A Healthy Child Needs a Healthy Brain, A Healthy Brain Needs Healthy Sleep

Bedtime routines (Blog Posts 10 and 87) help children calm down before falling asleep because children learn to associate the routines with the natural state of relaxed drowsiness (Blog Posts 10 and 87). Pick and choose from the following list of soothing activities based on your child’s age and your personal preferences. Try to do bedtime routines on most nights and to follow the same sequence at bedtimes. Follow any routine that you feel comfortable with and stick with it. But it is not necessary that Mom and Dad have the same bedtime routines. Your baby will learn to associate each style with each parent. Here are some examples of bedtime routine activities:

• Bathe, massage.
• Dress for sleep.
• Feed.
• Read books, lullabies, singing.
• Say prayers.
• Brush teeth.
• Reduce stimulation: less noise, less playing, dimmer lights.
• Bedroom: quiet, dark, not too warm.

1. How often do you perform a bedtime routine? The more frequent you perform a bedtime routine, the better the sleep for your child.

Professor Jodi Mindell showed that:

• Within three days, instituting a new bedtime routine consisting of a bath, massage, and quiet activities (cuddling, singing, or lullaby), children fell asleep faster, had less wake time after falling asleep, and fewer night wakings.
  
• “Having a regular nightly bedtime routine is associated with improved sleep for young children, and that the more consistently a bedtime routine is instituted and the younger started the better.” Furthermore, comparing whether there was a bedtime routine 0, 1-2, 3-4, 5-6, or 7 times per week, as the bedtime routine increased in frequency, sleep improved more. In other words, bedtime routines practiced every night produce the best improvements in sleep and, in a stepwise fashion, lower “doses’ of bedtime routines produce lesser improvements. Improvements were an earlier bedtime, falling asleep faster, fewer night wakings, and increased sleep duration.  

2. How consistent should you be when performing a bedtime routine?  The more consistent you are with each bedtime routine, the better the sleep for your child.

A 2021 paper described bedtime routines, and children’s sleep across the first 2 years of life. Children were studied at 3, 12, 18, and 24 months. They studied ‘Bedtime Routine Consistency’ and ‘Bedtime Adaptive Activities’.

‘Bedtime routine consistency’ was evaluated by responses to questions:

• How often is a bedtime routine practiced?
• Does your child go to bed at the same time (within 10 minutes)?
• Does the same person put your child to sleep?
• Does your child sleep in the same place?
• Are the bedtime routine activities the same?

‘Adaptive Activities’ in the hour before putting to sleep included:

• Cuddle with caretaker.
• Read/listen to a story.
• Taking a bath
• Get tucked in.
• Say prayers.

“These activities are typically calming routines that allow a child to transition from a highly arousing environment to a safe and more serene environment that promotes sleep.”

Conclusion: “More bedtime routine consistency predicted less nighttime waking and fewer sleep problems, and more bedtime adaptive activities predicted longer sleep duration and fewer sleep problems.”

3. Do you believe that promoting self-soothing is important? Promoting self-soothing predicts longer sleep for your child.

A 2020 study compared Israeli Arab and Jewish infants and toddlers (3 to 36 months). They observed that the Arab children had later bedtimes, shorter night sleep duration, and longer periods of nocturnal wakefulness. There were no group differences in daytime sleep (naps) duration, so the Arab children also had shorter total sleep duration

A 2021 article by the same authors, on the same group of children, compared maternal sleep-related cognitions between Israeli Jewish and Arab mothers. “Several studies have shown that parental cognitions that reflect difficulties in limiting parental involvement-emphasizing child’s distress upon night waking and the need to assist the infant in settling back to sleep-are associated with higher levels of parental active involvement at bedtime (e.g., rocking, cuddling, feeding). These practices in turn predict more infant night-waking. Expectant mothers who strongly tended to interpret infant night-waking as a sign of infant distress that requires immediate intervention were more likely to get actively involved in settling their infants to sleep, and their infants had more night-wakings, compared to infants of mothers who were more likely to endorse cognitions emphasizing the importance of promoting infant self-soothing.Arab mothers were more likely to hold sleep-related cognitions reflecting their difficulty in limiting nighttime intervention in response to their child’s. awakening.”  

The results showed that Arab children had longer periods of nocturnal wakefulness but the actual number on night-wakings was the same in both groups. 

(To be continued)

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