Dealing with sleep issues beyond the baby years
Friday, October 05, 2012
Just when you think your sweet baby has the hang of sleeping through the night-boom-she turns into a 3-year-old sleeping monster. Or an adolescent night terror. Or a tween-aged zombie.
Whatever the age and whatever the issue, getting your kids to sleep, and sleep well, never is easy. Plus, it's extremely tiring. So we went to the experts to help us tackle sleep issues for toddlers, adolescents and tweens because parental sleep deprivation isn't just for the newbies.
Issue: My baby was a great sleeper and now my toddler is a screaming nighttime terror!
I've always believed in tough love when it comes to sleep training my boys. I let them cry it out, and as a result, they slept through the night starting at four months. Now, however, the youngest, almost 3, is a sleep monster: Screaming at bedtime and naptime and waking in the middle of the night like a newborn.
Here's what the expert says:
"Many kids who have sleep problems have parenting problems, and there is an issue of control that bleeds over into sleep time," says Dr. Harvey Karp, renowned pediatrician and author of the new book, The Happiest Baby Guide to Great Sleep. "Sometimes if you're too strict during the day or not enough, the kids can rebel at night."
Remedy this by creating a star or sticker chart or even using-and you won't believe it-poker chips to reinforce good sleep behavior, Karp says.
"One of the beauty of star and sticker charts is that it gives kids encouragement of good behavior," Karp says. "But don't make the chart just about sleep because it puts too much emphasis on the sleep issue. Incorporate other behaviors you want to change as well."
When using poker chips or cards for 3- to 5-year-olds with sleep problems, kids can use the cards as "payment" to have you come and check on them in the middle of the night, Karp says. When the cards or chips run out, well, the kid is out of visits.
"Poker chips and cards give toddlers a choice and something tangible to make a finer decision," Karp says. "Then they can decide in the middle of the night what they really want."
Issue: My 6-year-old still sucks his thumb and still has a security blanket at night. Help!
Laura Sawyer Dhokai's son Lincoln, now 6, was a thumb-sucker even in utero and has had a blankie since birth. After a warning from a dentist that he couldn't suck his thumb when his adult teeth grew in, Dhokai and Lincoln came up with a plan involving Band-Aids on thumbs to prevent sucking and prizes for giving up both the blankie and thumbs.
Here's what the experts say:
Dr. Kevin Boyd, a pediatric dentist in Lincoln Park and part of the Sleep Medicine team at Lurie Children's Hospital of Chicago, is an expert on how children's mouths develop and how that affects sleep, and ultimately, behavior.
"If the teeth stick out from thumb sucking, it affects the shape of the palette," Boyd says. "Dhokai is right-a reward system shows you are paying attention and can be very effective."
What some parents may not know, however, is that palette formation and the way the child's mouth closes, or fails to close from thumb sucking, may interfere greatly with sleep and behavior.
"According to a recent study in the journal Pediatrics, children who snore and mouth-breathe can be more susceptible to ADD and ADHD," Boyd says. "We have a real opportunity to change soft spots in the mouth that contribute to adolescent and adult sleep apnea."
So while thumb-sucking is a no-no, sleep consultant Janeen Hayward of Swell Being says blankies are OK for comforting little ones in times of distress.
"Blankies should be reserved for sleep, doctors' offices or a place the child needs soothing," Hayward says. "But otherwise I'd restrict blankies to the crib so that the child knows the blankie is reserved for sleep."
Interestingly, Karp encourages those props instead of thumb-sucking and sees some children take their first blankies all the way to college.
"Blankies are good friends, sometimes the child's first `friend,'" Karp says. "I see no reason for kids to give up blankies or teddy bears as support tools. I love them."
Issue: My tween will not go to bed or stay in bed and I know she needs the rest. I want to help her, but how?
Cindy Rudman's daughter Natalie, 11, was never a great sleeper and has always been an early riser, but somewhere along the line, her going-to-bed routine went off the rails. She needed multiple trips to the bathroom, extra goodnight kisses and closing the door just the right way and complained because she could not fall asleep.
Here's what the experts say:
"First thing I ask parents is if the tween-age child has had any caffeine or a soda or a sweet with dinner," says Dr. Kenneth Lyons, pediatrician at Children's Healthcare Associates in Lakeview. "Caffeine in kids is public enemy number one when it comes to sleep."
If that's not the problem, Lyons suggests 20 minutes of "dead time" right before bedtime that is not TV oriented.
"You've got to rev those neurons down before you can get them to sleep," Lyons says.
"Create a bedtime routine that doesn't include a device with an LCD screen," Hayward says. "Anything with an LCD screen suppresses production of melatonin and sleep."
Hayward also says people often underestimate the amount of sleep a tween or teen needs-as much as 9.5 hours a night-and that even 15 more minutes of sleep a night helps a child's executive functions immensely.
Karp, an avid supporter of white noise for good newborn sleep, sees great benefits for tweens as well.
"White noise cues tweens to not be disturbed and it also covers intrusive thoughts an older child might have," Karp says.
However, sometimes with older kids, sleep is just a power struggle. If that's the case, Karp suggests figuring out ways to diffuse the conflict.
"I give them more choices, options and family meetings to discuss the problems," he says. "I like figuring out a way to compromise and work creatively with the child. Don't wag the finger at them."