Sleep

Sleep

Sleep
Written by D. Preston Smith MD and Paul Banas Presented by

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Sleep Whats Inside...

Dad's Guide to Getting Your Baby to Sleep...................................................... 4 How Much Sleep Does Your Child Need? ......................................................... 7 Helping Your Baby Sleep ...................................................................................... 8 Putting Kids to Sleep: Tips for Dads...................................................................... 9 7 Tips for New Dads to Get More Sleep ........................................................... 10 Sudden Infant Death Syndrome........................................................................ 11 Your Baby Should Sleep On Her Back .............................................................. 13 Sleeping With Your Baby..................................................................................... 14 Know the Pros and Cons of Co-Sleeping......................................................... 15 Sleeping Without the Pacifier............................................................................. 16 Tips on Putting Your Twins to Sleep.................................................................... 17 Coping With Light Sleepers ................................................................................ 18 Scared in Sleep A Short Background............................................................. 19 Deep Sleep Some Symptoms of Terror .......................................................... 20 Toddler Terrors, Infant Anxiety?.......................................................................... 21 The Difference between Night Terrors and Nightmares ................................ 22 Bedwetting Causes Sleep Disorders............................................................... 23 About the Authors ............................................................................................... 24 Recommended Reading ................................................................................... 26 Acknowledgements ............................................................................................ 27

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Sleep Dad's Guide to Getting Your Baby to Sleep

Getting a baby to sleep often presents a major parenting concern. Babies don't naturally take to sleeping through the night and most dads and moms have to work at teaching their infant to sleep by setting up a sleep schedule for them.

There is no one way to do this however and various specialists have proposed different approaches to sleep training a baby. Its important that the strategy you choose is one that is consistent with your individual lifestyle and schedule. Below are some methods to help your baby enjoy a good night's sleep, put forth by experts:

Richard Ferber, M.D., author of Solve Your Child's Sleep Problems

According to Dr. Ferbers controversial theory of "progressive waiting", babies can be taught to sleep by allowing them to cry on till they feel inclined to sleep. Dr. Ferber stresses that it is important to put the baby in bed while hes awake in order to encourage him to develop the habit of settling into sleep himself. Thus it is okay for your baby to get accustomed to a late bedtime (even up to 10 p.m.) as long as he is ready to fall asleep on his own by then.

Dr. Ferber, however, also attributes various reasons for sleepiness, ranging from medical conditions to inappropriate sleeping hours.

He recommends his method for babies over the age of 4 to 5 months as before that babies are not physically mature enough to sleep through the night.

Suzy Giordano, author of Twelve Hours' Sleep by Twelve Weeks Old

Suzy Giordano suggests a four-step plan to getting your baby to sleep: 1. Feeding the baby every four hours, four times in a day. 2. Gradually reducing and stopping the nightly feedings. 3. Getting your baby up to sleep in bed for 12 hours a night. 4. Implementing one-hour a.m. and two-hour p.m. nap times.

Giordanos method involves keeping a record of all the babys feeding, sleeping and diaper changes, right from the time of birth till the time he is sleeping through the might.

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It is recommended for babies between the ages of 8 to 10 weeks old and weighing at least 9 pounds.

Harvey Karp, M.D., author of The Happiest Baby on the Block

Dr. Karps advises simulating the environment of a mothers womb to calm the baby to sleep. For this he has developed the five Ss: Swaddling Holding a baby in a side or stomach position by the parent (not in the crib) Creating shushing sounds or using white noise Swinging the baby to imitate movement inside a womb Encouraging sucking, either on a pacifier or breastfeeding

Dr. Karps method aims at making a baby comfortable by recreating the womb environment as closely as possible by swaddling the baby real tight, using loud enough sounds and vigorous swinging, using an automatic swing if necessary.

It can be used on babies right from the time of their birth.

Jodi A. Mindell, Ph.D., author of Sleeping through the night

Jodi Mindells strategy for includes setting routines to follow through the day, including a fixed bedtime at around 7 or 8 p.m. She recommends encouraging the baby to fall asleep by putting him in bed while hes drowsy and gradually withdrawing from activity such as rocking or breastfeeding. This way the baby will give up crying during the night and learn to sleep peacefully.

The key to success using this method lies in getting the baby so accustomed to his routine that he starts anticipating sleep at the fixed time.

A routine can be established as early as 6 weeks, though active training should only begin between 3 to 6 months.

William Sears, M.D., co-author, along with wife Martha and two sons, of The Baby Sleep Book

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According to the Dr. Sears "attachment parenting" theory, parents need to administer to the babys needs by responding to his crying. He also endorses breastfeeding as and when the baby displays hunger and co-sleeping with the baby. Dr. Sears also suggests that fathers actively interact with the baby.

This kind of parenting makes rigorous demands on parents, especially the mom, who needs to ensure that she gets adequate rest and sleep.

This method works fine with babies right from the time of their birth.

Marc Weissbluth, M.D., author of Healthy Sleep Habits, Happy Child

Dr. Weissbluth suggests that babies should not be allowed to remain awake for more than two hours as they get tired, which then interferes with their ability to fall asleep. According to him, it is okay to put the baby to bed even if hes already dozed off.

He suggests letting a newborn baby sleep every two hours till he is 4 months old, and then selecting a method based on the needs of the baby. He proposes three methods: "No cry" (picking up and comforting a child whenever he cries,) "graduated extinction" (similar to progressive waiting) and "extinction" (letting the baby cry.)

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Sleep How Much Sleep Does Your Child Need?

Sleep Requirements for Your Child Sleep Required During Day* 7 (3) 5 (3) 3 1/4 (2) 3 (2) 2 1/2 (2) 2 1/4 (1) 2 (1) 1 1/2 (1) Sleep Required During Night 8 1/2 10 11 11 11 1/4 11 1/4 11 10 1/2

Age

Total Sleep

1 month 3 months 6 months 9 months 12 months 18 months 2 years 3 years

15 1/2 15 14 1/4 14 13 3/4 13 1/2 13 12

* number of naps in parentheses

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Sleep Helping Your Baby Sleep

Babies will sleep most of the time during their first few months. At this time, they require all the sleep they can get, so parents need to resist the temptation to wake them up and fondle or hug them. Your child needs the right amount of sound sleep at this age to grow up strong and healthy. These are guidelines to help you ensure that your baby enjoys good sleep: Make sure your baby is comfortable with the appropriate amount of light or warm clothing as required. Keep your baby's crib in a place that is not directly exposed to bright lights, noise, or cold drafts of air. Ensure that your baby's room is not stuffy, but is well ventilated. If you are busy with household chores, keep checking at appropriate intervals for any tell-tale signs that might suggest that your baby is not comfortable or is about to wake up. You will get to know your baby's sleep patterns with time. Make sure your activities correspond with the baby's sleep schedule. Put your baby back to sleep if he or she wakes up suddenly in the middle of the night or at any time inconsistent with his sleep patterns.

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Sleep Putting Kids to Sleep: Tips for Dads

For some parents, getting their children to sleep is no problem at all. For others, it invariably involves a major struggle. Here are some easy tips on putting your kids to bed: The first step to ensuring that your children take to their bed without much fuss is to establish a bedtime routine. When children sleep at the same time everyday, their body adapts to the cycle and they fall asleep easily. It helps to restrict activities that are physically or mentally stimulating, such as watching a television or computer screen or indulging in physical play, at least a couple of hours before bedtime. More sedate activities such as reading, drawing, or playing with stuffed toys are fine. It is a good idea to get your child in the mood for sleep by telling a bedtime story, or putting on some soft music. Besides helping them unwind, such activities form an association with bedtime in children's minds, and help them to anticipate sleep. Take steps to make your child comfortable during the night. You may keep a favorite stuffed toy or object alongside to comfort your child. Ensure that your child's clothes are comfortablenot too tight, and neither too hot or too cold. Once you have tucked your child in bed, leave the room. Let your child learn to settle down and fall asleep without depending on your presence to be able to do so.

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Sleep 7 Tips for New Dads to Get More Sleep

1. Trade off nights of sleep with your spouse. No one will like this arrangement, but at least you can get some sleep every other night. 2. Consider co-sleeping with a newborn. Many people recommend it since cosleeping babies have a lower incidence of SIDS. But the greatest benefit is that mom can nurse while half-asleep and roll over and go back to sleep immediately. Some moms almost sleep right through it and cant remember nursing during the night. 3. If you have to get a night of absolute sleep due to job demands, discuss it with your wife and then dont hesitate to sleep in another room. Just dont make it a routine. 4. If you have an early-riser, go to bed when the kids do. Most people think this is a good idea, but fail to implement it since it steals the only time of the day when they get some peace and quiet. 5. Break the night into shifts. One parent takes the 102 and the other the 2-6. The hard part here is that one parent of the two is usually the more conscientious of the pair. 6. Get a rocking cradle and put the baby in it right next to you. 7. Gorge the baby with milk. Babies always sleep better after a big meal. Just make sure the inevitable diaper change falls on your spouses watch.

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Sleep Sudden Infant Death Syndrome

Sudden Infant Death syndrome (SIDS) is defined as the sudden, unexplained death of an infant, and is the one of the main causes of death among infants between a month and a year. SIDS is said to occur only when no possible explanation can be found even after: Autopsy Examination of the place where the death occurred Review of medical history of infant and family

The baby typically does not seem to show any sign of suffering and death occurs rapidly. In addition, SIDS is commonly known as crib death because of a strong link with sleep. It is estimated that 2,500 babies in the United States die of unknown causes every year.

Probable Causes

While no single cause can be pinpointed, researchers believe that SIDS may be the result of a combination of several factors. During pregnancy: Consumption of prohibited substances during pregnancy (tobacco, alcohol, drugs, etc.) Early motherhood Poor medical care during pregnancy Short interval between two pregnancies

After birth: Exposure to smoke after birth Sleeping on the stomach or sleeping on too soft a surface

The last point should be emphasized, as babies tend to pause in their breathing, or rebreathe exhaled air, reducing the amount of oxygen in their blood while increasing carbon dioxide. Babies need clear space around their heads to breathe freely.

Prevention Ensure that your child always sleeps on the back. Sleeping on the side is also not a good alternative. For babies, sleeping on the back reduces the chance of accidental death greatly.

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Sleep
Your infant's sleep area should be firm, without any pillows, toys, or covering. A firm mattress is preferable to a soft one. Remove stuffed animals during nap or sleep time. Keep a comfortable room temperature. Excess body heat is seen to increase the chances of SIDS. For unknown reasons, breast-feeding and pacifiers are known to decrease the risk of SIDS. Keep the air around the baby free of smoke.

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Sleep Your Baby Should Sleep On Her Back

You want to keep your baby safe when she sleeps. Most babies are healthy and have no problems when sleeping. But sometimes babies die in their sleep. This is called Sudden Infant Death Syndrome (SIDS) or crib death. Doctors have not found out what causes SIDS.

Research shows that babies who sleep on their backs are less likely to die from SIDS. If your baby has a health problem, your doctor may tell you to put her in another position. Otherwise, always put your baby to sleep on her back.

Other factors in lowering the danger of SIDS are: BreastfeedingYour breast milk is the perfect food for your baby. Breast milk helps protect your baby from many illnesses, as well as SIDS. Smoke-free environmentDont smoke around your baby. Dont take her around others who smoke. Babies in smoke-free homes have fewer colds and infections. ClosenessKeep your sleeping baby nearby. Its good for your baby to learn to sleep in her own crib. Be sure you can hear her if she cries or is in distress. BeddingBe sure your baby is sleeping on a firm mattress. Dont put your baby to sleep on soft or fluffy things, such as a pillow, quilt or waterbed. Keep stuffed animals out of the crib at sleep time. TemperatureMake sure your baby is warm but not too hot. Doctor visitsTake your baby in for her regular checkups. Any time your baby seems sick or has trouble breathing, take her to the doctor or clinic.

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Sleep Sleeping With Your Baby

Your picture-perfect view of new parenthood probably involves mom and dad staring lovingly over a crib as the baby sleeps. However, you, especially as a dad, may want to evaluate sleeping options and here's why: 1. The baby-in-crib alone is a relatively recent and distinctly American practice. If you think about it, before multi-room dwellings and back to caveman days, families used to sleep together for warmth and safety. Most of the rest of the world "co-sleeps" and finds it completely natural to do so. 2. Crib death, or SIDS, is a very American phenomenon, and perhaps can be related to the distance mommy is from a struggling baby. 3. And finally, and most importantly for dads: co-sleeping keeps mom close to baby for middle-of-the-night feedings. When we had our first and second babies, they slept with us for the first 6-7 months. In the middle of the night, baby was hungry and baby reached out and had a snack. My wife often said she barely remembered the feeding. Compare that with the story of some of my friends who kept the baby in a crib across the hall. Very often it was the DAD who got up in the middle of the night (wife had baby all day after all and was still recuperating from delivery) and it was DAD who spent 15 minutes at midnight and 4AM warming the bottle and another 15 minutes feeding and burping the baby. Now, I will grant you that middle of the night feedings have a certain romantic glow to them - there you are, the great dad, alone with your thoughts and your new son and daughter in the moonlight... However, after a week of completely interrupted sleep you may get a little tired of this routine, especially when you count the months before "sleeps through the night" is a reality.

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Sleep Know the Pros and Cons of Co-Sleeping

Is it okay to let the baby share your bed with you? There is no single correct answer to this situation. It is up to you, as a parent, to decide after knowing its pros and cons:

Advantages of co-sleeping Sleeping with your baby can foster a closer bond between you and your child. It gives you more time to spend with your baby. This is especially important for working couples. According to some studies, breastfeeding is higher amongst babies who share their parents bed Babies who sleep with their parents are believed to enjoy better sleep. Some studies report that babies who co-sleep wake less often during the night and fall asleep faster. Co-sleeping tends to reduce crying amongst babies. It is easier for parents to attend to the babys needs at night. Co-sleeping enables parents to respond immediately to babies when they cry.

Disadvantages of co-sleeping Once they get used to sleeping with them, babies may refuse to sleep in the parents absence. It may be difficult to teach co-sleeping babies to sleep alone later. Sleeping with a restless baby may disrupt the parents sleep. Parents may see a baby in bed as an intrusion in their love life.

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Sleep Sleeping Without the Pacifier

The difficulty begins that first night or with the first naptime. Children will get in the bed and then realize there is no more pacifier. You will have to remind that that they can't have it anymore. You won't have to worry about giving in, since you've gotten rid of the pacifiers!

It will likely take a good hour or more for the children to now fall asleep, because they dont know how to without the pacifier, and need to learn a new way to fall asleep. Be prepared for tears and screams, but don't scold them, just support them as they work their way through this.

Usually, by the third or fourth night, your kids will have learned how to fall asleep in a short time again; though don't be surprised if they still ask about the pacifiers. The one thing you have to make sure of is that you don't substitute yourself as the new "object" that your toddlers need in order to fall asleep.

You want them to learn how to fall asleep on their own.

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Sleep Tips on Putting Your Twins to Sleep

Looking after twins usually means more work for the parents. It also often presents parents with tricky situations. One of these is putting a pair of twins to bed. Here are tips to help parents of twins cope with this situation: Maintain fixed bed times: Helping your twins sleep at the same time everyday will ensure that they will form good sleeping habits. A fixed bedtime will help them fall asleep without fuss as soon as you put them to bed. Devise a pre-bed routine: This could be a warm bath, some massage and cuddling, or a story telling or lullaby session. When repeated daily, this will help your twins anticipate and get into the mood for sleep. Swaddle your babies: Swaddling or wrapping your twins in a blanket, or sheet will help your twins sleep more snugly. This will make it less likely that they will get up at night. Teach your twins to sleep: Help your twins to learn to fall asleep. You can do so by putting them to bed while they are drowsy, but still awake. This way they learn to rely on their own ability to get sleep. Let them sleep together: Babies feel more secure when they can enjoy physical contact with their parents or siblings. Twins who sleep together are more likely to enjoy undisturbed sleep through the night. When they grow older and you decide to separate them, ensure that they can still see each other. Help the calm baby first: When twins wake up from sleep, parents tend to the one who is crying more. But this often leads to the calmer of the two being neglected. It is better to settle in the quiet baby first and then attend to the one who is fussing. Tackle frequent waking: Babies who are excited or stimulated have trouble falling asleep and are more likely to keep waking up at night. You can make them feel restful and ready to sleep by maintaining a calm and quiet atmosphere just before sleep. This may be done by keeping lights dim and keeping noise to a minimum. This helps babies to relax better and they sleep sounder.

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Sleep Coping With Light Sleepers

While most toddlers learn to fall asleep alone, others wake up frequently and find it difficult to get back to sleep.

There is no right or wrong way of putting a toddler to sleep. Healthy diet patterns, lots of love and affection, and a stress free life can be positive factors influencing your toddlers sleep. The knowledge that they are secure in their room with their parents close by can be comforting to toddlers. At times, they may get up at night and you may have a difficult time trying to put them back to sleep. If this happens occasionally, you can ignore it.

However, if it is happening frequently you need to ask yourself some questions: Is it a deliberate attempt to sleep with parents? Are they unhappy in some way and trying to attract your attention? Are they watching horror movies or other violent acts on TV before they sleep? Do they have any medical problems (related with breathing) that prevent them from sleeping peacefully?

After you have examined the situation, you may consider taking the following steps to help your light-sleepers: Be firm and explain to them that no amount of drama will give them an opportunity to find their way into your bed. The first few days will be hard on the parent and the child but will work positively. Try to find out if they have problems at pre-school or when you leave them alone with the caretaker or the baby sitter. Check for medical problems with your pediatrician. Give them a transitional object like a stuffed toy or a favorite blanket that they can carry to bed. Eliminate any unusual sound disturbance in their room (creaky fans, the air conditioner, heaters etc.) Exercise parental discretion on their TV schedule.

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Sleep Scared in Sleep A Short Background

Night terrors strike more than one-third of children in the United States, according to the Washington, D.C.-based National Sleep Foundation. The disorder is particularly common in boys and usually occurs between the ages of 3 and 7, says Dr. John Tedeschi, chairman of Virtua Health West Jerseys pediatric department.

For most children and worried parents the episodes are mercifully short-lived, beginning and ending within a few weeks of each other. For others, night terrors can haunt children for years, hanging on well into the preteen years.

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Sleep Deep Sleep Some Symptoms of Terror

Night terrors happen most often when children sleep deeply. Fathers, who have ever carried a limp child from the car to their bed without waking, understand what it means to have a child in deep sleep. The normal sounds that would arouse a sleeping adult a slamming car door, rattling house keys, stumbling over hidden toys dont awaken these children.

Yet, it is during this same deep sleep that a childs body can jolt into action; when the slumbering body responds to some kind of stimuli, yet the mind stays asleep, night terrors occur leaving children in a sort of sleep limbo.

These sudden, partial awakenings occur most often during the first two hours of sleep and typically begin with a high-pitched scream which brings panicked parents running only to find a child appearing awake, pupils dilated, sweat forming and heart racing, says Dr. Stephen Sheldon, director of the Sleep Medicine Center at Childrens Memorial Hospital in Chicago, one of five childrens hospitals in the nation accredited by the American Academy of Sleep Medicine.

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Sleep Toddler Terrors, Infant Anxiety?

Although little research has been done on the subject, some sleep experts believe not only toddlers but infants are affected by night terrors.

Often simply trying to awaken and comfort their daughter when the night terrors begin works. The biggest thing is to remain totally calm. This medical advice takes a common sense route, encouraging parents to calm and reassure themselves as well as their children.

Fathers must remember that if they are frightened, their fears can be transmitted to the child, which can make night terrors more frequent and more intense. It becomes a vicious cycle of fright.

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Sleep The Difference between Night Terrors and Nightmares

Night terrors which have a physiological cause are very different from nightmares or other night awakenings caused by previous psychological trauma.

A few months after Shelia Jordans granddaughter was born, the infant survived a car wreck that killed her mother. Today, at 3 years old, Jordans granddaughter is haunted by nightmares triggered after she hears loud noises reminiscent of the car crash, Jordan believes.

Unlike night terrors, which are largely caused by a physical reaction, nightmares can be caused by the subconscious recollection of a traumatic incident, says Dr. Paul Saskin, clinical director of Sunrise Hospitals Regional Center for Sleep Disorders in Las Vegas, Nev.

The difference between night terrors and nightmares is simple, Dr. Saskin says. With night terrors, the child has an active body and sleeping brain. With nightmares, the opposite is true, enabling the child to recount a nightmare and welcome reassurance from parents.

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Sleep Bedwetting Causes Sleep Disorders

Parents will often describe their child that suffers from nocturnal enuresis (bedwetting) as being a deep sleeper. They will tell stories about how their child will be soaked in the bed without even waking up. If the child is taken to the restroom to pee in the middle of the night she is usually not aware of what is taking place and she does not remember it in the morning. My child is a sleep-walking zombie when I take her to the restroom in the middle of the night.

Studies have shown that sleep disorders such as sleep apnea (not taking normal breathes or having difficulty breathing while sleeping) are more common in those that wet the bed. Enlarged tonsils are a known cause of sleep apnea and some physicians have gone as far as to recommend a tonsillectomy (the removal of tonsils in the throat) in children with bedwetting and sleep apnea. This is not standard practice, and should be viewed as potentially aggressive treatment for bedwetting.

Bedwetting alarms are used to wake a child during sleep when they wet. There is certainly some correlation between being a deep sleeper and not being aware of the need to wake up and use the restroom. It may be true that bedwetting is associated with deep sleep, but most deep sleepers are not bedwetters. Most children are deep sleepers because they are very active during the day and their bodies burn a lot of energy. Deep sleep and sleep disorders are only part of the explanation as to why some children wet the bed.

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Sleep About the Authors

D. Preston Smith MD Dr. D. Preston Smith attended Rice University in Houston, Texas where he graduated with honors in Economics.

He graduated from the University of Texas Medical School at Houston in 1987. Following medical school he spent two years in General Surgery at the University of Tennessee Medical Center at Knoxville. In 1993, he finished his Urology Residency at Northwestern University in Chicago. He concluded his training upon completion of a two-year fellowship in Pediatric Urology at the University of Tennessee at Memphis and LeBonheur Children's Hospital in 1995.

Dr. Smith is board certified and he has authored or co-authored many articles, papers, chapters, and books in Urology and Pediatric Urology. His research has been presented throughout the world. Dr. Smith's dedication to helping children with urologic problems inspired him to establish PottyMD.

Dr. Smith is a father of three young children.

Paul Banas As a new dad, Paul Banas was looking for a business idea that would allow him the flexibility to spend time with his family. And, as a dad, he became very aware that many dads today are more involved in parenting but have limited resources from a mans point of view from which to better understand the challenges of their changing role. Based on this insight and his experience of more than 20 years of marketing and business development at companies including Unilever, Visa International, Alibris.com and most recently, Yahoo! Inc., Banas founded GreatDad.com.

While nothing can imitate or replace the special mother/child bond, dads develop incredible relationships with their children and it is vitally important that they have a place to discuss the parenting process from a male perspective. Data indicates that fathers today are more involved in family life versus a generation ago due to factors including post-911 security fears, loss of career-long job security, and increased demands on working moms and dual-career families, said Banas. GreatDad.com enables all

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Sleep
dadsworking, stay-at-home, single, gay, domestic partners, and moreto find ways to be involved and understand how dads are functioning as parents today.

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Sleep Recommended Reading

Books by D. Preston Smith MD The Complete Bedwetting Book: Including a Daytime Program for Nighttime Dryness

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Sleep Acknowledgements
We would like to thank D. Preston Smith MD for the following article: Bedwetting Causes: Sleep Disorders

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