Sleep Care

Toddler and Preschool Sleep

Bedtime battles between parents and young children are nothing new. Because children spend as much as ½ of their lives sleeping it is essential for their growth and development that they’re getting enough sleep. The two main problems most parents face are getting their child to go to bed without excessive protests or tantrums and remaining asleep throughout the night. Bedtime problems in children 2 years and older include bedtime stalling, bedtime refusal, verbal protests, crying, clinging, getting out of bed, attention seeking behaviors and multiple requests for food, drinks, and stories. Parents often have difficulties dealing with these behaviors because they do not adequately enforce consistent bedtimes, limits and rules. The first step in bedtime success with your toddler or preschooler is setting a consistent routine. Research shows that daily routines in general lead to predictable and less stressful environments for young children, improved daytime behaviors and lower maternal mental distress. A recent study showed that not only was a consistent bedtime routine rapid and effective at eliminating bedtime protests but children who participated in the routine fell asleep faster and their sleep throughout the night also improved. Parents also noticed a decrease in the number of times their children awoke throughout the night. The routine in this study included quiet activities, a bath, and stories with a parent/caregiver. Researchers speculated that inclusion of a bath as part of the routine was highly effective because it affects the body core temperature resulting in improved sleep. Once you’ve set your nightly routine and it’s time for bed it is important that your child fall asleep on their own. If you rock your child to sleep or stay with them until they are asleep to avoid crying or tantrums you run the risk of sleep onset association disorder, which is one of the most common sleep disorders in children. A child learns to fall asleep only under certain conditions or associations such as being rocked, and does not develop self-soothing skills. When these children awake during the night they are unable to re-create the conditions they fell asleep under (being rocked, cuddling with a parent, etc.) and therefore need parental involvement to fall back asleep. There

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are several approaches you could take in helping your toddler or preschooler to fall asleep on their own. Extinction or more commonly known as “crying it out” is the method in which parents put their child to bed and then ignore their cries for attention until they fall asleep. Extinction has a very strong record of accomplishment. However it can be very stressful for parents at first. The biggest obstacle associated with extinction is lack of parental consistency. Parents must ignore their child’s cries every night, no matter how long it lasts. If parents respond after a certain amount of time the child will only learn to cry longer the next time. There are a few variations of this method that may be less stressful for parents, allowing them to be more consistent. Extinction with parental presence is when the parent stays in the room with the child but does not engage them in any way and ignores their behaviors until they fall asleep. If your child gets out of bed when you are in the room simply pick them up and place them back into bed without acknowledgement. Another variation on this method is graduated extinction. The parent does not stay in the room with their child but comes back after a specific length of time to check on them. This could be every 10 minutes or gradually taper off throughout the night, starting at 10 minutes, then 15, 20 etc. No matter which method you chose in helping your little one to fall asleep make sure you stay consistent. It shouldn’t be long before they are drifting off into dreamland and you are also getting a good night’s sleep. How Much Sleep Does a Toddler Need? It is well known that children need 9-11 hours of sleep each night to be healthy. However recent studies have shown that children who sleep less than 9-11 hours are at risk to become over-weight later in life. What might trouble parents even more is to learn that your child’s naps throughout the day are not sufficient in making-up for lost sleep during the night. The study, which has been conducted over the last 13 years and included 1,930 children throughout the U.S., showed that children sleeping less than recommended were between 33-36% more likely to be overweight. Additional studies show that inadequate amounts of sleep predispose children to a number of negative health consequences, including such conditions as diabetes, cardiovascular disease, depression, and obesity. The results “suggest that there is a critical window prior to age 5 years when nighttime sleep may be important for subsequent obesity status,” concluded authors of one study, Janice F. Bell of the University of Washington in Seattle, and Frederick J. Zimmerman of the University of California, Los Angeles. Napping is a commonly used tool by parents to make-up for their children’s lost sleep throughout the day. However, studies show that naps do not allow children to achieve the deep sleep that provides mental and physical restoration. Creating a consistent bed-time routine that will provide children with a sufficient amount of nighttime sleep will be the best tool in keeping children healthy.  

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