Blog Posts 1–5, based on the United States of America Department of the Army Field Manual: Holistic Healing and Fitness, describe what really matters for your child’s sleep. If sleep is an important enough topic for national defense than surely sleep should be considered a serious topic for parenting!
A healthy baby needs a healthy brain,
A healthy brain needs healthy sleep.
Circadian sleep rhythms for night sleep develop around 46 weeks, post conceptual age and around 4-6 months for naps. Observe and use drowsy signs for sleep timing.
Drowsy signs (Blog Posts 9, 83, 115X) tell you when to begin soothing your baby to sleep.
If you are too late, fatigue signs and presleep arousal (Blog Posts 159, 171. 172, 204) develops; the result is unhealthy sleep.
Just like junk food harms the body, unhealthy sleep impairs brain development (Blog Posts 50–51, 72–73, 108, 135–136, 148–151, 200, 221).
It may take weeks or months of a slightly too late bedtime to “all of a sudden; for no reason” to cause sleep problems; this is cumulative sleepiness (Blog Posts 84–86). Cumulative sleepiness may occur when the bedtime is just a little too late. If so, after a ‘reset’ (Blog Post 26 and Parents’ Reports #4), moving the bedtime just a few minutes earlier might make a big difference (Blog Posts 137, 162).
Solutions to sleep problems usually involve moving the bedtime earlier (just for a few days or maybe for months)
It is normal for parents to be skeptical that moving to an earlier bedtime (Blog Posts 74, 174) can dramatically help (Blog Posts 159, 188, 194, 210, 222, and Parents’ Reports #2).
Hi Dr. Marc,
My name is Daiane, I am a physical therapist from Brazil. I have a three year old son, a 1y9m daughter, Catarina, and am 38 weeks pregnant with my third child. We have a sleep problem with Catarina. She was sleep trained to fall asleep by herself at 2 months of age. Around the time of her first birthday, she started waking many times per night (around 10x). These wakings are marked by very loud crying and screaming, and have gotten worse over time. She is only soothed by her father, with some difficulty; when I try going in, she does not calm down. After he soothes her, he puts her back in bed (still awake) and she returns to sleep. He has always been the one to attend to most of her night wakings.
About her routine: she wakes up around 6:30am, and we start her day at 7:00 am. She takes a single nap (transition from 2 naps to 1 was at 1y3m) around 11am. She frequently (but not always) wakes up one hour into the nap and goes back to sleep for another hour if soothed. Dinner is at 5:45pm, followed by a consistent bedtime routine which she has been resisting, asking for more water and more cuddles (bedtime battles). She falls asleep between 6:30pm and 7pm.
A friend who read your book told me this could be due to a cumulative lack of sleep, and that things would improve if she had an earlier bedtime. She especially thought this was so when I told her that Catarina is very irritated, clingy and ill-humored in the morning, up until her nap. Close to bedtime, she is also somewhat irritated but distractible. We are trying for a slightly earlier bedtime but are not fully convinced that this will solve this chronic problem. We are supremely exhausted, and anxious about the impending arrival of our newborn, which will only complicate things further. I don’t have much help at home, my husband often comes home late from work, and an accomplishing an early bedtime is more difficult having to care for my first son as well, usually by myself, compared to if I only had Catarina.
Could you give me some advice?
Thank you.
What is a common time when when you start the bedtime routine and the common time when she falls asleep at night? Please describe her mood and behavior when alone with toys (no screens or parental involvement) during the 60 minutes before you start the bedtime routine.
“And sometimes she wakes up after only under an hour and I quickly rush to put her pacifier in. She’ll sometimes sleep more and sometimes keep fussing…” What percent of the time does she “sleep more”?
“but will go to sleep if I hold her and she’s sleeping in my arms. I know that’s not a good habit – I’m not sure if it’s better to just have it be that she takes a short nap and is still tired but won’t go back to sleep or if it’s better for her to sleep in my arms and sleep longer” When you do this nap extension in your arms, how long was the “short nap” and how long is the nap extension in your arms?
Yes, sorry that I did not respond to you.
Please carefully read Blog Posts 64 & 65 to understand the cultural challenges you will face with an attempt for an earlier bedtime.
Please carefully read Blog Posts 84-86 to understand why your friend is correct regarding cumulative sleepiness.
Please carefully read Blog Post 204 regarding pre-sleep arousal.
Share this information with your friend and husband because he will have to get on board because you are about to deliver your third child. Have your friend help you convince him (and you) that Catarina is sleep deprived from a bedtime that is too late and this is why she began, about 9 months ago, to have sleep issues.
I understand that you have your eminent delivery on you mind but your older son, newborn baby (soon) and your marriage will benefit if you make some dramatic changes quickly.
If you wish to proceed, I will help you help Catrina sleep better.
Is this acceptable?
Is your friend the mother whom we recently exchanged comments here regarding her own child?
Hi Dr. Marc,
Her bedtime routine starts at 5:30 pm, including dinner and a bath. By 6pm we are in her room with a book, and I’m out of her room by 6:15 pm. She often will only fall asleep around 7pm, taking 45 minutes to soothe herself to sleep.
In the 60 minutes before her bedtime routine, she plays with her 3 year-old brother, so she is not by herself as you asked about, but she is mostly calm.
I think a part of your reply was possibly mixed up with someone else’s post. Just to recap, during her nap, she will sometimes sleep for ~1h30min – 2h with no assistance, while other times she calls/cries after one hour of sleep, and naps for an additional 30 minutes to an hour if soothed.
Hi Dr. Marc,
Thank you! I have read the posts you recommended, they have much improved my understanding of early bedtimes, sleep debts and drowsy signs. We are making the effort towards an earlier bedtime for Catarina. Also, we observed that she would often calm down as soon as she saw some light coming from the hallway, even before my husband went over to soothe her; so, the past few nights, we’ve left a very small red nightlight on, and she woke up only twice during these nights.
Yes, my friend is Laura, with whom you have recently exchanged messages.