Kids And Sleep Disorder

Many children at some point in their young lives will have problems with sleeping.  There's nothing more frustrating for a parent than a child who won't sleep or sleeps irregularly.  Is there anything you can do?  You bet!
The most common sleep problem with infants, toddlers, and preschoolers is sleep-onset association disorder sometimes accompanied by issues of parent and child sleeping together

Children who have this type of disorder just don't sleep.  Parents often describe a child who insists on being nursed to sleep or on having a parent lie alongside until he or she falls asleep. Parents are often unaware that their well-meaning habits have created the difficulty.

The problem occurs when the child awakens fully if the parent or other condition he or she has learned to associate with falling asleep is not present. The child has learned to rely on the parent to fall asleep and may lack the self-soothing skills necessary to settle back into sleep independently.   Sleep-onset association disorder can lead to frequent nightly arousals for both child and parent.

Management of sleep-onset association disorder involves two critical elements.  First, you must gain an understanding of your child's "brain clock" or typical time of sleep onset and morning awakening.  It might be helpful for you to keep a sleep log to accomplish this.  

Then, you must undertake a period of training the child to shift from wake to sleep independently. Making this transition requires that parents put the child to bed when he or she is drowsy but still awake--in other words, at a time that coincides with natural sleep onset rather than at an arbitrary hour they have chosen as bedtime.

Even when timing is optimal, most children protest when their bedtime routine is changed. Parents vary in their ability or willingness to allow their child to cry for brief intervals during this period of training. Simply allowing infants to cry themselves to sleep is unnecessary and potentially harmful, particularly in babies with daytime symptoms of separation anxiety.

Try also using a delayed-intervention method.  This only works in children older than ten months.  This method gradually increases the time parents remain away from a crying child at bedtime--from several seconds to 2 minutes on the first night depending on the child and parent comfort level and up to 5 minutes on subsequent nights. When they return to the room after each interval away, parents are advised to reassure the child over the crib rail or at their bedside, without picking him or her up, and without turning on the light.

Talking in a slow, quiet voice to a child who is distressed or angry can help calm both the parent and the child. After comforting the baby for a minute or two with endearments (e.g., "I am right here with you, you are okay, sleepy baby, slow down"), the parent may need to again step out of the room while the child is still crying. Many parents find looking at a watch with a second hand during these intervals helpful, because listening to their baby cry for just 1 minute feels like an eternity to many parents.

The goals are to offer nurturance, comfort, and safety; to enhance the baby's self-soothing skills; and to set a clear, consistent limit regarding sleep location, assuming the parents choose not to have the child sleep with them.

For many cultures around the globe and for many families in the United States, parents sharing their bed with their infants and children are the norm and a strongly felt personal preference. This is a sound option when both parents are agreeable to it and commonsense safety precautions are observed.  Whatever the sleep location, supine sleep positioning is recommended in babies.

Nighttime snacks and drinks, with the exception of water, should be avoided, because these can exacerbate nocturnal arousals from a physiologic standpoint and negatively affect dental health.

During the middle-childhood years, short sleep requirement, sleep-onset anxiety, and obstructive sleep apnea are commonly encountered problems.  In these cases, making a sleep chart is very helpful both for parent and doctors if the problem becomes persistent.