Remedies for Parents to Address Common Childhood Sleeping Problems Evidence-Based Practice

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Remedies for Parents to Address Common Childhood Sleeping Problems
Evidence-Based Practice

Summary:
– one of the most common problems reported in childhood (affects 1 in 4)
– sleep impacts on children:
– can develop further across the lifespan
– mood (upset/swings)
– irritability
– academic performance/ affects thinking & learning
– most kids are not getting enough sleep
– infants need 17 hours during both day and night
– 2 year olds need 11 hrs sleep at night & 2 hrs during the day
– 4 or 5 – daytime sleep not required (but 11 hrs per night)
– 14/15 – 9 hrs per night
[general rule of thumb: 30 minute decrements per year of age from 6/7 years)
– sleep is as critical as diet & the type of school a child goes to
– society/kids are busier than ever
– takes a lot of commitment, & is harder to stick to the schedule, to enforce family rules about sleep
– common problems:
– going to bed earlier (one of the top problems)
– kids resist going to bed (often because it is seen as boring)
– issue of “curtain callers” – for e.g. “Just one more drink of water/hug/story”
– or with tantrums or anxiety about it
– then they come out later after you think they were asleep
– need parents in there, need TV on, need to have mum in there
[Note: this is a “stimulus control problem” – the child has not associated bed with sleep]
[to become a successful sleeper, we need to teach sleep hygiene – no TVs, lights, music; dark room; quiet, comforter]
[best strategy: push bedtime back by 30 minute decrements to when the struggling child will actually fall asleep, & then over time, wind it back][establish a regular sleep window – sleep/wake times]
[stick at it until bed time cues are established]
[if child needs you there, or needs you stroking his/her cheek – again do on a graduated basis where this slowly gets wound back & discuss this strategy with the child & why you are doing it][say “i will wind back & I will be right back” & increase intervals until fall asleep]
[establish morning rewards to support this]
[tantrum: cold turkey option – a dangerous strategy to attempt & most parents cannot sustain this]
[or graduated basis as described earlier / attention & graduated return schedule]
[hybrid – wait out in the hall]
– kids can be cue-dependent to go to sleep (high maintenance kids) & often need comforters, regimens/routines
– frequent night time awakening / sleep terrors (like a nightmare / but do not seem awake & later cannot recall content

Infants – sleep is chaotic initially, particularly for the first three months
– expect this
– after first three months: lay in bed when drowsy (but still awake) [to establish bed association & sleep] rather than sleeping in your arms
– loosely structure their – sleep, eat, wake cycle [repeat][this avoids dependence on the bottle]

Once the child turns 18 months, if sleep remains a critical issue – seek professional help
– wait for a pattern that establishes itself after a month to 6’weeks
– remember: children when sick or developing can experience sleep disruption

Source: CBT RADIO by CBT WNC | 9 De ember 2014

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