Annie was having a tough time. While her five-year-old son Paul would sleep through the night, her two-year-old daughter Nina would wake every few hours, meaning Annie was exhausted. “My little girl had extremely interrupted sleep patterns and would rarely sleep for more than three hours at a time,’’ says Annie, a Dubai HR officer. “She’d wake up crying as if she’d had a nightmare and it would take a lot of comforting before she’d go back to sleep.’’
Her husband Mathew helped her to soothe Nina and put her back to bed, and the lack of sleep was taking its toll on both parents. “I was finding it difficult to concentrate at work and my husband said that he once even dozed off at the wheel,’’ says Annie. “I realised then I needed to do something before a disaster happened. The lack of sleep was becoming dangerous.”
She took the toddler to her doctor for a check-up, but there was nothing physically wrong with her. “We tried all kinds of things like rubbing her back, cuddling her and putting her to bed at fixed times,” says Annie. “It took nearly a year before she fell into a regular sleep pattern.’’ Annie’s not sure what caused the problems, but suspects it was a stage her daughter eventually grew out of.
Nothing that can’t be tackled
Battling through months of disturbed sleep is to be expected when you’ve got a new baby. But when your child is older and still not sleeping through the night, it can be a huge family problem. However, there are very few issues that can’t be tackled, promises Dr Richard Ferber, director of the Centre for Pediatric Sleep Disorders at Boston Children’s Hospital.
He stresses that while children’s sleep problems vary widely (common issues include being unable to fall asleep without help, getting up repeatedly during the night, waking early, being hard to wake up, bed-wetting and sleep apnoea) they are rarely the result of poor parenting.
A revised version of Dr Ferber’s book, Solve Your Child’s Sleep Problems, was published recently, and he hopes parents of children of any age will read it to help them understand sleep so they can prevent problems occurring. “Pretty much all children have the ability to sleep fairly normally,” he says. “But there are many ways sleep patterns can be disrupted and that’s when it’s worth trying to sort it out.”
Stop it at the source
Dr Ferber says that one of the most common problems is children not being able to go to sleep easily or stay asleep. This is often due to schedules (the timing of sleep and how it’s controlled) and habits related to sleep (what they’re used to doing before sleep) such as feeding. As a child gets older, there may be issues around limit setting (sticking to strict rules on sleep-delaying tactics), and night-time fears may also cause problems.
He explains that solutions will differ depending on the child, and says that while trying something such as controlled crying – where babies older than six months are left to cry but checked regularly and reassured without being picked up – may help in particular situations, it’s often not appropriate.
It shouldn’t be used if children are in pain or discomfort, if their sleep schedule isn’t correct (if parents think the child should be sleeping for longer than he or she is capable) or if they’re frightened. If a child has night-time fears, it’s important to identify the source of the fears and deal with it so the problem can be resolved. “The first question is ‘why is a child crying?’” stresses Dr Ferber.
He says that it’s to do with some sort of association, for example if they have to have their back rubbed to fall asleep, then if they wake up in the middle of the night, which is a normal part of the sleep cycle, someone can’t be there to rub their back all night. “If they learn how to go to sleep without back rubbing, there’s no problem, so withdrawing it is appropriate,” says Dr Ferber. “If the child is upset, you may want to check them at increasing intervals to show you haven’t disappeared, but without reinstating the back rubbing or the habit related to them getting to sleep.”
According to Dubai-based Dr Onita Nakra, educational psychologist and counsellor, American School of Dubai, poor sleep can impact a child negatively. “The child’s health, safety, development, learning and behaviour can be affected,” she has said. “A common complaint is difficulty concentrating or poor retention at school. A tired child also has difficulties focusing in the classroom.”
Dr Ferber points out that children often have a combination of more than one sleep problem, and parents need to be aware that if they deal with one problem such as a sleep association and the child still has sleep difficulties, it may be because there’s an another issue. This may be an incorrect sleep schedule. “Parents may come to the conclusion that their child is just a bad sleeper, but if they fix the schedule as well, they may find the child’s actually a great sleeper,” he says.
Another sleep problem is a child not getting enough sleep. While Ferber stresses there’s no way of telling from numbers alone, a general guide for how much children should be getting is around 14-18 hours for a baby, around 12-14 hours for a toddler and around 11-13 hours for primary school-aged children.
A bedtime routine is very important. A child put to bed straight after watching TV without any transition period can cause problems. “Establishing a routine the child looks forward to, such as a song or a story, makes the process more pleasurable,” says Dr Ferber. “It’s also a chance for parents to get away from other distractions and interact with their child. It can be as special a time for parents as it is for children. We’re not talking about much time, but it’s time well spent.”
Press Association with additional reporting by Anand Raj OK, Features Editor, Friday magazine
