Monday, June 6, 2011

Sleep: Part III

If you read my last two Sleep posts looking for advice on getting your child to sleep better, you were probably disappointed. But this post might help. This is not a method, or a technique, or even a general overview of various techniques. But it is a list of things I'm beginning to feel are "truths", and knowing them might help you come up with a plan of your own for handling your current sleep situation, if you feel it needs handling, or reassure you that maybe you don't need to make any changes, if that's the direction you're leaning in.

All kids are different. This is always true, regardless of topic. All people are different, all kids are different, all babies are different. Yes, even ones within the same family. Yes, even twins. Some kids will sleep better if left alone, while others won't sleep unless they have company. Some kids will wrap themselves around you when they sleep, while others need their space. Some kids will only sleep once you put them down, while others will only fall asleep while you're holding them. Some kids will hardly move at all when they sleep, while others might end up in the toy box by midnight. Some like to be covered; others like to be unencumbered. Some like their feet free; some like footed pj's in the depths of summer. The point is, what worked for one of your kids might not work for the next. What works for your friend's kid might not work for yours. Or might work differently.

Consistency is key. Whatever you decide to do, you need to stick with it. If you decide you're going to let your baby cry it out, you have to keep letting him cry it out. If you decide to refuse to nurse at night, you have to keep refusing. Once you relent, you're back to square one. That's not to say you can never try it again later. And, if you start a process and decide it's not for you, of course you can (and should!) stop. But if you intend to do it, then you have to do it. Consistently. The same way every time, every night. (Variables happen - if the baby is sick, everything goes out the window. If you're traveling, things will change. But be as consistent as you can.)

Bedtime routine is very important. One thing you'll see in all the sleep books is to create and stick with a bedtime routine. I agree with this 100%. Pick a bedtime, build a routine around that bedtime, and don't waver from it. Try to get your baby to bed around the same time every night, within about 30 to 60 minutes of that time. This helps to set his internal body clock so that he'll know when to be tired. The bedtime routine will help him know that bedtime is coming and will signal his body to start releasing all those lovely hormones that help you relax and fall asleep. If you're starting this process for the first time, I recommend starting on a Monday night. This gives you five nights to enforce the same weekday routine, so that when Saturday comes and the day is different, you'll already have a head start. Then maybe for that first weekend, try to stick as closely as you can to the same routine. By the following Friday evening, a blip here and there shouldn't matter as much (for example, if you go over a friend's house for dinner and are there later than the usual bedtime), as long as you go right back to the routine as soon as possible. You can also try to do the routine as closely as possible in your different situation. For example, bring the baby's pajamas, music, book, or lovey, whatever you've begun to establish, and get the routine started. That way, if the baby falls asleep in the car on the way home, you can just put her to bed.

Don't miss the sleep window. There's about a 20 to 60 minute window of time where your baby's body is primed for sleep. This happens around his usual bedtime. If you get him to bed within that window, he is likely to fall asleep peacefully and easily. If you miss it, you'll probably have to wait another hour and a half, at least, before he'll be able to fall asleep. This is a biological phenomenon which happens for everybody, adults and children alike. If you don't go to sleep at your usual time, your body assumes that there is some kind of stressor or danger that requires you to be awake. You get a flood of adrenaline and other hormones that will help you stay alert. We usually call this the "second wind," and we take advantage of it when we want to stay up later, pull "all nighters" in college, party, or finish one more chapter of a book before going to bed. You'll notice that you have a great deal of trouble falling asleep during that second wind, even if you want to. The same is true of babies.

It takes about four nights. For babies and toddlers, it takes about 3 to 5 nights for a new sleep "rule" to kick in. The first night, he may seem bewildered by the whole thing. The second night may be worse than the first night, because he starts to protest the new rule. By the third night, he should start to get the idea that you mean it. And by the fourth night, you'll know whether your new "rule" is working. If there is no change for the better by the fifth night, either this method simply won't work for your baby, or you're not being consistent enough.

Different parents can handle different levels of sleep "problems." You may be the type of person that, once awakened, takes an hour to fall back asleep. You may be the type of person who can't function on less than six solid hours of sleep. You may be the type of person who just keeps chugging along regardless of how you slept. You may be someone who can practically sleepwalk through the nightly feedings and barely remember waking up and feel quite refreshed in the morning. If you are functioning at a level that is acceptable to you during the day, then your night time sleep is fine. Just because your baby is waking up three times a night to nurse or your toddler wanders in every night to climb into bed with you doesn't mean that you're doing something wrong by allowing it to continue if it doesn't bother you. Your friend, however, might find this to be intolerable because she finds herself falling asleep at her desk at work, or, G-d forbid, while she's driving. Remember "If the solution is worse than the problem, then you don't have a problem"? Yeah. If you think whatever sleep changes you might "need" are going to be harder on you than just leaving things the way they are for now, then leave things the way they are.

Some changes are more possible at some ages than at others. There's a fantastic book out there called Bed Timing, by Marc Lewis, Ph.D., and Isabela Granic, Ph.D. They are developmental psychologists who have broken down the zero- to five-year-old brains and pinpointed developmental ages at which their brains are better able to handle changes in their sleep habits. They make suggestions as to when to "sleep train," rather than how. From my observations, I agree with this general thesis. There are definitely times where making changes to sleep habits will go very easily, and other times where you'll fight for weeks to set a new pattern, even if you use the same techniques with the same kid. I think my success with my two kids at 16 months has something to do with them having been in "stable" periods of development at that age.

Sleep regressions will happen. There are certain ages where everything you've worked for, sleep-wise, will seem to vanish. There are classic "sleep regressions" at four months, eight months, 13 months, 18 months, and usually on the "halves" after that - 2-1/2, 3-1/2, like so. At those ages, for a few weeks, your baby/toddler will suddenly start sleeping even worse. (If you have a particularly "poor" sleeper to begin with, you may not notice a dramatic change. However, if you have a baby who previously slept four hours at a time, you may notice she suddenly starts waking every hour for no apparent reason.) Usually, once the sleep regression has passed, sleep will return to basically the patterns you had established pre-regression. There's not much you can do about this. You can stick to your guns or you can let it all go, whichever works better for you. I do think that if you have made sleep changes in the stable period before a regression, it will be easier to return to those established patterns afterward. Also, you may notice poorer sleep in the days or weeks leading up to a major developmental change, such as crawling, walking, or talking. The baby will be "practicing" the new skill even in bed, and it will be hard for her to sleep. Once the new milestone is reached, sleep should improve. And don't forget things like teething, illness, or change in environment can have an effect on sleep.

You'll have to sleep train more than once. This isn't a one-shot deal. First of all, you may make one change at a time, over time. Secondly, after developmental milestones, sleep regressions, vacations, major changes such as moving house or adding another baby to the family, and so on will probably necessitate a "retraining" of sorts, although the retraining typically only takes a night or two to reestablish what you've already done.

How your baby sleeps now is not an indicator of how she will sleep as an adult. Sleep is natural for all humans. Eventually, your child will fall into the normal human pattern of nocturnal sleep and diurnal activity. (Until he becomes a teenager? Haha.) Some kids need a little push to learn to stay in bed and go back to sleep on their own, but just because you have a nine-month-old who wakes four times a night to nurse does not mean that your son will be getting up four times a night as an adult to raid the fridge. Don't worry about it.

Sleep begets sleep. Being "overtired" is real, and being overtired makes it harder to sleep well. The more sleep-deprived or sleep-confused your baby is, the harder it will be to fall asleep and stay asleep. The healthiest sleep (for anyone, not just babies!) is to go to bed and wake up at the same time every day, and to get enough sleep. Babies need a lot of sleep, generally around 12 hours in a 24-hour period (this changes depending on age and on the particular child - some kids need less sleep; others need more). If they are getting significantly less than what they need for more than a couple of days, they will become so tired that they will find it difficult to fall asleep, difficult to stay asleep, and the cycle will perpetuate until they become so exhausted that they can't help but sleep. It's messy. If you're as consistent as you can be about getting your baby to sleep at the same time each night, she should start waking up naturally at the same time each morning, and then if you are consistent about naps as well, you should end up with a well-rested, happier baby who sleeps better for it.

One thing I think helps put all this in perspective is if you think about yourself. Most of us feel better and sleep better when we're sleeping consistently. If we have too many nights in a row of poor sleep, we get "hyper" and find it harder to sleep well when given the opportunity. If we mess around with our sleep cycles, we basically get "jet-lagged," without the vacation, and it takes a few days to get back on track. Babies are the same. Babies are people. The only babies I would say this doesn't apply to is very young ones - newborns naturally and biologically do have different sleep patterns than adults and older babies, simply because of their need to feed often and grow rapidly. But once you've come out of the newborn stage, or probably by about six months of age, babies basically follow the human need for enough sleep, most of it at night, and to follow a consistent sleep/wake schedule.

One last thing before I think seriously about getting some sleep myself. Whatever you decide to do, whenever you decide to do it, and however you decide to proceed, keep in mind that you need to do what you believe is healthiest for your family. You make all kinds of decisions for your child, even before he's born. How he "should" sleep is just another in a long line of decisions you make that will impact how he grows. I'm not here to tell you what will happen if you do a "cry-it-out" method versus cosleeping until he's five. I'm not here to tell you if you're doing any psychological damage by having him sleep alone or letting him sleep between you and your spouse. I'm not here to judge you for needing eight hours of uninterrupted sleep, and I'm not here to judge you if you're willing to walk around in a zombie-state just so that your child can get eight hours of uninterrupted sleep with his head on your chest. Honest. Any of those things are your choices to make.

As for me, I personally am uncomfortable with leaving a baby alone in the dark to cry, as you may have gathered. I think feeling secure is the most important aspect of good sleep. Even if it means a lot of sleep interruptions in the early days, I think the security of knowing that Mommy and/or Daddy are nearby and will respond when he feels he is in distress can only be beneficial as the child grows.

1 comment:

  1. I agree, I don't like the idea of leaving a baby to cry it out at night. - Esther