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8/24/12blog post

a good night's sleep... uninterrupted!

Ahhh… the blissful feeling of a full night’s sleep… uninterrupted!!!

Well, ok, realistically it was only 6 hours of sleep, with maybe only a bit of interruption by the 3 year old wanting to snuggle, but still… more sleep then I have had in probably the past 6 years. And that has happened every night for the past week. I feel like a new person!

What is happening at my house you might ask?

Ethan is FINALLY sleeping through the night, for the past week anyway. Yes, I am sure that you remember that he is 15 months old, and yes, he SHOULD have been sleeping through the night way before now. But the combination of needy child wanting (NOT NEEDING) to nurse 2 or 3 times through the night and his wimpy mother who wanted to provide comfort and not make him cry it out… has caused many months of poor sleep for mother and child!

Finally last week, when his wanting, needy, cries, escalated into a full blown temper tantrum in the middle of the night because I would not nurse him on demand, I said enough is enough. I love my child, it pains me to hear him cry, but it pains me more to see him so dependent on me for sleep and comfort that he is unable and unwilling to comfort himself, causing both of us to have disrupted sleep. I FINALLY decided to do as a mom what I knew was best for my child as a pediatrician (see, the two sides are not always in agreement… but the pediatrician side is usually correct!) I let Ethan cry it out. Magically, because we have done this before, it only lasted about 30 minutes. I told myself the whole time that this was for the best because in the long run he would sleep better which would lead to a whole cascade of better things such as better temperament because of better sleep, better learning because of better sleep and most importantly, more patient mommy because of better sleep.

I did set the stage for optimal sleep this time.

  • I monitored his behaviors and watched the time when he was acting sleepy.
  • I nursed him, but not to sleep.
  • I turned out the lights in his room except for a night light.
  • I turned on the fan from our central air for noise. (You could also use individual room fans or other forms of white noise, pointing airflow away from the child.)
  • I placed him in his crib, drowsy, but awake.
  • I left the room.

He cried for about 30 minutes the first night, less the subsequent nights, and he slept. He has woken a couple of times off and on through the night. By the time I have heard him over the fans I have left him be for a few more minutes and each time he has quieted himself back to sleep.

So, here is my review of healthy sleep habits:

  1. Use a simple, consistent bedtime routine.
  2. Place a child in their crib when they are drowsy, not asleep. Children’s sleep cycle causes them to fluctuate between deep and light sleep many times through the night. There are times when they may be making noise like they are awake or may be moving, but they are really still asleep. If you consistently rock, cuddle, or nurse your child to sleep then as they enter a light sleep state they will wake themselves up completely and expect their “routine”- rocking, cuddling, nursing, to be reinstated before they fall back to sleep. You want your child to fall asleep at the beginning of the night in the same manner that you want them to return to sleep through the night.
  3. Do not immediately respond to your crying, fussy, or whimpering child. Give your child a few minutes before responding to them and they may settle back down without your help. Remember, starting between 4 and 6 months you want them to learn self-soothing techniques for sleep.
  4. Make nighttime waking as non-stimulating as possible. Keep the room dark, do not talk to, sing to, or really interact with your baby or they will wake up completely and think it is play time. Plus they will be more energized then you thanks to their quick “nap”.
  5. Have a consistent routine through the day. Have your child nap at about the same time every day. Overtired children often have MORE trouble falling to sleep rather than crashing from exhaustion. If a toddler refuses to nap then ensure that they use nap time as quiet time that they spend in their bed.

Even though I provide families with these recommendations daily and I have even lectured on the topic, I find that sleep enforcement, encouragement, routines all a little more challenging as a mom. However, whenever I put into place the above guidelines I find that they DO work and everyone in the house functions a little better.

So, good luck to you! I welcome any feedback you have on how you have managed to create good sleep habits in your house. If you have an older adolescent or teenager in your house I have also written a blog about sleep and those children based on some of the discussions I have been having in clinic.

Happy zzz’s!!!!