“Insomnia In Infants and Children”
Natural Insomnia Cures Better Sleep

Silent Night: Treating Insomnia in Infants and Children

There are some people who have problems falling asleep each and every night. If they do, chances are they are afflicted by a psychological sleeping disorder called insomnia.

Usually, people suffering from insomnia blame this for too much stress, worries, depression and a very worrisome life.

People mostly believe that these feelings cannot be experienced by infants and children because they are too young to worry about anything. Based on this reasoning, some people think that insomnia would not occur in children.

But this is not true. Just like adults, insomnia can also happen to children and infants.

Children have different sleeping habits and time patterns. For infants who are one week old, the average length of sleep per day is 16 hours. There are parents that believe that babies who sleep less are geniuses or have a high I.Q.

But there is no scientific evidence to support this belief. Babies usually wake once every evening at the minimum. Unless breast fed, infants can go back to sleep on their own.

Insomnia or sleeping disorders can be defined in the following parameters:

• Having a hard time to sleep at night
• A person who wakes up very early
• A person who wakes up often at night

This ailment can cause the feeling of tiredness and drowsiness even after waking up in the morning. A person with insomnia also has a hard time concentrating.

Other terms for insomnia are Wakefulness, Sleeplessness and Dysomnia. Infants usually wake up frequently at night. At the sixth month, babies basically have a normalized nocturnal pattern by being asleep the whole night.

When the infant reaches a year old, he or she sleeps at a rate of 16 hours per 24 hours. The baby will sleep during daytime from 2 to 3 hours.

Reasons why babies suffer from insomnia:

• They want their parents to notice them

• They may be suffering from digestive ailments or infantile colic which is a condition where babies cry for more than 3 hours a day.

• Infants that are often hungry

• Their teeth are beginning to grow

• They may be ill or afflicted by a disease

Here are some tips in curing insomnia for infants:

• Try not to comfort the baby immediately when crying at night. It would be best to wait until the infant stops crying on his or her own. Constant attention can be a stimulus for infants to stay awake at night.

• Observe if the child is unable to sleep because of excessive noise. Try playing classical or slow songs to cover up noisy environment.

• Do not make a child go to bed as a penalty or reprimand for something. This can cause insomnia because instead of them enjoying being asleep, they dread it.

• Parents should not make an infant accustomed to falling asleep in their arms. When the baby is already six months old, try making them used to fall asleep on their cribs by themselves.

• Reading stories in bed, tapping or scratching a child before sleeping, singing a lullaby is often a cause of insomnia because without these routines children will be unable to sleep.

• Do not give a child sleep inducing medicine unless the doctor advices it. As much as possible, do not use chemicals or drugs in curing insomnia.

• Remember that sleeping pills may have side effects.

• If the condition remains after trying home measures to cure insomnia, consult a doctor.

To cure infant insomnia, parents should be ready to let their baby cry without comfort until they learn to sleep by themselves.

They can also try to slowly lessen the attention that they give each night to put an infant to sleep until they can totally do it without parent’s supervision.

Children especially infants need enough and regular sleep for them to grow healthy emotionally and physically.

Parents should be very sensitive and vigilant in observing their child’s sleeping habit. Eventually both the parents and the child will be affected by insomnia if this is not given attention.

The bedroom should be a place to sleep and should be peaceful not rowdy. A bedroom in not a room for a child’s play but for a child’s restful evening.

Finally, sleeplessness is a sign of a mind not at peace. A child is always an angel and an angel should always be at peace. Making your baby grow like an angel is not easy and most of the time it takes sacrifices.

In time, parents can sleep soundly at night because their child grew up to be a good person; all because they made their child sleep right since birth.

CHAPTER 12. Treating Insomnia - Do OTC Meds Work?

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Baby sleep:

Newborn Babies daily sleep requirements:

0-2 months: 10.5-18.5 hours

Despite their small size, babies can wield tremendous power over their parents.

Some new parents will go to extreme lengths to get their baby to sleep, rocking them to sleep in their arms for hours or driving them around town until their eyelids finally flutter shut.

Bedtime doesn't have to make parents and their babies crazy.

A newborn’s sleep cycle is disorganized. In the first few weeks, you can expect your baby’s sleep to be distributed throughout the 24 hours, with each sleep period lasting anywhere from 30 minutes to 3 hours, and with frequent waking periods through the night. In about six weeks a more regular, defined sleep pattern should begin to emerge.

While sleeping, your baby may be very busy twitching, jerking, sucking, snuffling—even smiling. This is normal. Even with all this activity, your baby is actually getting a perfectly sound sleep.

When addressing difficulties that your child may be having with sleep, it is important to be aware of the general developmental progression of sleep behavior in kids. Newborns alternate between sleep and wakefulness every 3-4 hours, awakening often associated with hunger.

As the child grows this develops into what is called a "diurnal" pattern. This means there are progressively longer periods of wakefulness during the daytime as well as longer periods of sustained sleep at nighttime.

By about 12 weeks, an infant may sleep at night for periods up to 8 hours.

At 3-4 months, more than 70% of infants are sleeping for sustained periods of time at night. This is sometimes referred to as "settling in" and it occurs as the infant's brain matures.

If we look at EEG patterns (an EEG is an instrument that measures brain waves) we can see the patterns becoming increasingly organized into distinctive stages differentiating sleep from wakefulness.

An infant probably spends 16 hours of a 24-hour period asleep. This decreases to 12 hours in the second year of life, 10 hours by age 3, and to 9 hours from ages 8-12.

Remember that this varies according to the child. With some children, this kicks in quite early and with others it happens much later on. This is simply a variation in normal development.

While the development of the brain plays a very important role in the establishment of the sleep-wake cycle, learning and conditioning are equally important.

This is good news for parents because it means they can also play a role in enhancing and facilitating the development of their child's sleep behavior.

Just as parents pay attention to their children's general hygiene, they can also address their sleep hygiene.

This can help to establish life-long patterns of good sleep. It's much easier to prevent a sleep problem than to treat one.

Here are some guidelines on what to expect, from the time you bring your tightly swaddled bundle home to your baby’s third birthday.

Every living creature needs to sleep. It is the primary activity of the brain during early development.

Circadian rhythms, or the sleep-wake cycle, are regulated by light and dark and these rhythms take time to develop, resulting in the irregular sleep schedules of newborns.

The rhythms begin to develop at about six weeks, and by three to six months most infants have a regular sleep-wake cycle.

By the age of two, most children have spent more time asleep than awake and overall, a child will spend 40 percent of their childhood asleep.

Sleep is especially important for children as it directly impacts mental and physical development.

There are two alternating types or states of sleep:

Non-Rapid Eye Movement (NREM) or “quiet” sleep. During the deep states of NREM sleep, blood supply to the muscles is increased, energy is restored, tissue growth and repair occur, and important hormones are released for growth and development.

Rapid Eye Movement (REM) or “active” sleep. During REM sleep, our brains are active and dreaming occurs. Our bodies become immobile, breathing and heart rates are irregular.

Babies spend 50 percent of their time in each of these states and the sleep cycle is about 50 minutes. At about six months of age, REM sleep comprises about 30 percent of sleep. By the time children reach preschool age, the sleep cycle is about every 90 minutes.

For newborns, sleep during the early months occurs around the clock and the sleep-wake cycle interacts with the need to be fed, changed and nurtured.

Newborns sleep a total of 10.5 to 18 hours a day on an irregular schedule with periods of one to three hours spent awake.

The sleep period may last a few minutes to several hours. During sleep, they are often active, twitching their arms and legs, smiling, sucking and generally appearing restless.

Newborns express their need to sleep in different ways. Some fuss, cry, rub their eyes or indicate this need with individual gestures. It is best to put babies to bed when they are sleepy, but not asleep.

They are more likely to fall asleep quickly and eventually learn how to get themselves to sleep. Newborns can be encouraged to sleep less during the day by exposing them to light and noise, and by playing more with them in the daytime. As evening approaches, the environment can be quieter and dimmer with less activity.

GO WITH THE FLOW

The first few weeks of your baby’s life are all about adjustment—for your baby and for you.

It’s simply too soon to expect structured sleep patterns, so it makes sense to take your cues from your baby. Do what works for your baby now, and before long you’ll have the beginnings of a sleep routine.

Every child is different. Your baby’s sleep habits will be different from your friend’s baby, or from an older sibling at the same age.

Build your routines and rhythms around your baby’s sleep needs and patterns. Once you’re familiar with your own baby’s sleep patterns, you can begin establishing regular routines to help your baby—and the whole family—get to sleep and sleep well.

Learn your baby’s signs of being sleepy. Many babies become fussy or cry when they get tired, but others will rub their eyes, pull on their ears, or even stare off into space. Put your baby down for bedtime or a nap when your baby first lets you know he or she is tired.

Follow your baby’s cues. Your newborn may prefer to be rocked or fed to sleep. This is fine for the first few weeks or months. By three months, however, begin to establish good sleep habits.

Always put your baby down to sleep on his or her back. A baby should sleep on a firm mattress, with no fluffy or loose bedding.

After the first few weeks, start to actively encourage nighttime sleep if your baby is awake a lot at night and sleeps much of the day. Do this by making sure the bedroom is dark or dim and cutting down on nighttime play

Have realistic goals about sleep. Your baby will not be able to sleep for long stretches at a time for the first few months.

Make sleep a family priority. It’s usual to be sleep-deprived with a newborn.

But no one benefits if you’re crying from exhaustion while the baby’s crying to be calmed. Tell your spouse (or a friend who’s offered) when you need a break.

And, tempting as it is to use naptimes to get things done, you’ll be able to cope better if you nap when your baby does.

Take the first steps toward a bedtime routine.
The important thing is that it’s built around things that both you and your baby enjoy.
Your newborn’s bedtime routine could include:
Taking a bath
Getting a massage
Changing into pajamas
Rocking and cuddling
Sharing a song
Or whatever works best for you and your baby

Sleep Tips for Newborns

• Observe baby’s sleep patterns and identify signs of sleepiness.
• Put baby in the crib when drowsy, not asleep.
• Place baby to sleep on his/her back with face and head clear of blankets and other soft items.
• Encourage nighttime sleep.

Infants daily sleep requirements:

2-12 months: 14-15 hours

A 3- or 4-month-old is taking three to four naps a day, and a 12-month-old is typically taking two naps a day.

One of the problems answering that question is the definition of “sleeping through the night.”

The original definition in 1957 was a baby who sleeps from midnight to 5 a.m. is sleeping through the night.

Gradually, over the first few months, your baby will begin to develop a more predictable pattern. Between 2 and 4 months, you will notice a regular rhythm of sleepiness and alertness throughout the day.

Between 3 and 6 months most babies begin to sleep for longer stretches at night. In the first year, babies naturally cut down their daily naps from 3 or 4 a day to 1 or 2 a day.

Note that developmental milestones, such as rolling over and pulling up to stand, can temporarily upset sleep

So if you're looking for 12 hours straight, they will be at least 6 months of age until they can sleep for that long without a nighttime feeding.

By six months of age, nighttime feedings are usually not necessary and many infants sleep through the night; 70-80 percent will do so by nine months of age.

Infants typically sleep 9-12 hours during the night and take 30 minute to two-hour naps, one to four times a day – fewer as they reach age one.

When infants are put to bed drowsy but not asleep, they are more likely to become “self-soothers” which enables them to fall asleep independently at bedtime and put themselves back to sleep during the night.

Those who have become accustomed to parental assistance at bedtime often become “signalers” and cry for their parents to help them return to sleep during the night.

Social and developmental issues can also affect sleep. Secure infants who are attached to their caregiver may have less sleep problems, but some may also be reluctant to give up this engagement for sleep.

During the second half of the year, infants may also experience separation anxiety. Illness and increased motor development may also disrupt sleep.

For all children, adolescents and adults, you want a bedroom that's cool, quiet, dark and comfortable.

All babies should sleep on a firm surface. There should be very little bedding in their crib, so that there's no concern about suffocation.

And, of course, all babies should be put down on their backs to sleep to decrease the risk of sudden infant death syndrome.

A consistent sleep schedule with set nap times and a set bedtime is going to set their internal clock and make it so they fall asleep quickly and stay asleep. A typical baby bedtime is between 7:30 and 8:30 at night.

One of the key things in getting a baby to have good sleep habits is a bedtime routine.

You want that bedtime routine to be 20 to 30 minutes long and include about two to three activities, which are exactly the same every single night.

A typical bedtime routine may include taking a bath, massaging the baby, reading, singing lullabies.

You want activities that are soft and soothing. Now, if your baby hates taking a bath or can't sit still for books, you want to do that at a different part of the day.

One of the most important things that you want to do as a parent is figure out the sign your baby gives when he or she is sleepy.

Does she rub her eyes? Does she pull her ears? Does she twirl her hair? One baby I knew used to stare off into space.

The mom thought the baby was bored so she would sort of do antics, but, really, that was a sign for the baby that he wanted to go to sleep.

The moment your baby gives you that sign, that's your window of opportunity.

You want to go right away and put them down for their nap or for bedtime.

All babies naturally awaken between three and six times throughout the night.

As they change from one sleep stage to another, they're going to have a normal arousal. The question is whether or not a baby can fall back to sleep on their own.

A baby who can fall asleep on their own at bedtime is a baby who's going to fall right back to sleep when they waken during the night.

The National Sleep Foundation data from the Sleep in America poll found that 46 percent of children are being put down awake in their cribs rather than asleep.

So the majority of children are being put down asleep. But children who are put down awake fall asleep faster and sleep, on average, one hour more at night.

A baby who's rocked to sleep, nursed to sleep, driven in the car to sleep, pushed in a stroller to fall asleep at bedtime is going to need that exact same thing to fall back asleep at 1:00, 3:00 and 5:00 every time they naturally awaken.

If a parent has a baby who's having a difficult time falling asleep or staying asleep, they may choose to do what we often refer to as sleep training. So you do your bedtime routine, you put your baby down awake in their crib and then leave the room.

At that point, you want to check on your child. How often you check is going to depend upon your tolerance as a parent and your baby's temperament.

For some babies, it makes them more upset to check on them than not to check on them.

Every time you go in to check on your child, you want to go in for just a minute or two, be really calm, let them know everything is OK and leave.

It's best not to pick them up, but, if you need to, that's OK, as long as you put them back down.

The first night, they will often fuss (that's our nice way of saying they may be upset) for 30 to 45 minutes.

The second night is going to get worse, because it's sort of "last night was a fluke, tonight I really mean it."

By third night, you're going to see dramatic improvement and, if you stick with it for a week, what you're going to find is a baby who falls asleep very quickly at bedtime and will start sleeping through the night.

The most important thing parents should do when they start sleep training is consistency. If they're consistent, they are going to see a major improvement.

When there are two parents in the household, sleep training always takes some negotiation. You both need to come up with a plan that you're going to stick to.

If there is one parent who can't tolerate any crying by their child, you may want to send them out to the store or to a friend's house, so you can help the baby get over the hump.

The other thing that's important for parents to realize is that they're doing this for the benefit of their baby.

Some parents feel as if they're being selfish. You have to realize that a baby waking three times a night is going to feel as awful the next day as a parent waking three times per night. Also, having a parent who's well rested is going to have huge benefits for babies.

Create a bedtime routine that works for both you and your Infant.

From 6 weeks to 3 months, start creating a familiar sequence of calming events that unfolds night after night and clearly says, “It’s time to settle down and go to sleep.”

Now that your baby’s sleep patterns are becoming more organized, it’s time for a bedtime routine that will fit in with your family’s needs as well as your baby’s needs.

Keep the sequence of events basically consistent even with caregivers or when away from home. It can also be helpful to have parents take turns putting their baby to bed.

Learn your infant’s signs of being sleepy. Many babies become fussy or cry when they get tired, but others will rub their eyes, pull on their ears, or even stare off into space. Put your baby down for bedtime or a nap when your baby first lets you know he or she is tired.

Start developing a bedtime routine. Make sure your routine is not too long or too impractical to stick to. Rock your baby to sleep at 6 months, and you may end up doing the same when the baby wakes in the night—as all babies do for short periods—or even when your little one turns two.

Set a regular sleep schedule for your baby. Settle on regular naptimes and a bedtime that allow your baby to get all the sleep he or she needs. Contrary to what you may think, cutting down on naps won’t help at night. It can be a recipe for overtiredness and a worse night’s sleep. But you’ll also want to avoid naps too close to bedtime.

Give your infant soothing surroundings. Keep the bedroom dark, cool and quiet. And make sure lights and environment, are the same at bedtime as they will be throughout the night.

Wind down your routine where you want your baby to sleep. The last part of the routine should happen in the room where your baby sleeps.

Put your infant to bed drowsy but awake. This may teach your baby to soothe himself or herself to sleep, as well as to go back to sleep in the night on his or her own, with little if any intervention from you.

Make sleep a family priority. Remember, you need sleep, too. If friends and family have offered help, take them up on the offer. Resist as much as you can treating your baby’s naptime as your chore time. Take a nap when your baby does.

Avoid making bedtime feedings a permanent fixture. They rarely help either how long or how well your baby sleeps. And after 6 months nighttime feedings are rarely necessary. Move a bottle or nursing time earlier in the evening, to avoid the association between eating and sleeping.

Create a consistent bedtime routine you and your infant enjoy, this could include: • Develop regular daytime and bedtime schedules
• Create a consistent and enjoyable bedtime routine.
• Establish a regular “sleep friendly” environment.
• Encourage baby to fall asleep independently and to become a “self-soother.”
• Develop Taking a bath routine
• Getting a massage routine
• Changing into pajamas routine
• Hearing a story routine
• Sharing a song routine
Or whatever works best for you and your infant

Toddler - Children’s daily sleep requirements:

1-3 Years Toddlers – kids sleep

12-18 months: 13-15 hours
18 months-3 years: 12-14 hours
3-5 years: 11-13 hours
5-12 years: 9-11 hours

Toddlers need about 12-14 hours of sleep in a 24-hour period. When they reach about 18 months of age their naptimes will decrease to once a day lasting about one to three hours. Naps should not occur too close to bedtime as they may delay sleep at night.

Many toddlers experience sleep problems including resisting going to bed and nighttime awakenings. Nighttime fears and nightmares are also common.

Many factors can lead to sleep problems. Toddlers’ drive for independence and an increase in their motor, cognitive and social abilities can interfere with sleep.

In addition, their ability to get out of bed, separation anxiety, the need for autonomy and the development of the child’s imagination can lead to sleep problems. Daytime sleepiness and behavior problems may signal poor sleep or a sleep problem.

Your toddler may be finished with morning naptime by around 18 months, and naps will disappear altogether between 2 1/2 and 5 years.

At the same time, most toddlers will have learned to sleep through the night, although stressful events and other interruptions (an illness, a trip) can temporarily upset this welcome pattern.

Switching to a bed is another change that can be disruptive for a toddler, especially if it happens too early. Most toddlers switch to a bed between 2 and 4 years.

If you regularly have to wake your child in the morning, it could be a sign that he or she isn’t getting enough sleep. The number of hours a toddler sleeps will be different for each child. However, most toddlers are consistent in how much they sleep from one day to the next. Build a regular bedtime routine everyone enjoys.
For a toddler, this could include:
Taking a bath
Changing into pajamas
Reading books together
Sharing a song
Or whatever works best for you and your toddler

Your toddler’s sleep patterns will continue to change. Toddlers can generally sleep through the night, although change and stressful events (a trip or illness, for example) can cause temporary setbacks.

All children wake briefly at regular intervals throughout the night. A toddler who’s learned to fall asleep on his or her own will be able to return to sleep in the middle of the night without help from you—although normal bedtime fears and nightmares may need your reassurance.

Set a regular sleep schedule. Establish regular naptimes and a bedtime that allow your toddler to get all the sleep he or she needs. Restricting naps won’t help a toddler sleep better at night.

Quite the opposite—it can lead to overtiredness and more sleep problems. But avoid naps late in the afternoon.

Many babies become fussy or cry when they get tired, but others will rub their eyes, pull on their ears, or even stare off into space. Put your baby down for bedtime or a nap when your baby first lets you know he or she is tired.

Wind down your routine where your child sleeps. Make sure the last few soothing minutes of the bedtime routine happen right in your toddler’s room.

Give your toddler soothing surroundings. Keep the bedroom dark, cool and quiet. A night-light is fine. A television isn’t. And make sure the environment is the same at bedtime—lighting, for example—as it will be throughout the night.

Put your child to bed drowsy but awake. This may teach your toddler to fall asleep, as well as to go back to sleep in the night on his or her own, with little if any help from you.

Whatever routine you have established at bedtime will need to occur again if your child wakes in the middle of the night. So create a routine that helps your child fall asleep on his or her own.

Set limits. If your child stalls at bedtime, set clear limits, such as how many books you will read or how many drinks of water you will allow.

Make sleep a family priority. Remember, looking after a toddler takes plenty of energy. You need your sleep, too.

Sleep Tips for Toddlers:

• Maintain a daily sleep schedule and consistent bedtime routine.
• Make the bedroom environment the same every night and throughout the night.
• Set limits that are consistent, communicated and enforced.
• Encourage use of a security object such as a blanket or stuffed animal.

Preschoolers daily sleep requirements:

(3-5 years) Preschoolers typically sleep 11-13 hours each night and most do not nap after five years of age.

As with toddlers, difficulty falling asleep and waking up during the night are common.

With further development of imagination, preschoolers commonly experience nighttime fears and nightmares. In addition, sleepwalking and sleep terrors peak during preschool years.

Sleep Tips for Preschoolers:

• Maintain a regular and consistent sleep schedule.
• Have a relaxing bedtime routine that ends in the room where the child sleeps.
• Child should sleep in the same sleeping environment every night, in a room that is cool, quiet and dark – and without a TV.

School-aged Children daily sleep requirements:

Children aged five to 12 need 10-11 hours of sleep.

At the same time, there is an increasing demand on their time from school (e.g., homework), sports and other extracurricular and social activities.

In addition, school aged children become more interested in TV, computers, the media and Internet as well as caffeine products – all of which can lead to difficulty falling asleep, nightmares and disruptions to their sleep.

In particular, watching TV close to bedtime has been associated with bedtime resistance, difficulty falling asleep, anxiety around sleep and sleeping fewer hours.

Sleep problems and disorders are prevalent at this age. Poor or inadequate sleep can lead to mood swings, behavioral problems such as hyperactivity and cognitive problems that impact on their ability to learn in school.

Sleep Tips for School-aged Children

• Teach school-aged children about healthy sleep habits.
• Continue to emphasize need for regular and consistent sleep schedule and bedtime routine.
• Make child’s bedroom conducive to sleep – dark, cool and quiet. Keep TV and computers out of the bedroom.
• Avoid caffeine.

Kid’s Sleep Disorders:

Problems with sleep behaviors are commonly seen in children. Sleep is of primary importance at all stages of human development, and in the newborn, is the primary activity other than eating.

Childhood sleep disturbances affect not only the child but also the whole family. There is an abundance of different beliefs and lore on this topic. Sifting through the enormous amount of material, approaches, and opinions about kids' sleep can be daunting for parents.

There is not one correct way to deal with your child in regard to sleep. Each child is unique and has his own special set of circumstances and needs. What's important is for parents to identify what they feel comfortable with and what they feel is best for their child.

Just as parents pay attention to their children's general hygiene, they can also address their sleep hygiene. This can be made a pleasurable event.

This can help to establish life-long patterns of good sleep. It's much easier to prevent a sleep problem than to treat one.

The important keyword in sleep hygiene is consistency. Bedtime should occur at the same time each night.

A regular habit of storytelling, reading a book, or talking about the day's events are often nightly rituals that parents can implement.

This can be a meaningful period of engagement for both the parent and the child.

Typical bedtime sequences take around 30 minutes. Often children engage in what has been referred to as "curtain call" behaviors.

These are behaviors by the child that delay separation from the parents before bedtime. Kids will often get up and say they need to go to the bathroom, or that they need to get a glass of water.

Sometimes these behaviors become problematic. I recommend children be asked to do these things for themselves. This avoids reinforcing these behaviors by granting more contact with the parents.

Different sleep difficulties tend to cluster around different ages. Before the age of three it is common for infants to have problems going to sleep and nighttime awakening.

Nightmares, fear of the dark, and night terrors usually begin to occur between ages 3-6, and sleepwalking usually has its onset after age 6.

Sleep problems appearing later and in adolescence are more frequently associated with underlying psychiatric disorders, drug abuse, or medical conditions like narcolepsy.

At what stage should kids sleep in their own beds? There are different philosophies about children sleeping in the same bed as their parents. Western culture expects children to sleep alone from a very early age.

In non-Western cultures, families tend to sleep together for a much longer period of time. Parents generally have to decide what works for them and their lifestyle. This issue can sometimes be a source of conflict between parents.

The older a baby is when he is sleeping with his parents, the more difficulty they are likely to experience when making the transition from their bed to the child's own bed.

Kids generally love to sleep with their parents. Once used to this they can be quite resistant to changing. It's important for parents to be aware of the impact that this has on their own time for both sexual and emotional intimacy.

Night Wakings Infants sleeping alone often wake at night and fall back asleep without the parents being aware of the arousal. Some infants, as most parents know, cry upon awakening and this can become a regular and frequent habit.

The concerned parent may rush in to see that the child is okay and to provide comfort. If a healthy baby continuously awakens this can be a source of distress for the parents. One popular intervention is "Ferberizing."

This is a method popularized by Dr. Richard Ferber. Basically it involves letting the child continue to cry for increasingly longer periods of time without intervening.

The goal is to foster the child's ability to "self-sooth" or put themselves back to sleep. This is effective after a few days for many children.

However, some parents don't feel comfortable with what they perceive as a "cold turkey" approach. Parents need to do what they feel comfortable with and often do well with modified approaches.

I advise parents to try and not respond instantaneously to the child's awakening and crying. An instant response is likely to be gratifying to the child and increase the likelihood that this behavior will recur.

Frequently a baby will cry for 20-30 minutes and then fall back asleep. A timer is often useful to keep track of how long your child has been crying (20 minutes at 2 am can seem like 2 hours).

Children often respond rather quickly to methods like "Ferberizing." However, transitions, changes in environment, travel, and illnesses can causes these difficulties to recur.

Night Terrors versus Nightmares Night terrors start to occur in the 3-5 age range, as well. Night terrors are distinct from nightmares. With night terrors, children will begin to scream and cry in the middle of the night but still be asleep.

These episodes are self-limited and it is best to hold the child, not attempt to awaken them, but comfort them until they have settled down again. Night terrors tend to run in families and usually resolve spontaneously.

At times the problem will be frequent and severe enough that medication is used.

Nightmares are frightening dreams that occur during REM sleep and awaken a child. They usually occur in the later part of the night. Most children have at least one nightmare during childhood; three percent of preschool and school aged children experience frequent nightmares, according to NSF’s 2004 Sleep in America poll.

They can be upsetting and a child will need reassurance when they occur. Nightmares can result from a scary event, stress, a difficult time or change in a child’s routine. Use of a nightlight or security object is often helpful.

Sleep terrors occur early in the night. A child may scream out and be distressed, although s/he is not awake or aware during a sleep terror.

Sleep terrors may be caused by not getting enough sleep, an irregular sleep schedule, stress, or sleeping in a new environment. Increasing sleep time will help reduce the likelihood of a sleep terror.

Insomnia is a sleep problem that occurs when a child complains of difficulty falling asleep, remaining asleep, and/or early morning awakenings. Insomnia can be short-term due to stress, pain, or a medical or psychiatric condition.

It can become long-term if the underlying cause is not addressed or healthy sleep practices are not employed.

Treating underlying conditions, developing good sleep practices and maintaining a consistent sleep schedule can improve the ability to fall asleep and stay asleep.

Restless Legs Syndrome (RLS) is a movement disorder that includes uncomfortable and unpleasant feelings (e.g. crawly tingly or itchy) in the legs causing an overwhelming urge to move.

These feelings make it difficult to fall asleep. RLS can be treated with changes in bedtime routines, increased iron, and possibly medications.

Snoring occurs when there is a partial blockage in the airway that causes a noise due to the vibration of the back of the throat.

About l0-12 percent of normal children habitually snore. Snoring can be caused by nasal congestion or enlarged adenoids or tonsils that block the airway. Some children who snore may have sleep apnea.

Sleep apnea – when snoring is loud and the child is having difficulty breathing, it may be a sign of a more serious disorder, obstructive sleep apnea.

Sleep apnea is characterized by pauses in breathing during sleep caused by blocked airway passages, resulting in repeated arousals from sleep.

Sleep apnea has been associated with daytime sleepiness, academic problems, and hyperactivity. Treatment for sleep apnea is available.

Sleeptalking occurs when the child talks, laughs or cries out in his/her sleep. As with sleep terrors, the child is unaware and has no memory of the incident the next day. There is usually no need to treat sleeptalking.

Sleepwalking is experienced by as many as 40 percent of children, usually between ages three and seven.

Sleepwalking usually occur an hour or two after sleep onset and may last five to 20 minutes. As sleep deprivation often contributes to sleepwalking, moving bedtime earlier can be helpful.

Sleepwalking, like night terrors, tends to run in families. This problem emerges more frequently sometime after age 6.

A child can get up and walk around while still in a sleep state.

At times, the child can open doors and go outside. When the problem is this severe and can possibly endanger the child, medication is used.

Generally the child should be led back to bed without attempting to awaken him.

Sleepwalking tends to spontaneously resolve.

Pointers for parents: Talk to your child’s doctor if any of the following symptoms are observed:

• A child is having problems breathing or breathing is noisy.
• A child snores, especially if snoring is loud.
• Unusual nighttime awakenings.
• Difficulty falling asleep and maintaining sleep, especially if you see daytime sleepiness and/or behavioral problems.

CHAPTER 12. Treating Insomnia - Do OTC Meds Work?

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