If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial. I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. This is a reference book. Read only the topic of interest to you.
The most common cause of sleep problems in young children is a bedtime that is too late.
This is my opinion, based on my general clinical pediatric practice over 40 years, my many sleep consultations, my own research, and reviewing published scientific papers.
Consider two groups of children:
These children are often cared for in academic centers (Blog Post 66) and may give professionals working in these centers a skewed perspective suggesting that sleep problems are usually a primary problem within the child. The sleep problems subsequently produce secondary or interactive problems with the parents.
Here is an example:
Dr Jenny Radesky’s research suggests that having a television or other media in the child’s bedroom may be a parental response to their child’s not sleeping well; that is, allowing more screen time is a coping strategy. “Our findings demonstrate that, longitudinally, infants with regulatory problems [excessive fussiness, poor self-soothing, difficulties in falling asleep and staying asleep and modulating their emotional state] do watch more TV and videos later in their toddler years. However, the relationship is probably not unidirectional: child self-regulation abilities and media habits likely influence each other through a transactional process whereby parents try to soothe fussier infants through screen time, which reduces the amount of enriching parent-infant interactions and other developmental activities, exposes infants to potentially inappropriate content, and contributes to continued regulatory difficulties, which in turn predict greater media exposure, and so on.” Blog Post 22.
Those children with mild and moderate sleep problems unnecessarily might suffer the life-long adverse effects of sleep deprivation (Blog Posts 1–5) and, over time, the entire family suffers.
Those children with severe sleep problems might be referred to professionals in academic centers and incorrectly appear to have a primary neurological problem, a primary mental health problem in a parent, or both. Sadly, only focusing on neurological diagnoses in the child or mental health problems in a parent is common because physicians in medical school and pediatricians in training are not taught about sleep problems in children.
Here is an example:
My daughter Zaylin was born with complex birth defects requiring multiple surgeries and prolonged hospitalizations during her first few years. The consequence of this medical history, that resolved approximately one year ago, at age five, is that she had many behavioral problems not only at school but also in our home. We regularly got reports from her teachers for “acting out” and she had an IEP [Individualized Education Plan] as she struggled with academics in school. In addition, she was very mean and nasty to her brother and very defiant at bedtime. I sought out many therapists and advice in an effort to help her, but nothing seemed to work. Part of the stress for me was Zaylin’s struggles and also, the difficulty for doctors to properly diagnose her problem. At first, she was diagnosed with autism. She was later diagnosed with developmental delay and PTSD (from her repeated and prolonged hospitalizations). After many tests and many therapists, none of these diagnoses seemed to fit my daughter.
We used Sleep Rules and she protested. I started by taking away her stuffed animals one by one. She loves them and has plenty of them on her bed. Then I offered her a cookie for breakfast. I would let her dad put her to sleep because I would baby her and he didn’t. Her normal bedtime was 9:00 p.m. and we moved it to 6:00 p.m.
It was not until I got Zaylin on a better sleep schedule, at age 6 years, that I realized that her sleep deprivation was causing all of these behavioral issues. I was skeptical because of my past failed attempts. After one week of applying Dr. Weissbluth’s advice, I saw some changes. It has been four months and my daughter is a new person! The sleep strategy allowed Zaylin to sleep longer through the night without any more bedtime battles and her improved behavior in school was noticed by her teachers, and, at home, she turned into an entirely new child, saving my daughter and our family.
Two years after her mother wrote her story, her bedtime is 7:00 p.m. and she continues to thrive academically, socially, and artistically! (see Blog Post 66).
(To be continued)