• Kid Won't Sleep? How to Banish those Bedtime Blues

    Does parenting have to mean sleepless nights and bedtime blues?
    by Maan Pamaran .
  • child wide awake in bed

    Photo from mommyish.com

    My little bundle of joy can be such a perfect angel during daytime, but when the sun goes down and it is time for bed, Ino transforms into a whining, sulking, struggling little monster. When he eventually drifts off to sleep an hour or so later, I feel like all my energy has been zapped by the single activity of putting a three-year-old to sleep. When I told my sob story to my girl friends, they all sighed and said, “Welcome to the joys of parenthood!”

    Armie Diño complained that her son Mikko keeps calling her into his room every 10 minutes for a glass of water, a story, or a lullaby. Christy Azarraga is dead tired when she comes home from work. Yet after dinner, she has to contend with her two very energetic kids who “just won’t lie down on their beds.” Tina Abcede, a new mom, struggles to keep awake during the day, because four-month-old Zoe keeps crying in the middle of the night.  

    So does parenting have to mean sleepless nights and bedtime blues? What is it about their kids’ bedtimes that can drive ordinary people into the brink of madness?

    Roland dela Eva, M.D., a sleep specialist and pediatric pulmonologist at St. Luke’s Medical Center in Quezon City, gives some sure-fire tips and tricks to get the tots (and the teens) in bed.


    The importance of Zzzzs
    The common warning that parents give their kids who won’t go to sleep is, “Sige, hindi ka lalaki!” Dela Eva says that there is truth to that admonition. Kids grow when they sleep, because the surge of growth hormones happens during the first few hours of the night when they sleep.

    Hyperactivity in kids can be a sign of sleep deprivation. That mini monster who’s been tearing around your living room, jumping on the couch and tormenting the cat could actually just be in serious need of sleep.
    Dela Eva says, “We speculate that these kids are sleepy during the day, but engage in hyperactive behavior to keep themselves awake. They have this self-stimulating mechanism, wherein they tend to move around, cannot sit still, run, crawl under tables, etc. At the clinic, we always see hyperactive kids who are suspected of having sleeping disorders.” Of course, if a child lacks sleep, his school performance will be affected. He will either be sleepy during class or cannot sit still at his desk. Either way, he won’t be able to focus on his lessons.      


    Kiddie bedtime tricks
    Dela Eva advises parents to create an atmosphere conducive to sleep. “To condition your child, you have to do a lot of preparation. So, if you say that bedtime is at nine o’clock, he should be prepared for nine o’clock. Parents should develop rituals or routines so the child will be conditioned. His system will be accustomed to what he usually does every night,” he says.

    For a nine p.m. bedtime, Dela Eva suggests that 8:30 p.m. be some sort of retiring time. He says, “Everything that he is doing should stop. Give him a warm bath, hot milk and some light carbohydrates like biscuits, so that there is some time for him to settle down. There should be no TV watching, roughhousing, or other stimulating activities. They can just do anything that can relax them. Then at nine o’clock, he should be tucked into his bed.”

    For cases like Ria Mauleon’s, who works late nights at a call center, or Angel Carlos’ whose kids stay up late to wait for her to come home from the office, Dela Eva recommends that they stick to a schedule: “Kids would want to stay up to play with their parents when they get home, but it is still advisable for the kids to have that fixed bedtime.” He suggests that the other parent or a caregiver put the kids to bed. If the kids develop the habit of sleeping late, they tend to be awake longer. If, at an early age, they already have bad sleeping habits, these will continue through their teenage years. At adulthood, they will have difficulty initiating sleep.

    Here’s a bonus: By gently insisting on the rules, and praising your child when he stays in the room and behaves, you are nurturing his self-esteem.


    Rise and shine!
    Dela Eva also advises parents to set a fixed wake-up schedule as well. According to him, if the child wakes up at erratic times, this may disrupt the sleep schedule that you have set for your child and defeat the purpose of a fixed bedtime. “So in order to have a good sleep pattern, you have to be consistent -- and firm,” he recommends. Everything should be at its proper time, even breakfast, lunch and dinner. “If your child sleeps longer on weekends, when there is no school, you can allow that. But if you observe that it is disturbing everything, then you have to stay fixed on the wake-up time.”

    And contrary to popular belief, not all kids have to nap. Dela Eva discloses that children more than five years old need not be forced to sleep during daytime. He says, “Children undergo different stages of development, so even their sleep becomes different as they grow older.”

    When a child is born, he spends 17 hours of sleep spread out for the whole 24 hours. There is still no nighttime sleep and daytime nap. But when he reaches six months, he tends to concentrate sleep at night, and then he develops napping, usually a one- to two-hour nap in the morning, and a two-hour nap in the afternoon.

    At two to three years, the nap requirement will start to go away, and at three to five, he doesn’t really need to nap anymore.

    Kids from five to seven years old are usually very alert. As long as the child meets the sleep requirements during the night, he does not have to take a nap.      

    Here’s a tip: Never use nap time as a threat or a punishment. Children will resist or resent taking naps if you present it this way.


    What about teens?
    Regina* confesses that she burns the phone lines until the wee hours of the morning. “Once, my ex-boyfriend and I talked until sunrise!” When she got to school that day, “I couldn’t keep my eyes open. It was really embarrassing because I kept yawning during math class. By late afternoon, my head felt like it was being hammered.”

    Dela Eva advises parents to discourage teenagers from using their phones until very late at night. This is one of the major causes of sleep deprivation of teens, along with parties, which usually start after midnight and end shortly before dawn.

    According to sleep researcher Mary A. Carskadon, Ph.D. of Brown University, today’s American teen sleeps on average only seven to seven-and-a-half hours on school nights, incurring significant sleep loss. Most adolescents need about nine hours and fifteen minutes to be at their best (although eight-and-a-half hours may be adequate for some).

    To make up for lost time, teens usually try to snooze during holidays and weekends. But staying up an hour later than usual on two or more consecutive nights can seriously affect their sleep patterns.

    Dela Eva says that for these teens, taking naps can be fine, as long as it is not too late in the afternoon. For older teens who are already developing insomnia, nap time can be very detrimental to them.


    Parents' sleep debt
    Sleep deprivation is definitely nothing to yawn at. Everyone who has felt sluggish in the morning after indulging in an all-night movie spree will agree. A study published in Psychosomatic Medicine last year even links chronic insomnia with an increased susceptibility to infections like the common cold.    

    So how do parents cope with the extra stress of waking up in the middle of the night from baby’s crying? Dela Eva says, “In making the baby go back to sleep, there is such a thing called conditioned response. Babies associate something -— usually the presence of the mother, or a bottle -- with sleep. The problem occurs when the child wakes up in the middle of the night and does not see his mother, and therefore cannot go back to sleep. That’s what we call an association sleep disorder.”   

    To handle this, use the technique called Delayed Response Time. Dela Eva describes it as having longer and longer intervals before you respond to your baby’s crying. If you used to rush to his side on the first sob, the next night, wait for five minutes, then 10, and so on and so forth. Soon he will learn that crying is not so effective anymore. Then check if he is hungry, wet or sick. If he is not, you shouldn’t pick him up. Just pat him and croon softly until you hear him relax.  

    You may also try to give him transitional objects such as a baby-friendly toy, which is always with him. If he wakes up in the middle of the night and sees the toy, he feels comforted.     

    If the parents have been up in the middle of the night, Dela Eva recom-mends that they schedule a nap time for themselves as well.


    A monster in the closet
    T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., authors of Sleep the Brazelton Way, say that a child may have bad dreams because of external factors, such as the child’s arm “fell asleep,” his bladder is full, or his feet got cold when he kicked off his blanket. Nightmares are also likely during a stressful period, such as a new baby, a death in the family, or a parent away on a trip. Daytime fears about thunder or police sirens, or from watching violent TV shows and video games can also trigger bad dreams.

    Here are some tips to calm your child down:
    - Chase away his fears.
    Look around his room, peer into the closet and under the bed to show that there are no monsters there.

    - Leave a nightlight on.
    If you don’t have one, just switch the hall light on, and leave his door partly open.

    - Give comfort.
    If he scoots into your room after a bad dream, comfort him, but bring him back into his room afterward.

    - Don’t linger.
    Stay with him for a while, sing a song or read a story, then go back to your room.

    - Allay his fears.
    Show him his fave stuffed animal or toy so that he may feel comforted.

    - Look for reasons.
    During the day, talk to him to find out the underlying issues or stressful situations that may be causing his dreams.

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