Sleep Problem in Children

Sleep problem in children is a cause of headaches to many parents. This guide discusses some solutions and constructive actions you can take to head off any problems. Which parents haven't faced such problems with their kids? Don't we wish that they would sleep more so we wouldn't need to go around in a sleep-deprived haze?

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Most children sooner or later in their first 4 years develop a sleep problem. These include crying when put to bed, refusal to go to bed, refusal to lie down, waking (with or without crying) in the night, prolonged failure to go to sleep, sleep rituals and early morning awakening.

My 3 children sleep so little, less than 11 hours a night since they were babies. They constantly wake up in the night, no matter what I do. I have been sleeping maybe 6 hours of interrupted sleep for the last 9 years, I am going around with permanent eyebags!

I have read several books on sleep solutions for babies including one which advocated controlled crying. I couldn't bear to sit around and hear my baby crying for me, and my hubby who is a doctor said that it would lead to learned helplessness. Babies who aren't attended to when they cry, grow up thinking that no one including mommy and daddy are going to help them when they are in distress.

I knew of one mother who would lock her daughter in her room at 8pm sharp. She wouldn't go into the room even if her baby was crying. Once, after her baby wailed for about 1 hour, she finally entered the room to find that her 1 year old daughter had defecated in her cot. She had smeared poop all over herself and even eaten some of it. After I heard that, I resigned myself that I would just suffer and hope that my babies would sooner or later grow out of their sleep problem. I am still waiting...

Habit Formation

Some of the bad sleep associations that children have are actually habit forming practices that parents adopt to get their kids to go to sleep. We rock them to sleep, sing to them, put sleep music on, sit with him until he goes to sleep, breastfeed the baby until he falls asleep, read to him or play games, lie down at his side, or wait until he falls asleep in your arms before putting him asleep in his cot.

I have been guilty of checking on my baby repeatedly just to make sure that she was still breathing. Yep, I was a hysterical, over-protective mother when I had my first child. Now I go, "Will you just go to sleep already?!!" and my girls just giggle at me.

Other bad sleep habits include taking the child down to join the family when he cries out, offering bribes to go to sleep, some kids may be smacked for not going to sleep etc. It is also common to threaten to put a child to bed if he is naughty. This causes a child to associate sleep with punishment, and may lead to sleep refusal.

It is also believed that breastfed babies are more likely to awaken at night than formula fed babies.

How much Sleep do children need anyway?

The duration of a child's sleep depends largely on his age, personality, intelligence and on the duration of the afternoon nap. Each child has his own sleep requirement. As long as they do not display any fatigue during the day, the child is getting adequate sleep.

The newborn baby sleeps most of the day. At 3 months, he is likely to have 3 or 4 sleep periods. At 1 year, he might have 2 or 3 sleep periods. At about 3 years (often earlier), he discards the afternoon nap.

The active child sleeps less and at 5 months, may be awake for the greater part of the day. In general, according to Dr Ronald S Illingworth in 'The Normal Child', the brighter, more intelligent and more active child sleeps less. Though I have come across extremely intelligent children who sleep 15 hours a day. Oh, the things you could get done in that time!

Over-fatigue can shorten sleep, though that might sound counter-intuitive. Children require sleep to grow. Apparently, their growth hormones are only secreted when they are sleeping, not when they are awake.

Causes of Awakening

Some kids sleep more soundly than others. You need look no further than yourselves to see how your kids are likely to sleep. When I was younger (before my current sleep deprivation period), I could sleep through Singapore's noisy thunderstorms, robberies (twice) and any kind of commotion, while my husband can be awakened by the flipping of a magazine page. Guess who my kids took after?

Children may also sleep badly in hot weather. Sometimes our presence in the room may also cause the child to wake up due to the noises we make. He knows that we are there and demands our attention. Every effort should be made to get your child used to the normal household noises, instead of sneaking around and trying to create an unnatural environment of complete silence and darkness.

In the first month, most babies awaken twice for feeding in the night, but most drop the night feed by 10 to 12 weeks. After that age, babies may awaken because of thirst, discomfort from a wet nappy or a rash. But research has shown that teething rarely causes sleep disturbance.

After 6 months, children may awaken with a sudden scream due to a nightmare. After 2 or 3 years, the child may cry out because he wants to pass urine.

Bedtime Rituals

Most books suggest that kids should wind down before sleep time. I normally read to my kids (this could go on for almost an hour!), then lights out. Some children after 18 months may associate an object (eg a Teddy or blanket) with sleep and will not go to sleep without it.

Sleep rituals could also include demanding a drink, asking for the door to be left open or the lights on. If we aren't careful, kids can add to their sleep ritual just to delay the departure of the mother from the bedroom.

Most kids think that the universe revolves around them, they will grow out of it in time and focus on the wider world. However, this same ego causes them to enjoy a situation in which he attracts attention to his sleep problem, especially when the whole household is concerned about it. Never discuss his sleep problem in front of him.

A vicious cycle can develop when his perceived bad behaviour at night deprives the mother of sleep, making her impatient and irritable with him. This leads to scoldings and an even tougher time getting the child to sleep. I dose myself with Brand's Essence of Chicken, coffee, iron tablets and Yomeishu tonic to get through my days. Any mother will know what it is like to be so tired to the bone. I have worked very hard in an office environment before, but caring for kids is different.

Sleep Fears

Fear of the dark is extremely common in children, especially after two years old. There may also be a fear of strange shadows and sounds or a moving curtain. Horror movies are a big no-no. Sometimes what adults consider a pretty harmless show can turn out to be too scary for the child. My younger daughter developed a fear of vampires after just seeing a picture from a Dracula play. My attempt to explain to her that vampires were derived from stories of Vlad the Impaler made matters worse.

Sometimes kids just go through phases for which there is no explanation. Provide the necessary reassurance and security to help your child overcome her sleep fears, whatever is her bug bear.

Prevention of Sleep problems

Open-air exercise is a good source of healthy fatigue. Be careful not to over tire your child as that can cause difficulty sleeping.

Many a mother of ADHD kids have told me that they had to exhaust their child through some sport, mostly swimming, before the child would stop being hyperactive at home and sleep earlier. My elder daughter used to sleep at 12 midnight everyday. Now with the combination of waking up at 6.30am for school and doing competitive swimming, she is ready to knock off by 10pm. That's a great improvement for her!

For young children, don't worry about having toys in bed as long as they are safe. Your child is more likely to be quiet in the morning after early awakening if he has something to occupy him.

Try and have a wise prebed routine. It may include a warm bath, let your child learn to be more independent by assisting him but allowing him to do what he can on his own. Remember our job is to sooner or later, make ourselves redundant!

Make sure your child's room is well-ventilated. If possible, ensure that the room is completely dark, that is light does not seep in through the windows in the morning. It has been suggested that this prevents the baby from waking up at dawn when light can be seen at the window.

The child should be put to bed with an air of certainty. Children are like dogs, they can sense uncertainty and anxiety with astonishing speed. If possible, parents should take turns to put the child to bed to avoid trouble in the event of the mother falling ill. Or in my case, childbirth! My daughter followed me to the hospital when I gave birth to my second daughter. She was in my hospital bed with me. Believe me, it was not a comfortable experience.

Check on your child only when necessary in case you accidentally wake your child up during your 'visits'. Have an extra blanket handy to cover your child in the night if the child cannot be covered up without disturbing him. Ensure that your child cannot accidentally suffocate himself on anything in his bed.

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* Please note that I have only done reviews on products I have used personally. I am quite an anal-retentive mom, so I compare the many brands / models / varieties available before I purchase a product. I have written about the products I really loved. I don't want to make any harsh criticisms of products that were less than stellar ;-)

Treatment of Sleep problems

The whole daytime management has to be reviewed. If you are worried about your child not being able to wake up early for school, the key is not to make him sleep earlier, it is to wake him up earlier for a period of time. Naturally, he is tired earlier in the evening and will sleep at an earlier time. Taadah...

Sleep problem in children can cause conflict between the parents and result in the child being punished unnecessarily. Mothers can feel powerless, embarrassed, guilty, even incompetent. This may lead to loss of temper and anxiety. Furthermore, we are worn out and tired from all the bad nights, and longing for sleep. Remember that your child benefits from a well-rested mother, so Love yourself too.

Break any bad habits that might cause sleep problems. If your baby cries when he is left to sleep, just check on him in intervals to make sure he is safe. In the early years, I had been unable to bear my babies crying without picking them up immediately, however in the 9 years since, my heart has grown much harder after my third child, so I can bear it a little longer, though my hubby is still a softy.

Some children can make themselves cry until they vomit. This is probably due to air swallowing. Don't let such a baby cry for long. You can also try shortening the afternoon nap to see if your child will sleep better. This is usually by trial and error. Some children can get through the day just taking a short power nap.

Nightmares usually occur within 2 hours of going to sleep, but they become less frequent as the child gets older. This is part of the sleep cycle. If your child suddenly screams at night, he should be attended to without delay. If he has had a nightmare, provide security and love by cuddling and soothing until the crying and sobbing stops.

Try reasoning with your child if possible, you might be surprised at your child's response. After 18 months, intelligent kids can sometimes understand why they shouldn't be disturbing mommy and daddy at night. Sometimes the child claims that he can't sleep, they do not realize that as a consequence, they will be tired the following day and unable to wake up early.

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