Sunday, April 16, 2006

Sleep success!

After four nights of putting Rebecca in her crib awake but drowsy every time she was tired, she finally slept through the night! Ten hours straight! (Which is normal for her age). And just now, she was drowsy and went down for a nap without a fuss.
Of course, next week I am taking her with me to Halifax, which will probably prove to be a major disruption. But I am hoping that she will adapt after a few days. At the very least, we know she has learned!
My physician had recommended I read about sleep, in order to get Rebecca on a reasonable routine. Basically, she suggested I peruse two books in particular - the infamous Ferber "Solve your child's sleep problems" and another books which emphasized the importance of naps, was written by someone whose last name starts with "W", and which advocated a slightly differently approach. For the latter, I ended up selecting "Good Night, Sleep Tight: The Sleep Lady's Gentle Guide to Helping your Child go to Sleep, Stay Asleep and Wake up Happy" by Kim West. The Ferber book was first published in 1985, and takes a very scientific/clinical approach. The Sleep Lady book is more soft and cuddly and has little lambs in it. The Ferber book is famous because it's very strict. There is no debate about it's effectiveness - it works about 99% of the time. However, the methods may be a little harsh for softie parents. The expression "ferberize" has even entered parental common parlance.
Regardless of which method selected, if you stick to them, they work (provided your child does not have a physiological reason to have sleep trouble - such as reflux or apnea or what have you). In fact, all books seem to agree that most of the problems are behavioural - i.e. learned.
The underlying concepts and principles in the books are the same (which is reassuring to me). They both highlight the importance of routine, and winding down at bedtime. Both indicate that naps are important. Both encourage you to bond your child to an inaminate object (be it stuffed animal or blankie - as you may have read in an earlier post, Becca is a ratty towel girl) as a transitional aid, to ease separation anxiety. And most importantly, both are based on an actual understanding of how sleep works.
Forgive me for oversimplifying, but here is the core idea with all the sleep approaches I have encountered: There are three states: awake (mind awake, body awake), REM sleep (mind awake, body asleep), and non-REM sleep (mind asleep, body asleep). There are sub-stages of each of these, and there are predictable cycles. In essence, no one sleeps through the night. There are miniscule moments of awakening at regular intervals between sleep cycles. At those times, there is the possibility that you might become fully awake - if you sense that something is wrong. So for example, if you hit ones of these moments of awakening and hear screaming, you will wake up. Or if your pillow is missing, you might wake up. Or if you smell something burning, you might wake up. Clearly, this is a good thing. (There was some very interesting speculation about the purpose and evoluationary origins of REM and non-REM sleep in the Ferber book which I found to be fascinating). But what is it that enables you to perceive something as wrong? Learned associations! Inadvertently, parents create associations/crutches for their babies when their babies are learning to sleep. And yes, falling asleep is something that must be learned. It does not come naturally to babies. At any rate, if you always hold your baby to get her to fall asleep - she creates an association between being held and falling asleep. Therefore, when she has one of these moments of awakening, and discovers she is alone in her crib - bam, she feels that things are "wrong", and starts crying. She doesn't know how to get herself back to sleep. So, the idea with putting the baby to bed awake but drowsy is to give her the opportunity to learn how to soothe herself, calm down, and fall asleep on her own. Then, when she has the brief moments of awakening, she knows how to go back to sleep, and does not require your intervention. You might think that intervening is not so terrible - but baby sleep cycles are a lot shorter than ours (think, half hour long), and eventually, lack of sleep catches up to *you* and your ability to parent effectively, or at least be remotely cheerful, is seriously impaired (to say nothing of the mental/emotional strain of a baby crying on and off most of the night). Sometimes, if you are not careful, you are so tired that you cause a fire to ignite in your very own kitchen (perhaps this is an anecdote I will relate some other time).
The Ferber approach is supposed to be employed starting at 5 or 6 months. The Sleep Lady method differs depending on the age of the child, but has suggestions starting as early as 2 weeks of age (and age does make a difference, especially when you consider amount of sleep required, level of development, feeding requirements etc.).
Interestingly, and I'm sure some of you have heard this before... if people are left in an environment without light or devices which indicate time - their bodies will assume a cycle and rhythm of sleeping and eating which exceeds 24 hours and is more like 25 or 26 hours. So, when a child doesn't have a sleep routine, their big stretch of sleep will get progressively later in the day. It is only the daily routine we impose on ourselves, and cues from light levels, that allow us to be consistent in a 24 hour day. And of course, being consistent is very important in parenting.
Greg and I tried one night of Ferber and realized that we could never stand it. We just don't have the nerve to endure it. I decided it would be our back-up plan. Fortunately, we won't need to use the back-up plan. The major difference between the Sleep Lady method and Ferber is that the Sleep Lady lets you soothe your child, touch her, and speak to her. In Ferber you just stand there and leave at regular intervals.
Now, while Rebecca *is* sleeping well now (naps and through the night), the phase of her sleeping is off - that is, her bedtime is a little more "night owl" than we would like. Her bedtime seems to be consistently midnight. I will have to gradually change that by waking her up a little earlier every morning (say by 15 minutes), and adjusting her bedtime (all while not allowing her to retrieve her 15 minutes during an afternoon nap). But that is a task for when I am back in Ottawa.

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