Friday 9 December 2016

Irish Sleep Expert: How to train your toddler to enjoy a sleep in

An early-rising infant or toddler can send parents around the bend. Sleep expert Lucy Wolfe has the solution

Published 02/11/2016 | 02:30

An early-rising infant or toddler can send parents around the bend. Sleep expert Lucy Wolfe has the solution
An early-rising infant or toddler can send parents around the bend. Sleep expert Lucy Wolfe has the solution

Waking too soon to start the day is possibly one of the most debilitating sleep challenges that parents report. To put this into context, early rising can be considered anything before 6am. After 6am may be a typical and appropriate wake time for many young children and should be considered acceptable, provided they have consolidated their night-time sleep and are getting close to the amount recommended for their age group, which is generally 10ƒ-12 hours overnight.

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If you find that your child is over six months of age and they are inclined to start the day too soon, you may want to know about the most common contributory factors and slowly work through them, so that if they can sleep longer, they will.

To start, let's examine the environment for sleep:

Darkness influences sleep

Make sure that the bedroom is suitably dark with blackout blinds used together with blackout curtains. Ensure that there is no light whatsoever entering the room from either an outside source or indeed from a hall or bathroom light inside the home. Sometimes even the smallest slither of light signals to the child's brain to wake before anyone is ready.

Noise should be limited

Consider any disturbance within the household at this early time - someone getting ready for work, an alarm clock going off, another child getting up to use the bathroom or even central heating coming on. This early part of the morning is the most fragile part of sleep, and any of the above can trigger a wake up. Although you will still need to get up for work, look at ways of minimising the household disturbance to preserve the extra couple of night-time sleep hours.

Monitor the temperature

Examine the bedroom temperature along with the bedding and the clothing that your child is wearing. Between 3am-5am is potentially the coldest part of the overnight period and if your child is not warm enough, it may disturb their sleep. This is particularly relevant to this time of year, so adjust the tog of the sleeping bag and plug this gap. Ideally, the bedroom temperature would be constant, with any dips or spikes throughout the night-time avoided.

Outside activity and fresh air

Next, analyse your child's activities during the day: are they getting enough fresh air and outside activity? An hour a day is the recommendation - so aim for 30 minutes in the mid-morning, and again in the afternoon. If the weather is not suitable, ensure that they are exposed to bright and natural light to help regulate sleeping patterns.

Try to avoid or limit the exposure to television and electronic media. Overuse can have a negative impact on sleeping patterns and result in a lighter and less restful sleep. Definitely stop an hour before bedtime.

Review the diet

Is your child getting enough to eat and drink? I like to make sure that there is a feeding and sleeping balance in place and, once appropriate, that the child is getting three solid meals a day, with possibly two to three healthy snacks and their age-recommended milk intake and proper hydration.

Some children have an over-reliance on milk and, as a result, don't eat as much solid food as they need to keep them feeling full overnight and can wake early due to hunger. I would also suggest that dinner in the evening is a meat protein (once established) and carbohydrate-orientated meal.

Some children are having a main meal at lunch time and then lighter or lower-calorie foods as the day unfolds, which can result in waking, not necessarily hungry, but not feeling full for as long as the night-time period.

Now we need to make sure that the sleep elements are correctly in place. There are five key reasons behind waking too soon, once you have covered the above:

1 The child is helped to sleep

The child relies on the parent to help them get to sleep at bedtime in some capacity. For example, the parent may rock them, or lay down with them or feed them some or all of the way to sleep, after which the child falls asleep in their cot or bed super fast (under five minutes) having had a drink, or after being cuddled by you. This reliance may mean they are unable to cycle through some of their night-time sleep phases, which results in night-time waking, or they may just struggle to complete the last sleep phase from 3am onwards, resulting in a too-early start.

If this sounds familiar, then you need to consider weakening your input and creating a greater time lapse between the last feed and bedtime, to make sure that this is not inducing a sleep state and causing this issue. This can be done slowly and gradually and without leaving your child to cry - they can be supported physically, verbally and emotionally through this transition.

2 Nap imbalance

In this instance, the wakeful gap between the last nap and bedtime is too long. This can have a negative impact on the overnight sleep tendency and, although all children are different, these time lines are probably the closest to what most children do well on and diminish the exposure to early waking most effectively:

6-8 months: 2ƒ hours wake period between final nap and being asleep at bedtime

8-18 months: 4 hours

18 months-3 years: 4-5 hours

When you are in a negative early-morning cycle, then it can be a vicious circle of waking early and napping early and then the long gap emerges before bedtime. Do your best to close the last nap gap by slowly adjusting your day, even if your child is tired. The wake period between the morning wake-up and nap is less relevant than the one before bedtime, as this one causes all the problems.

3 Nap amounts - too little or too much

Additionally, if your child is not getting close to their age-recommended nap amount, then this will further exacerbate the issues. Whilst I don't put maximum emphasis on nap amounts as per the recommendations, I do try to get close to the amount. Of course, every child is different. Mood and behaviour can often indicate that your child is not getting enough, but sometimes, a mild-tempered child can power through on less. However, their body often responds by not staying asleep overnight.

Nap amounts by age:

6-8 months: 2ƒ-3ƒ per day

8-12 months: 2ƒ-3 hours

12-18 months: 2-2ƒ hours

18 months-3 years: 1ƒ-2ƒ hours

On the flip side, some children are napping too long in the day and they can only do so much sleep in a 24-hour period. So although limiting day sleep would never be my first course of action, over time, if it is obvious that your child can only achieve 13 or 14 hours in a 24-hour time frame, then you may need to adjust your day so that you ensure the longest night sleep that they can achieve.

4 Late bedtimes

A bedtime that occurs too late also fuels the early-morning issues. A knee-jerk reaction to improve the morning wake time is to push out bedtime later and later and, although this can sometimes help, it would not be typical. As over-tiredness at bedtime increases the risk of waking early in the morning rather than reduces it, I suggest that to improve the wake time, the bedtime should be adjusted forward. It is counter-intuitive, but, hormonally, the body responds better to sleep when applied consistently.

5 Parental responses

How the parent treats the wake-up also determines whether the early wake-up stays or goes. If you provide a feed that is no longer required biologically, bring your child into bed to extend the night, give them the iPad or get up at the early time, then you run the risk of ingraining the early wakes. I suggest that you make the necessary changes so that you don't continually fuel the issue and shift the body clock to an early setting. I try to treat any wake-up before 6am as night time. Once again, you can support your child in a different way as you weaken expectation.

Finally, you must understand that this particular sleep issue can take as long as six weeks or more to resolve, and often, the changes do not yield immediate results. But they do if you remain committed to the changes and observe all the elements outlined. Good luck.

Lucy Wolfe, CGSC, MAPSC, is a paediatric sleep consultant and mum of four young children. She runs a private sleep consulting practice where she provides knowledge, expertise and valuable support to families across the country. See www.sleepmatters.ie;

t: 087 268 3584 or e: lucy@sleepmatters.ie

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