Sleep Syllabus: Resources for Tired Families

I’ve said it before, I’ll say it again, sleep is the holy grail of parenting.  Adequate, quality sleep is essential for children’s growth and development.  Poor or insufficient sleep can contribute to a host of child health problems.  And, we all know how the mood of a household can plummet when kids (and therefore parents) aren’t sleeping well.  But, achieving adequate sleep for all family members is, at times, a daunting and difficult task.  In honor of National Sleep Awareness Week, I thought it would be a good time to provide a sleep syllabus of sorts.  So, here it is- a list of resources for tired parents facing sleep difficulties.  I hope you will find it useful.

The newborn period:  One of my very first blog posts, Resting Easy, focuses on safe sleep in the newborn period based on the AAP’s recent sleep guidelines. It is now accompanied by wonderful readers’ comments about their own sleep experiences and the importance of empowering parents to trust their instincts when it comes to sleep.

Sleep “training”:
This is one area that truly depends on your parenting style and your child’s personality.    As our son approached four months of age, a time when most experts agree a baby is physiologically able to sleep through the night, I found Marc Weissbluth’s book, Healthy Sleep Habits, Happy Child helpful, and I’ve come back to it a few times since then.  I must confess we did not follow any one method to the letter, instead finding a happy medium that worked for us.  But, Dr. Weissbluth provides a good overview of sleep physiology and needs at each age, with some flexibility in approach to sleep based on child and parent temperament.

Toddlers:
A wonderful recent collaboration between Seattle Mama Doc, Dr. Wendy Sue Swanson, and pediatric pulmonologist and sleep specialist, Dr. Craig Canapari, provides useful suggestions for those with toddlers who still have trouble with night (or early morning) awakenings.  Their posts 4 Reasons Toddlers Wake Up at Night and Early Morning Awakenings feel particularly relevant to my life right now.

School Age:
Drs. Julie Kardos and Naline Lai from Two Peds in a Pod have some great tips for keeping school-age children well rested and ready to learn in their post, “Wake Up Sleepy-Head, It’s Time for School!”

Finally, for those times when you’re tired and/or overwhelmed and you just aren’t sure you’re doing this sleep thing “right”, Dr. Claire McCarthy and Dr. Melissa Arca are here to provide some reassurance. Dr. Claire confesses she is a pediatrician, who also happens to be a “sleep softie” in her lovely recent post.  Dr. Melissa encourages us to follow our own parental intuition and get some rest in her article entitled “I Support Sleep, That is All“. She writes, “Whenever I answer parents’ questions about sleep, I first ask this: are you okay with your current sleeping arrangement and is the sleeping area safe? If yes to both…forget the negative chatter, ditch the guilt, and carry on.”

Here, here.

Okay, dear readers, now it’s your turn. Please help me add to this list.  What has your “sleep experience” been?  What resources have helped your family sleep better?

13 thoughts on “Sleep Syllabus: Resources for Tired Families

  1. I’ve got two wonderful girls – now aged 7 and 8 years old. Both are on the Autism Spectrum.

    One stays up really really late, even when lying in her bed, lights off, nothing to do, she lies there awake and worries. Highly anxious is she.

    The other wakes during the night seeking sensory input as she has high sensory needs.

    We tried so many different techniques, nothing worked.

    About 6 months ago we started them on a small dose of melatonin – under our paediatricians guidance and care. It has been a life saver… well a sleep saver and tired mama was prone to making mistakes so likely a life saver.

    Both girls now fall asleep around 8pm, one sleeps through, the other wakes for sensory input every 2-3 days, no where near as often as before.

    • Marita- thanks for highlighting this point. I have been recently hearing more anecdotes, such as yours, about the utility of melatonin for improving sleep, especially for kids on the autism spectrum. A quick review of the literature supports this. A 2007 overview of care for children on the autism spectrum published in Pediatrics states, “There is some evidence of abnormality of melatonin regulation in children with ASDs, and melatonin may be effective for improving sleep onset in children with ASDs, as well as children with other developmental disabilities and otherwise healthy children with sleep/wake disorders. A recent open-label study suggested that controlled-release melatonin improved sleep in a group of 25 children with ASDs and that treatment gains were maintained at 1- and 2-year follow-up, but randomized, double-blind, placebo-controlled studies are needed.” Hopefully we will continue to learn more about this. So glad your girls are sleeping better!

  2. Thanks for the good overview in this post. I think I’ve read about 50 sleep books, and one of my favorite approaches is by Kim West in The Sleep Lady’s Good Night, Sleep Tight. We have had two vastly different experiences with each kid, and found that no single approach worked for us either. I also really liked the approach by James McKenna, in Sleeping with Your Baby. We used this as our bible for night weaning for each of our kids–a step that was really key to my getting some rest!

    I had some problems with the Weissbluth book. I agree the overview of physiology was solid, but in his training, I recall in one part he suggests it was appropriate to let your child cry hard enough to induce vomiting a couple times. I’m really, really uncomfortable with that logic or approach.

    • Ceri, thank you so much for your thoughtful comments. I’m glad you mentioned James McKenna. I’ve read a bit of his work from the Mother-Baby Behavioral Sleep lab at Notre Dame. He has fascinating data regarding the physiologic connection between a breastfeeding mother and her baby. I have not read his book, and I will set out to do so. The Sleep Lady’s Good Night, Sleep Tight, is also a great suggestion. We also didn’t feel comfortable with an extinction (i.e. cry-it-out) method for our little guy, and ended up with an approach that is very similar to what Kim West advocates.

      Thanks as well for the thoughtful critique of the Weissbluth book. While Weissbluth’s overview of sleep needs and physiology are great, I think the criticism I have most often heard about Healthy Sleep Habits, Happy Child, is that it sometimes seems too “strict” for some families. While he does offer options based on temperament, I definitely came away from the book with the feeling that Weissbluth most advocates for the extinction approach, which I don’t believe is the answer for all kids. I also completely agree with you on the point about vomiting.

      Achieving “sleeping through the night” is such a unique process for each child and family. I’m so glad you added a couple more resources for people to consider.

  3. I really enjoy reading your posts-you are very insightful and clearly expert in your field! While we don’t have sleep issues with our daughter, I thought I’d share our practices and how she developed relatively good and consistent sleeping habits (8 year old girl now). First and foremost, I believe that all beings need and enjoy structure. I don’t mean sterile and strict-just predictability and familarity. I call it “freedom within fixed boundaries”. We set a pattern, including what helps make her comfortable at night (in our case, a night light and opening her door right before we go to bed so we can get things done without distracting her sleep but offer her the comfort of a partially opened door if/when she wakes up to use the bathroom). Also, while trips/storms can disrupt the pattern, we make sure not to alter it in a permanent way just to appease a one-off event or avoid a mild tantrum. We’ve done this for the entire time, and now she is comfortable sleeping anywhere as long as she has certain queues that help her find that “boundary” or comfort zone (familiar patterns in strange places seems to make things okay). She’s a well-adjusted kid who is always happy, and I think knowing what the boundaries are in her life, including sleep patterns and habits, helps aleviate insecurities both at night and day that can interfere or limit mental and emotional growth.

    • Great points Josh! Kids thrive on consistency and routines they can count on. This is true in areas like discipline and feeding, and definitely true when it comes to sleep- in fact this may be the most important part of achieving good sleep habits for kids. Regardless of the method you choose or the specifics of the routine, just the fact of having one and sticking with it will certainly help your child. Thanks so much for reading.

  4. Pingback: Snooze News: Worthy Reading for the Weekend | Craig Canapari, MD

  5. Help. My 27 month old has stopped sleeping through the night. She has developed a seizure disorder(May). They do not know why. She is on seizure meds 3 times a day. We had issues right after that getting her to go to sleep so the doc had us use melatonin. That has worked great for almost 2 months. Now for the last 1.5 weeks she is waking between 2-4 am and I cannot get her back to sleep. She isn’t screaming or appearing scared. She just wants to get up and play etc for hrs. The first few nights it was so abnormal I got up wither because I thought something was wrong. Now, even to tonight, I try and just leave her alone, prayi g she will go back to sleep-nope. Then I go in. No words. Lay her back down, cover her up. Still awake. Wait 30 min. Go back in. Changed her diaper, night night prayers again, lay her down, leave. She lays quietly for about 3-5 min then up agai. Playing in her bed. Kicking,etc. what can I do? I am exhausted! (FYI she is getting tested for autism in October, she is verbally delayed, walks on toes, seizures). Help me. We both need sleep!!

    • Hi Carrie, I’m sorry that you are going through such a tough time! It sounds very frustrating and tiring. Unfortunately, I don’t think yours is a situation that I can help with in this forum. Children who are taking medications or have seizures/developmental delays are each unique and may have various reasons to not sleep well. My recommendation would be to make an appointment with your pediatrician and/or pediatric neurologist and discuss this issue with them. They may even have a child sleep specialist that they would recommend that you see. Best of luck and I hope you all get some rest soon!

  6. I need anyones help… Our nearly 3 year old has always been a perfect sleeper (7am-7pm) every night sense 6 weeks, odd time would wake when teething etc, we have a bed time routine, books etc, then bed, she has a night light in her room, always has. She now goes to sleep straight away (last few weeks would contest and consistenly get out of bed i would be putting her back over 100 times before she would stay in there) but would still wake at about 11pm and get out of bed and try and come into our bed, we get all the excuses, i need to go wees, i have a runny nose, and i consistenly put her back to bed, ignoring all that ( trying the super nanny thing) and she will even get to the point where she is worked up and vomits! and this goes on consistenly from 11pm til sometimes 3 am , she may fall to sleep for about 20mins thorughout that period but will wake consistenly, sometimes im so tied ive fallen asleep (in my own bed ) and wake in the morning to find her in our bed. i have tried natural sleep stuff from the health shop, she is at daycvare most of the day, we have play time and she eats healthy food, this has just really started all of a sudden in past 4 weeks, no changes have happend in her enviorment..please help

    • Dear Michelle,
      I’m so sorry- this sounds really difficult and frustrating. First off, I would say that if your daughter has any symptoms of illness- weight loss, fever, fussy during the day, not eating well- then it is definitely time to visit her health care provider. Even if she has none of these, it really may be useful at this point to sit down and talk with her pediatrician about the sleep problems you are having and get to the bottom of it. I wonder if anything has changed- perhaps toilet training, a vacation, an illness, that set off this new pattern? Has anything changed about her room or sleeping environment?

      It sounds like you are trying the “silent return to sleep” method. That is a great start. Most often bedtime woes at this are behavioral in nature and consistency is key to improvement. However, it does get very difficult when kids get so upset that they vomit.

      In terms of general print/on-line resources, I highly recommend Dr. Canapari’s site. He is a pediatric pulmonologist and sleep specialist and has a number of excellent posts on sleep difficulties. He wrote a guest post here that addresses bedtime resistance.

      I found Dr. Weissbluth’s book to be useful, but as other comments have noted, it can be a bit “strict”. The Sleep Lady’s “Good Night, Sleep Tight” is also a good option.

      Best wishes for improved rest!

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