Tackling Toddler Sleep Problems (cont.)

In two-parent households, bedtime can become tumultuous. "Either one parent says, 'I put her to bed last night and now it's your turn,' or one parent is better than the other at putting the kid to sleep and resentment comes in to play," he says. "This is more related to family dynamics than the child, but kids pick up on their parents' stress and anxiety around bedtime and that gets them stressed out and prolongs bedtime."

Try this instead: "Both parents should go into the room, dim the lights, and chat amongst themselves for about 20 minutes or so because there is nothing more boring, yet more reassuring and safe, than having both parents there," he says. "Instead of saying, 'Let's get this kid to sleep,' just hang out, talk, relax, and think about how lucky you are to have such a great kid," he says.

Nocturnal nuisance: Your 2-and-a-half-year old sleeps in bed with you and your partner.

Sound sleep solution: Some parents may enjoy sleeping with their children, but this can be a toddler sleep problem in other families. Whether you call it co-sleeping or bed-sharing, this is primarily a cultural or economic issue, says Pelayo, author of the forthcoming Sleeping Makes Me Tired. "You can only put baby in a crib if you can afford a crib, and your baby can only have their own room if you can afford it," he says. "It is really a cultural thing to have kids sleep in separate rooms or beds."

But if both parents agree that bed-sharing is a troublesome toddler sleep issue, "try telling them that mom and dad are happier when they sleep alone because children innately want to please their parents," he says. "Or say, 'There is no such thing as a three-person bed, just two-people beds.'" Children may be scared to be alone, so you need to let them know that they are safe and secure wherever they sleep.

Breaking this habit can be hard, Zafarlotfi agrees. It usually starts innocently enough. "A child may have had an earache and slept in their parents' bed and gotten used to it," she says. "If they are accustomed to your bedroom, you need to reverse it and spend more time in their bedroom," she suggests. Here's how: "Stay in their room on a recliner, dim the lights and act as if you too are dozing off or relaxing at bedtime or naptime so they know that you are present," she says.

Be positive. "Say, 'Mommy needs her time, but she will come to your room for a while.'" While you are there, "play soothing music and have fun in their room so they know that their bedroom is not for punishment or abandonment," she says. "When they fall asleep you can say good-bye or sneak out."

Consistency counts too. "You can't take them to your bed one night, and then not let them in the next night."

Nocturnal nuisance: Your child has nightmares.

Sound sleep solution: "The first thing you can do is to look for any physical problems that may be disturbing their sleep," offers Pelayo. Snoring, acid reflux, heartburn, or even allergies may be waking your child up at night, not nightmares. "If there doesn't seem to be anything physical causing them to wake and stir then it's time to talk about the nightmares," he says. "Tell them that they are always safe and that nightmares and dreams are like paintings and drawings, meaning that they can paint a nice picture or scary picture," he says.

Dream rehearsal may also help children take the sting out of nightmares. Here's how it works: "Discuss what happened in the nightmare and come up with a new ending," he says. If your toddler dreamed that he was falling off of a cliff, tell him to imagine that he can fly. Or if the nightmare involved a monster, perhaps the monster could be made of marshmallows, he suggests.

Nocturnal nuisance: Your toddler suffers from night terrors.

Sound sleep solution: "Night or sleep terrors are not nightmares," Pelayo says. These two toddler sleep disorders differ in certain important ways. "Sleep terrors occur in the first third of the sleep and nightmares tend to occur in the last third of the sleep," he says. Sleep terrors or night terrors are characterized by a bloodcurdling scream, crying, a racing heart, and no memory the next day, he says. By contrast, a nightmare is a dream, and your child is reassured that it was only a dream when they wake, he says.

"The first thing to do for night terrors is to rule out snoring because snoring destabilizes sleep and this can make night terrors, or even sleepwalking, more likely because destabilized sleep is not deep sleep," he says. These toddler sleep disorders tend to occur in light sleeps. Once snoring has been ruled out, try waking your child 15 minutes after they fall asleep, he says. "They will respond to this scheduled awakening by going to sleep more deeply." Abide by the 15-minute rule because waking a child much after that may actually cause night terrors.

Nocturnal nuisance: My toddler has suddenly started snoring.

Sound sleep solution: This toddler sleep problem could be caused by sleep apnea, a potentially dangerous condition in which your child stops breathing repeatedly while asleep, says Zafarlotfi. "Children do have sleep apnea and need to be studied to see if they stop breathing while they are asleep," she tells WebMD. "It is very well treated with a tonsillectomy or adenoidectomy (removal of the adenoids). If my child snored, I would take them for a sleep study and then to an ear-nose-throat specialist for such surgery, if needed." The reason to do the sleep study first is that you don't want to cure the snoring without knowing whether or not they have sleep apnea. "It is possible to have apnea without the snoring."

Nocturnal nuisance: Your child thrashes around during the night, banging the head, with outbursts of sudden crying, but the child seems to be asleep.



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