Making Bedtime Less Frustrating for NJ Parents
Sleep Onset Association Insomnia of Childhood is a technical name for an exceptionally common issue for parents -- getting children to sleep alone and in their own bed, according to New Jersey experts on the issue.
Children start associating certain things with sleep, and the most common thing is the physical presence of a parent, according to Dr. Matthew Davis, a neurologist and sleep specialist at Monmouth Medical Center in Long Branch.
"The treatment for this is exceptionally unpopular and gets a lot of bad press, but it's commonly referred to as just sort of the cry-it-out method," said Davis.
He said the idea is that, you put your child to bed, make sure they're safe, make sure there's no illness, put a monitor in the room if you need to, and essentially let them cry until they learn to self soothe to allow them to fall asleep on their own.
"It's very difficult emotionally for the parent but, that is very clearly proven to be the best method for handling it," Davis said.
He noted there is a lot controversy over it because some people claim the cry-it-out method causes some psychological trauma in kids.
"That data is sort of lacking that that's really true, and it is clearly very effective," said Davis.
The alternate way of getting a child to sleep independently is called "Graduated Extinction," according to Davis, a method that is a lot more palatable to most parents.
"You give the child increasing lengths of time to sort of let them try on their own," Davis said.
He explained that this method works by having parents put the child to bed and close the door. If they start crying, you give them five minutes, the go in and soothe them a little bit, and try again.
"You do it for 10 minutes, and you do it for 20 minutes, so over the course of the night you do it for increasing lengths of time, and that can be as effective and not as emotionally distressing to the parent. But again there's not really clear evidence doing either of these is harmful to the child," Davis said.
Davis and Dr. Matthew McDonald, chief of Special Needs Pediatrics at Children's Specialized Hospital in Mountainside, both recommend teaching children good sleep habits. Both doctors have young children and said they can personally relate to what parents are going through.
"Practically, what parents can do is to establish a very regimented or firm routine around bedtime for the older children that are late toddler-early school age. You can let them participate and give them certain limited number of choices, so that they're invested in the bed time routine," said McDonald. He added there's also some good sleep hygiene things that are helpful for parents, "Making sure that the time before sleep is quiet, dark, not filled with activities or stimulation."
Children beyond toddlerhood who continually wake up in the middle of the night present their own set of challenges too, because the parent's sleep is disrupted.
"For the middle-of-the-night child who wakes up, you sort of just have to set a firm limit to instruct the child that their room is where they sleep and put them back in the room and let them stay there. Once you have established what the expectation is, you have to stick to that expectation," McDonald stressed. "If you have established a bed time routine or a bed time, as much as possible, it's always a challenge in the busy world, you should not let the child dictate their own major decisions around sleep."
He said the older the child is, the more challenging that may be, which is why it's important for parents to establish that when they leave the room, they are not going to return to the room, otherwise the cycle will continue.
Both experts admit, it is easier said than done from the parent's standpoint, and acknowledge dealing with the issue is difficult and requires work.
"The earlier in the child's life that you establish a fundamental bedtime routine, the easier it is, so starting in late infancy and at the toddler age, bed time routine and sleep hygiene is important to making things easier on you later," McDonald said. In addition, he said it's important to note that "every kid is different and every kid presents unique challenges to their parents."