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​Sleep email series - issue​1234

​The ​​​​​​​Bedtime Routine

There comes a time when a young child goes through a ​phase of either refusing to go to bed or ​simply not sleeping through the night. While this can be maddeningly frustrating for sleep-deprived parents, it is actually quite understandable. Put yourself in your child 's place for a moment. In his or her mind, sleep means saying good-bye to everyone he or she loves, and that can be a scary prospect. So it's no wonder, then, that many young kids hold out as long as possible before finally drifting off to dreamland.

One thing that has been proven to help kids get to sleep at the proper time is to practice proper "sleep hygiene" - creating a bedroom environment and bedtime routine that are conducive to healthy sleep. This includes elements such as:

  • Winding Down - In the hour before bedtime, help your child wind down by engaging in relaxing activities such as taking a bath or having a story time.
  • Location, Location, Location - Once you are in the child's bedroom, continue doing calming activities. This is where your child will spend the night, so get him or her used to the surroundings. For example, have your child softly say "Good night" to every stuffed animal on the bed. Or sing a lullaby or read a few calming stories. In other words, don't tickle and wrestle with your toddler or fly your baby around the room in your arms.
  • Sleepy, but Awake - Put children to bed in the place they will be sleeping by laying them down while they're still awake. Resist the urge to rock your child to sleep in front of the TV or to lie down in your bed with him or her; if you do, and your child wakes up during the night in his or her bed, the surroundings will be unfamiliar because neither you nor the TV will be there.
  • Ritual Length - Spend as much or as little time as you need with your child's pre-bedtime routine. Just remember that whatever you establish is what your child will learn to expect. So, if you only have 15 minutes each night, don't start out with a 45-minute ritual. Keep it to what you know you can reliably continue and adapt.
  • Sleep Only - When your child is learning to sleep, he or she should be doing just that. That means no reading, homework, tablet, smartphone or audio players should be allowed. And no eating; beds are for sleeping only. The quicker a child learns this, the quicker he or she will learn to fall asleep routinely on his or her own.

Teaching Activity

Bedtime Ritual

This week, establish your child's customized bedtime ritual, paying close attention to the points above. You may find that you have to adjust the timing of the routine based on your needs and the needs of your child. Once you've established the timing, as mentioned in the last point, stick to it without deviation. Remember: Consistency is of paramount importance here.

Social Skills

Using Relaxation Strategies

Getting a child to adapt to a new bedtime ritual can be extremely stressful - especially if you're losing sleep because of it. To reduce your own stress level, try the following relaxation strategies:

  • Breathe - Breathe deeply and completely.
  • Relax - Tighten and relax any tense body areas.
  • Calm - Instruct yourself to remain calm.
  • Visualize - Visualize a relaxing scene (e.g. mountains, walking along a beach, etc.)
  • Count - At the first sign of increasing stress, say to yourself, "Three, two, one, relax," and continue breathing deeply.

You also can let your child know when it's time to "actively listen." Use catch-phrases like "1, 2, 3… look at me!" or "Give me five… minutes of your time!" to let him or her know it's time to pay attention and listen. You can even help your child come up with other catch-phrases they like.

Fear of Sleeping

Fear of sleeping - including nightmares and a general fear of the dark - is a very common issue with young children. Unfortunately, it's also a common cause of bedtime disruptions and sleepless nights for Mom and Dad.

As mentioned in the previous email, following proper sleep hygiene is very important when it comes to getting a young child off to sleep on time. It can also play a role in calming a child's fear of sleeping by creating a familiar atmosphere at bedtime. After all, fear of the dark is really fear of the unknown.

There are several small things you can do to help a young child overcome fear of the dark and nightmares. One is to make up a bottle of "monster spray." Add a few drops of lemon juice to some water and put it in a spray bottle. Before bed, spray it behind the door and under the bed - any other place "monsters" can hide. (Explain that monsters hate sour things like lemon juice.) Put the spray away until the next bedtime. It too must become a part of the routine, but you don't want your child interrupting you in the middle of the night for another squirt.

Another simple trick is to plug in a little nightlight in your child's room. This will give just enough light to banish fears while allowing enough darkness for your child to sleep. Be aware, however, that nightlights in dark rooms can cast odd shadows, and this could make the problem worse.

Teaching Activity

Monster Proofing

This week, use the information provided in the first part of this email to try to get your little one to sleep through the night with the lights off. If he or she is unable to do so, try the "monster spray" and/or nightlight tricks. You can also "tour" your child's bedroom with him or her during the day, making sure you look in every nook and cranny to demonstrate there's nothing to fear when the lights go out.

Social Skills

Communicating With Your Child

When explaining to your child that there's no reason to be afraid of the dark, it's helpful to communicate using the following method:

  • Talk - Talk face to face and look into each other's eyes.
  • No Distractions - Remove all distractions. Turn off electronic devices, put down toys and set aside the newspaper.
  • Level - Get on your child's level.
  • Communicate - Use simple, clear words. Show and tell what you mean. Teach good listening skills.

Of course, the usefulness of this approach goes beyond simply talking about the dark or sleep; it is also ideal for communicating with your child on just about everything.

Dealing With Crying & Refusal to Sleep

"He just won't stop!"

"How can he still be crying?"

"I have to be to work early. If he keeps this up, my day will be ruined!"

Your child won't sleep. All he or she does is cry and throw a fit when you try to leave the bedroom. You're at your wit's end. The good news is, you're not alone, and there are steps you can take to deal with this extremely frustrating issue.

However, before you address this on your own, it's a good idea to make an appointment with your child's pediatrician to rule out any medical reasons for his or her crying at bedtime. Assuming none are found, the answer lies in how you respond to your child's nighttime crying or refusal to sleep.

Unfortunately, the best thing to do in this situation - ignore your little one's crying - is not the easiest thing to do. It is vitally important to understand that ignoring the crying will not physically or psychologically harm your child. In fact, it's always worse for the parents than it is for the child. After all, it goes against everything you've learned: When a child cries, you respond. If strictly followed, however, this "cold turkey" approach can cure bedtime problems in three to five nights.

But be warned. It's difficult not attending to your child's crying at night. Time will seem to stand still, though most infants stop after an hour. Ignoring the crying may be harder on one parent than the other, and arguments may result. It becomes even more difficult when one or both parents must work the next day. The good news is that the situation should be resolved in a few nights.

If you simply cannot bring yourself to ignore your child's cries, you may want to try the Ferber Method. Developed by Dr. Richard Ferber, this approach calls for parents to ignore the child for specific lengths of time, gradually increasing the time periods. So, on the first night, the parents may respond after five minutes, on the second night after 10 minutes and so on until they go for 45 to 60 minutes. This graduated method is recommended for parents who cannot go cold turkey. However, in the end, a parent who chooses this approach must be willing to endure crying for a longer time - up to two or three weeks - before the situation is resolved.

With either approach, the primary objective is to help children learn to manage the distress they experience when they wake up and to put themselves back to sleep.

Teaching Activity

Cold Turkey

This week, your goal is to try to use the cold turkey method to address your child's bedtime crying issues - at least for a day or two. If you simply cannot resist responding to the cries, then use the Ferber Method as outlined earlier. You can of course postpone this if it becomes too difficult, but the longer you put it off, the more sleep you'll lose.

Social Skills

Persevering on Tasks & Projects

Once again, this skill is for the parent who is in this stressful situation. Ignoring the nighttime cries of your child is extremely difficult, and you will be tempted to give in. So while these steps are broad and can apply to any task, they are going to come in handy in dealing with this unfortunately all-too-common situation.

  • Know - Know exactly what must be done in order to complete a task or project.
  • Start - Get started promptly without procrastinating.
  • Persist - Remain on task until you are finished.
  • React - Deal appropriately with frustrations or disappointments (see sleep issues email 1 on "using relaxation strategies").

The Sneaky Co-Sleeper

Every parent has experienced it: the rustling of sheets and the vague ​sensation that it's no longer just you and your spouse in bed. Sure enough, your child has crawled under the covers with you to sleep.

It's tempting to allow this to happen. First of all, it's kind of cute. It shows affection and trust. Second, if your child is sleeping - even if it isn't in his or her own bed - that's a good thing, right? Well, yes... but co-sleeping does present certain issues that parents should be aware of.

First of all, co-sleeping, with a very young child or infant, can actually be dangerous. In fact, hundreds of children under age two die every year because an adult with whom they are sleeping rolls over on them, crushing or suffocating them.

With older kids, however, the choice of whether or not to allow co-sleeping is really up to the parents. That being said, parents need to be aware that sleeping with Mom and/or Dad can result in disrupted schedules. If the child's and parents' sleep schedules don't match, the one with the most disruptive sleep schedule will dominate everyone else. This can result in stress, distress and fatigue for the other sleepers.

And having a child in bed obviously means a lack of privacy for parents. It more than proves the truth of the old saying that two's company and three's a crowd. Having your child join you in bed can curtail intimacy between you and your spouse, and this can put a strain on any relationship. So while there are no real psychological or medical issues with letting a 9- or 10-year-old sleep with you, you should be aware that it may disrupt things for a while.

So what is the solution?

When a toddler sneaks into your bed, use the "robotic return" method: Treat the situation seriously and solemnly. Move stiffly and do not speak to the child as you return him or her to bed. Then, close the child's bedroom door so he or she associates a fully closed door as the consequence for getting out of bed. Don't argue, discuss, yell, threaten, promise or have any other communication with your child if he or she gets out of bed after bedtime. Children usually get out of bed to get their parents' attention, so by talking to them, parents are giving children what they want.

For an older child, if co-sleeping is not desired, it should be addressed as a boundary and privacy issue. Your child must understand that your bedroom is a private area, and that he or she can't simply walk in and crawl into bed to get your attention. One way to convey this is through role-playing, which is described in the following Teaching Activity section.

Teaching Activity


The first step to addressing this boundary issue is to describe to your child what you want him or her to do. Be clear and specific. Tell your child that it's important for him or her to stay in bed at bedtime. Make it clear there has to be a really important reason or an emergency for wanting to talk to you, and that he or she should first call you from bed. If your child has to come to your room, make sure he or she knows to knock on the door and wait until you open it. The second step is to give "kid" reasons for why doing it this way will benefit him or her (won't get in trouble, shows your child is a "big boy" or a "big girl"). The third step is to practice what you have just discussed. This could involve having your child practice calling out "Mom" or "Dad" and waiting for a response, or knocking on your bedroom door and waiting for you to answer. Then you can invite your child in to talk with you (but not get into bed). Afterwards, your child can return to his or her own bed to sleep.

One additional option is the Bedtime Pass. You create a pass of some sort - kind of like a hall pass at school - that allows the child to either call out for a parent to come to their bedroom or to get out of bed for whatever reason. But, once that pass is used, it is returned to the parent, and the child can no longer call out or get out of bed for the rest of the night. And if he or she does, the parent would use the "robotic return" method mentioned above.

Social Skills

Giving Instructions

If you want your child to follow your instructions - as in the earlier exercise - it is best to give those instructions using this method:

  • Look - Look at the child.
  • Please - Begin with, "Please..."
  • Action - State specifically what you would like the child to do.
  • Reason - Offer rationales, if needed.
  • Thank - Thank your child for listening.
  • Finish - Once the child does what you asked, thank him or her for following your instructions.

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