Although it appears so deceptively simple that we take it for granted, learning to go to sleep is often as much of a challenge to children as learning to walk. Bedtime is a cue for frustration for many parents and children. Babies cry when they wake up in the middle of the night. Toddlers refuse to leave their families’ evening activities to go to sleep. Preschoolers ask their parents for yet another story, drink of water or trip to the bathroom. Older children become frightened of ghosts or monsters that climb into their rooms when the sun goes down.
Sleep problems are among the most common difficulties of childhood. They affect about one in four children, according to Dr. Richard Ferber, director of the Center for Pediatric Sleep Disorders at Children’s Hospital in Boston. These problems may be as benign as a brief bout of insomnia or as dramatic as repeated sleepwalking or night terrors. A child’s difficulty sleeping is, in a sense, contagious. Because few parents can sleep well when their child is up during the night, sleep problems are a common reason parents seek help from pediatricians and psychologists. To put it bluntly: You don’t care whether your child wakes up in the middle of the night, as long as she doesn’t wake you up as well!
For some children, the problems start soon after they are born. During their first eight weeks or so, many infants fall asleep while they are nursing or bottle-feeding. Usually their parents carefully and lovingly put them to bed without awakening them. In some cases, however, this apparent kindness is a disservice, for those babies learn to associate the presence of a parent with the act of falling asleep.
When they wake up in the middle of the night and there’s no adult around, they become frustrated. They’re unsure how to make the transition to sleep by themselves, so they cry until someone comes. The parent picks the child up and, by doing so, inadvertently perpetuates the problem. The child again falls asleep in the parent’s arms, but is still unable to do so alone.
The key issue here is not sleep, although that is how parents will usually refer to it when describing the problem. The baby is sleeping just fine. The problem lies in mastering the transition from the waking state to the sleeping state. Once parents realize that, possible solutions to the problem become more apparent.
One simple solution is to look for times during the day when the child is awake but drowsy. Put her to bed, quietly leave the room, and let her fall asleep by herself. If that task is too much for her, you can make use of babies’ natural tendency to become sleepy after eating. Watch her eyes closely toward the end of a meal. You’ll probably notice that her eyelids become “heavy” as she blinks a few times before falling asleep in your arms.
Instead of letting her do that, place her in her crib when you see those first blinks. That way she’ll make the transition to sleep (which she’s too tired to fight) on her own. If she wakes up in the middle of the night, the situation will feel more familiar to her and she’ll know what she has to do to go back to sleep — at least most of the time.
This doesn’t mean that you should never let your child fall asleep while nursing or being rocked. That would be cruel. Besides, it feels very nice to both the parent and the child. What you want to do is help your child learn to fall asleep in a variety of situations so that she doesn’t feel she needs someone else to be present.
Among older children, sleep problems are more common during times of stress. Infants sometimes develop problems sleeping when they have colds. Stuffy noses may make them uncomfortable at night, causing them to wake up crying a few hours after midnight. Parents, who are acutely aware that their children are suffering, go to their rooms to comfort them and help them to back to sleep.
This sleep problem may persist, however, for a few weeks after the cold is over because parents keep going into the child’s room at 1 a.m. when they hear a noise. It’s an understandable reaction on the part of both the parents and the child. The parents are being protective; the child is getting extra attention. Often that extra attention, which was appropriate while the child was sick, has made her dependent on the presence of a parent in order to fall back asleep.
One approach to this problem is quick and effective, although initially bothersome to most parents. If you’re 100 percent sure there’s nothing wrong with your infant, simply don’t respond to her late-night cries. That’s a very painful decision to make, for it is both physically and emotionally difficult to tune out your baby’s cries. Recognize, however, that the infant simply has to relearn how to make that transition from wakefulness to sleep by himself. This usually takes three or four nights at most. If the problem isn’t solved within that time period, see your pediatrician.
Toddlers often need help shifting gears from the animated activities of the day to the more passive pursuits of bedtime. Parents frequently assume that children can mentally prepare themselves for bed as quickly as adults do. However, young children need a cool-down period. If Daddy’s just played horsey with them, it’s too abrupt a transition to go to bed.
Rituals form an important part of this cool-down period for toddlers and preschoolers. Quiet activities, such as being read a story or listening to soothing music, can help the child learn to fall asleep without problems. Television, however, is not good for this since it is filled with rapid-fire images that are too stimulating. The bedtime story or glass of milk becomes the child’s transitional object for falling asleep. That’s one of the reasons why preschoolers will often ask to have the same story read to them for weeks or even months at a time. It provides reassurance that all is well and that they will be safe when their parents leave them alone for the night.
Quick Tips for Sleep Problems
- Remember that you can’t control your children’s sleep. You can control only their bedtime. If a child says he can’t sleep, tell him that he has to be in bed. If he’s old enough, he can read. He can listen to calming music quietly. Usually the child will doze off in a short time.
- Not all children require the same amount of sleep at a particular age. While some children are groggy if they don’t get as much as ten or more hours of sleep per night, others are happy with as little as six hours. Often toddlers who have trouble sleeping through the night can change that habit by taking fewer and shorter naps during the day.
- Pay attention to when your child falls asleep. If a child goes to bed at 7 p.m. but always falls asleep at 8:30, you might be better off putting him to bed at 8:30. There will be less of a struggle at bedtime, and the child will get the same amount of sleep.
- One of the most common reasons toddlers have difficulty sleeping through the night is that they nap too much during the day. If that’s the problem, substitute some quiet play or listening to music or a story for some of the nap times. This is, of course, more easily said than done if your toddler is attending a child care program, since nap time is often one of the few breaks a child care provider gets during the day.
- If you want to teach your toddler or preschooler new skills having to do with falling asleep, such as learning to go to sleep in a strange bed, introduce those skills during daytime naps rather than at night. Young children perceive more dramatic differences between night and day than do adults. Daytime is much less mysterious and frightening than nighttime for these children, and is therefore a less stressful time to try new things.
- Encourage calming rituals around bedtime. Remember that children often need at least ten minutes to calm down from the excitement of the day. A warm bath is often quite effective.
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