Getting a Child to Sleep Through the Night
Wakefulness in Infants is Related to Maternal Depression
Aug 4, 2009
Nothing is more demanding on new parents than the loss of sleep that comes with caring for an infant.
If one’s own child isn’t sleeping well, it doesn’t help to know that 80% of infants sleep through the night by the age of six months, or that 90% do so by one year of age.
Although some children sleep through the night at an early age, it is not uncommon for them to revert to nocturnal awakenings between the ages of nine and 18 months, when separation anxiety typically becomes common. (Owens J. Sleep problems. In Developmental and Behavioral Pediatrics: A Handbook for Primary Care. 2nd Edition. Lippincott, Wilkins & Williams 2005:317-21)
Sleep deprivation or sleep interruption caused by persistent sleep problems in an infant has been linked to maternal depression—although these mothers do not necessarily exhibit different levels of stress, family function, or coping skills when compared to their well-rested counterparts. (Lam P, et al. Outcomes of infant sleep problems: a longitudinal study of sleep, behavior, and maternal well-being. Pediatrics. 2003;111(3)e203-e207)
How to Get a Baby to Sleep Through the Night
In 2006, following a review of more than 50 studies of sleep in children, the American Academy of Sleep Medicine (AASM) published guidelines to help parents who are having trouble getting their children to sleep through the night.
Although one method—or a combination of methods—may work well for a specific infant, there is no scientific basis for favoring one technique over another, nor is there ample evidence supporting the use of a combination of methods instead of just one.
These guidelines make the assumption that the child is under five years of age, well-fed, comfortably clothed, and in good health:
- Bedtime routine: Maintain consistent sleep and wake schedules on a daily basis.
- Unmodified extinction: The infant is consistently put down to sleep at a designated time; parents do not respond to any crying until morning.
- Graduated extinction: Following the establishment of a consistent bedtime, parents gradually respond less frequently to the child’s crying (e.g., at first, respond within five minutes of the onset of crying; after a few nights, extend the time of response to 10 minutes, and so on).
- Scheduled awakenings prior to expected times of awakening: For children who consistently awaken at the same times every night, awakening them 10 – 15 minutes earlier than the predicted time will eventually remodel sleep patterns so they sleep through the predicted times. For example, if the child awakens predictably at midnight, 3 am, and 5 am, awaken him or her at 11:45, 2:45, and 4:45, briefly comfort the child, and allow him to return to sleep.
- Parental education: Parents who are better-educated about childhood sleep patterns or who attend support groups are more successful at getting their children to sleep through the night. (Further Information About Childhood Sleep Problems)
(Adapted from Tseng A, Biagioli F. Counseling on early childhood concerns: sleep issues, thumb sucking, picky eating, and school readiness. Am Fam Phys. 2009;80(2):139-142)
Clearly, for some parents (those who live in apartments surrounded by neighbors, for example), allowing their child to cry for extended periods of time is unacceptable. However, with a bit of homework, a little innovation, and a lot of patience, nearly anyone can help their child sleep through the night.
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