Sleep: Your Child's Sleep Habits and You (cont.)
Any suggestions for when babies are refusing naps? Do you agree with letting them cry it out? At what age, if so?
Make sure that the environment is conducive to napping, such as the room is dark and quiet. It's also important to time the nap appropriately. Remember those circadian rhythms we mentioned earlier. There tends to be a dip in alertness around midafternoon and that's often a time when you can take advantage of that dip to put a child down for a nap.
If a young baby who still needs a nap is refusing to nap, it's important to look at how they're falling asleep at bedtime. If a baby needs to be rocked or held to fall asleep at bedtime, they're going to need the same conditions at bedtime, as well.
My daughter uses a stuffed animal as a transitional object. Should I send it to daycare and her grandmother's, where she is cared for on some days?
I would suggest the same transitional object be used in the other settings as well. I believe the transitional object will make the sleep transition a lot easier when she's not in her normal environment.
What are some solutions for frequent night wakings in toddlers?
The key to understanding night wakings is to know they are normal. Throughout the night all of us sleep in cycles, and at the end of a cycle, which in young children is about 60 to 90 minutes, there is a brief arousal or awakening. Most of us just roll over and go back to sleep. The problem comes when a child has developed those conditioned associations at bedtime that they need in order to fall asleep. If those same conditions are not present during night wakings, then they're going to have trouble falling back asleep.
If night wakings are a problem, look at how the child is falling asleep at bedtime. If they need you to be there, they need to be held or rocked or patted, then they're going to need those same conditions to fall back to sleep at night, as well. So the trick is to teach the child to fall sleep on his or her own without needing those conditions present. That's where putting a child to bed after the bedtime routine drowsy, but still awake, is key, because then they are not actually falling asleep while being held or rocked, etc.
How can you institute a routine in an older child (5-6) who has never had one? Can you use cry it out this late in the game?
I would keep it simple and I would use activities as part of the bedtime routine that the child enjoys, but that are not stimulating. So for example, television should not be part of the bedtime routine. I think it's important, first of all, to establish a set bedtime and then to make those 30 minutes or so prior to bedtime kind of a calm down period. That might consist of reading or listening to music or even talking quietly, as long as it's consistent, soothing, and not stimulating.
With older children you can also use reward systems, as well, which is an advantage because you can use positive reinforcement. You could use a sticker or star chart, for example, to reward a child for going to bed without protest, or for going to bed within a certain period of time, or going to bed and not getting up again after lights out.
So you establish the routine, make it pleasant, and also build in rewards if you're meeting resistance about establishing a routine.
How can you tell if your child has a sleep disorder, and is not just refusing sleep?
The most important thing to look at first when you have a child with bedtime resistance is to make sure they're getting an adequate amount of sleep. That's the first priority or measure when looking at the child's sleep.
Then look at whether the child is difficult to wake in the morning. A child who jumps out of bed in a great mood ready to start the day, probably is getting enough sleep, if that's a consistent behavior. If the child has to be called three or four times, is grumpy and irritable, that suggests they're not getting enough sleep and the bedtime issue is a problem. This is an important consideration, because sometimes parents try to put their children to bed too early, and that can be one reason for bedtime resistance.
Another common reason is there are some children who are really more night owls, even at a relatively young age. They may have more difficulty going to sleep at an earlier time. You can help a little bit with that by making sure the room they're sleeping in is dark. Darkness is important because it regulates the body's production of a hormone called melatonin. Darkness helps the body to turn melatonin on, and bright light shuts it off. So light and darkness can really help to set bedtime and wake time.
Another common cause of bedtime resistance is inconsistency on the part or parents in terms of bedtime, meaning not having a regular bedtime, not having a regular bedtime routine, and not having a window of time before bedtime where the child can get relaxed and ready for sleep.
We are almost out of time, Dr. Owens. What recommendations has the National Sleep Foundation come up with following the study of children's sleep habits?
No. 1, sleep needs to be a priority for the whole family. Parents are excellent role models for their children, and they need to pay attention to their sleep habits, as well as their children's. Make a good night's sleep high on the list of health habits. Think about getting sleep as a health habit, like good nutrition, wearing a seat belt, getting exercise, and all those important things we do for ourselves and our children. Sleep needs to be up there.
Second are good sleep habits include:
Third, parents should recognize potential sleep problems in their children, such as snoring or having difficulty waking in the morning, and bring those concerns up with their child's doctor.