The latest snooze on kids’ sleep

BATTLING through months of disturbed sleep is only to be expected when you’ve got a new baby.

But when your child is older and still not sleeping through the night, it can be a huge family problem.

However, there are very few such problems that can’t be tackled, promises child sleep expert Dr Richard Ferber.

Ferber, director of the Centre for Pediatric Sleep Disorders at Boston Children’s Hospital, stresses that while children’s sleep problems vary widely and can range from being unable to fall asleep without help, getting up repeatedly during the night, waking very early, being hard to wake up, bedwetting and sleep apnoea, they are rarely the result of poor parenting.

A revised version of Ferber’s book, Solve Your Child’s Sleep Problems, has just been published, and he hopes that parents of children of any age will read it, not just to help them deal with existing sleep problems, but to help them understand sleep so they can prevent problems occurring in the first place.

“Pretty much all normal children have the ability to sleep fairly normally,” he points out.

“The drive to sleep is very powerful, but there are many ways the sleep pattern can be disrupted, and that’s when it’s worth trying to sort it out.”

As well as discussing how to solve specific problems, Ferber’s book explains how sleep works, so parents can understand what’s happening and are therefore better equipped to deal with any sleep difficulties in the future.

One of the most common problems is children not being able to go to sleep easily or stay asleep.

Ferber says this is often related to schedules (the timing of sleep and how it’s controlled), and habits and associations related to sleep (what they’re used to doing when they go to sleep) such as feeding.

As a child gets a little older, he says there may be issues around limit setting (sticking to strict rules on sleep-delaying tactics such as an extra glass of water or coming into your bed at night), and night-time fears may also cause problems.

He explains that solutions will differ depending on the child, and says that while trying something such as controlled crying (where babies over six months of age are left to cry but are checked regularly, and reassured without being picked up) may help in particular situations, such as if a child’s awake because they have a certain association with falling asleep, it’s often not appropriate.

He says controlled crying shouldn’t be used if, for example, children are in pain or discomfort, if their sleep schedule isn’t correct (ie, if parents think the child should be sleeping for longer than he/she is capable), or if they’re frightened.

If a child has night-time fears, it’s important to identify the source of the fears and deal with it so the sleep problem can be resolved.

“The first question is why is a child crying?” stresses Ferber.

He says that it’s often due to some sort of association, for example if they have to have their back rubbed to fall asleep, then if they wake up in the middle of the night (a normal part of the sleep cycle), someone can’t be there to rub their back all night.

“If they know how to go to sleep without back rubbing, there’s no problem, so withdrawing it is appropriate,” says Ferber.

“If it’s done and the child’s upset, you may want to check them at increasing intervals to show you haven’t disappeared, but without reinstating the back rubbing, or the habit or association related to them getting to sleep.”

He points out that children often have a combination of more than one sleep problem, and parents need to be aware that if they deal with one problem, such as a sleep association, and the child still has sleep difficulties, it may be because there’s an additional problem.

This may be an incorrect sleep schedule, such as napping too long during the day, going to bed too early/late, etc.

“Parents may come to the conclusion that their child is just a bad sleeper, but if they fix the schedule, they may find the child’s actually a great sleeper,” he says.

One of the least obvious sleep problems is a child simply not getting enough sleep, and while Ferber says there’s no absolute way of telling from numbers alone whether a child is getting enough sleep, a general guide is around 14-18 hours for a baby, around 12-14 hours for a toddler, and around 11-13 hours for primary school-aged children.

He emphasises that a bedtime routine is very important, and a child being put to bed straight after watching TV, for example, without any transition period, can cause problems.

“Establishing a routine the child looks forward to, such as a song or a story, makes the whole process leading up to bed pleasurable.

“It’s also a chance for parents to get away from other distractions and have one-on-one interaction with their child. It can be as special a time for the parents as it is for the child.

“We’re not talking about a huge amount of time here, but it’s very much time well spent.”

* Solve Your Child’s Sleep Problems is published by Vermilion, priced €16.