Child Sleep Problems Basics
Child Sleep Problems Basics
Gary Feldman (Medical Director, Stramski Disorders Center, Miller Children's Hospital ) gives expert video advice on: Why won't my child fall asleep at bedtime?; What are the effects of parental sleep loss?; What is the best way for a parent to cope with sleep loss? and more...
Why do children develop sleep problems?
When we wake up naturally in the middle of the night, for most of us, as adults we may roll over, we may move the pillow, we may do something, again, we may, kind of, recreate the habit that we had when we went to sleep initially, and we put ourselves back to sleep. Now, for a child, if their sleep habit is, say, drinking a bottle or nursing or having the TV on, and they wake up naturally, which can happen multiple times a night, they wake up and they see that Mommy's not with them anymore, or where is the bottle that they were used to? They actually cannot put themselves back to sleep without having those additional sleep associations. And, so that's when it can become a problem – because a natural waking up at night, the child is unable to put themselves back to sleep because they don't have all those peripheral, habitual things that they're used to.
Why won't my child fall asleep at bedtime?
Children get used to going to sleep in a certain way. Now, sleep time comes and as they get older, babies or children won't really want to go to sleep, so they will resist. Babies can resist going to sleep for a number of reasons. One, they may not want to go to sleep if they're older. Number two, they may resist because whatever they were used to having as they were falling asleep has been withheld from them, and so there will be a resistance. So, it's very important to understand what the mechanics are and what is going on in order to deal with the problem. Broadly speaking, if you want your child to have healthy sleep habits then it's really important to set up what we call good sleep hygiene. Good sleep hygiene starts firstly by a good routine, and secondly by consistency. You establish your bedtime routine with very clear steps, and it's not all a big rush; it's very metered and very calm and soothing, etcetera, etcetera. As long as you can be consistent about it and you initiate this hygiene and these steps early on you may never have problems and your baby won't have problems going to bed, because it becomes so entrenched and they're used to that. Even as they get older, even as they're a toddler, it's just a part of life. Bedtime is fun, it's story time, it's cuddle time, and it's goodnight. So, you can actually avert a lot of problems initially if you get your routine right, you have good sleep hygiene, and you're consistent; you will be fine. What happens when it doesn't work like that? What happens, for example, if for whatever reason, your baby has bad sleep habits? There are multiple reasons why babies learn these bad habits; whether they're fed until they fall asleep, or whether they've come out of the hospital and they've been ill so they've been held and rocked until they've fallen asleep, and now they're used to being rocked. Maybe they're sharing a room with an older sibling and there's a television on, and now they're used to falling asleep with the TV on. Whatever the reasons are that got them into this habit, that reason is causing them to wake up in the middle of the night and require the same habit to be given to them in order to fall back to sleep; it's now becoming a real issue and you have to change it. This requires a great deal of behavioural modification. Essentially what you need to do is that you have to almost rewind and go back to the beginning and get your child used to a healthy sleep routine.
What is the key to helping my child sleep better?
I think the key for good sleep is good routine, in other words, it must be predictable. The child must have a predictable routine, and be consistent about it. So, you can't have a child, for instance, watching TV or running around and then say OK, it's bedtime. It doesn't work like that because their whole body is activated. You really want to have something where it is a progressive wind down phase, and the child knows that. It can be a special time with parents, a time of closeness, a high quality time, and it's got to be predictable so that the child associates it with sleep.
What are the effects of parental sleep loss?
If you're sleep deprived, it really affects how you function during the day. It affects how you make decisions. It affects, essentially, your executive functioning. It affects your mood; you become irritable, and less patient. It affects your memory - you may forget what you did a couple of minutes ago if you're severely sleep deprived. This has a direct impact on the child. If you're irritable as a parent because you're sleep deprived, you're going to be less patient and understanding with your child. You're not going to be able to "read" your child, in terms of your child's personality type, and how they are communicating with you. You may misunderstand and think that when your child's doing a particular thing, they're being naughty, but actually that's not really what the child meant to do. It really impacts on many, many areas in parenting and child-rearing.