilemma.   

Why do babies and children wake in the night?  Babies and children usually awaken as they come out of deep sleep into an “arousal.”  All human beings (adults and children) have arousals during sleep.  They occur as we cycle through stages of sleep and can happen every hour and a half to two hours or more frequently. 

When you are in deep sleep or if you are a very good sleeper, you may not even be aware of these arousals.  However, if you are a light sleeper (and almost all new moms fall into this category), you may awaken during these arousals, especially in the second half of the night.  All who struggle with sleep must learn to go back to sleep when this happens.  Babies or children usually need their parents help to do so.

Why are there babies and children who wake in the night and those who don’t wake or wake less often?  The answer generally lies in two realms.  The first is that of a child’s individual style.   Sensitive or “intense” children more often need their parents’ help in settling or soothing to sleep.  The second is related to sleep associations.  Everyone has these associations: they are the things or behaviors present when we fall asleep. 

Adults have routines which include sleep associations.  Examples of such routines are: 1) change into pajamas/brush teeth/read in bed/close the bedroom door halfway/sleep on back or 2) take a shower/change into pajamas/turn off light/sleep on stomach.

Sleep associations for children usually fall into two categories: 1) something that a baby or child does or needs to do to fall asleep on her own or 2) something that a parent or another adult does or provides to help a baby or child to fall asleep. 

Associations that depend on an adult are essential and appropriate in the first months of life, but become less helpful as babies mature.  Sensitive or “intense” children are more likely to develop sleep associations involving a parent to bring about sleep. 

The following are examples of common sleep associations. 

ASSOCIATIONS THAT HELP BABIES/CHILDREN FALL ASLEEP ON THEIR OWN:

·        Sleeping in a certain position (once they can find those positions on their own)

·        Sleeping with a favorite object

·        Sleeping with lights off

·        Sleeping with door closed

·        Sleeping with a fan or sound machine

ASSOCIATIONS THAT REQUIRE A PARENT’S OR ANOTHER ADULT’S HELP:

·        Nursing or drinking from a bottle to fall deeply asleep

·        Being rocked until deeply asleep

·        Being sung to or cuddled until deeply asleep

·        Having music playing until deeply asleep

Studies consistently find that babies and children who learn to soothe themselves to sleep because they are put to sleep awake or drowsy, sleep better than those who are put to bed already asleep.  Sleeping “better” refers to being able to sustain sleep through arousals and thus, reaping the benefits of healthy sleep. Growth hormone is released during sleep, stimulating tissue growth and repair.  Sleep is also crucial for brain development, for the consolidation of knowledge, and for overall good health.

How does one help a baby or child learn to self-soothe? Research supports both the “camping out” method (in which the parent remains in the room until the child falls asleep) and the “checking in” method (in which the parent puts a child to bed awake and returns at regular intervals for reassurance and comfort) as effective and safe for teaching a baby or a child to fall asleep and stay asleep on her own. 

Both methods are based on a baby or child developing self-soothing abilities.  With these new skills, she will no longer need the sleep associations that require her parent’s or another adult’s assistance to fall asleep.  The associations that allow her to fall asleep and stay asleep on her own will enable her to sustain her sleep throughout the night.  She will no longer need a parent’s or another adult’s help to go back to sleep during the normal arousals in the night. 

Every parent approaches the work of helping a baby or child learn self-soothing skills in an individual manner.  Every baby or child and parent will respond differently to the process.  There are many variations of the methods described above.  Developing a plan that honors these differences and “feels” right to a parent is the basis of my work.

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