From the Crib to the Bed

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Fifteen to 30 percent of toddlers have sleeping problems, such as trouble falling asleep, waking and crying often during the night, or (for preschoolers) nightmares. Some children have such sleep problems for months or years. This cycle can be stressful for parents, who can become exhausted from waking up to go to their crying child, night after night, or from having their child getting in their bed every night.
Sleeping problems – what causes them?
Sleeping problems can happen for several different reasons, and they may come and go.
At preschool age, your child is more independent – until he thinks he’s lost you or he’s left alone. Going to bed can feel like a separation, which can cause anxiety. Developmental issues – such as learning to walk or having nightmares – can cause a child to wake up during the night. An illness or new sibling can also cause nighttime waking.

How Sleep Works
Normal sleep includes different sleep patterns. Stage one is rapid eye movement sleep (REM). Stages two through four feature non-REM sleep. Stage one, or REM sleep, is the lightest sleep state. Stage four is the deepest sleep. During the night, REM sleep alternates with non- REM sleep every one to three hours. Infants go through these sleep cycles several times per night. Some children wake, however, after entering REM sleep – especially if they are troubled or upset. Some parents really mean it when they say their child wakes every hour of the night! All babies wake often like this for a short period of time, but the majority learn to soothe themselves and fall back to sleep.

Overcoming sleeping problems
Starting a sleeping routine for your child is the first step in helping your child overcome his sleeping problems. After your preschool child has become used to the sleeping routine, he must learn to fall asleep on his own. Unless children learn
to comfort themselves so that they can go back to sleep, they may continue to wake at night for years. This is stressful for your family. A calm, consistent bedtime routine is very important. The routine should be pleasant and relaxing, such as a warm bath followed by a bedtime story or lullaby. Try not to rock your child or feed him. Tell him in a loving, firm way that it is time to sleep. You may decide to use a night light or leave a door partly open so that he can hear voices and sounds. It’s very important to be consistent with the sleep program. Making an exception to the routine, even once, will let poor sleep habits take hold again. They will be even more difficult to overcome later.

Your child’s Sleep Program
There are some things you can do to help your child learn to fall asleep on his own.
1 Put him down to sleep without rocking, holding or feeding him.
2 Kiss him goodnight, say that it is time for bed, and leave the room calmly.
3 If your child cries, go back into the room after about five minutes. Do not pick him up. Speak to him quietly to reassure him.
4 If he still cries, try waiting a little longer before going back in the room. Do not pick him up.
Following the sleep program may be tiring and difficult for the first few days, but your child should learn to fall asleep on his own. Then, you can look forward to restful sleep for the whole family!

Dr. Sarah Landy is a psychologist at The Hincks/Dellcrest Centre and is a member of the Dept. of Psychiatry, York University, Toronto.

How do you know if your child has a sleep disorder?
Your child may have a sleep problem if he has the following problems for three months in a row, five or more nights per week:
He wakes three or more times per night.
He wakes for more than 20 minutes per night.
He must get into your bed during the night in order to settle down and sleep.
He will not go to sleep at bedtime or he needs you to be there with him to fall asleep.
Whether or not your child has all of these sleeping problems, even one or two can affect your family life and leave you feeling frustrated, exhausted, or even angry with your child.
Some reasons for sleeping problems
Teething or a brief illness disturb your baby, and waking becomes a habit.
Your child got used to going to sleep by being fed or rocked.
A new brother or sister has recently been born.
Your child is being weaned from breastfeeding.
Your child is learning to walk and wants to practice all the time.
Your child has fears, such as a fear of being alone at night.
Your child is having nightmares.
It’s important that you establish a bedtime routine and stick to it. Constant
lack of sleep because of a child’s sleeping difficulties can cause exhaustion and make it hard to get up in the morning. Sleep deprivation on an ongoing basis can cause irritability, depression and even disorientation.

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