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Sleeping Like a Baby

Sleeping Like a Baby: A Sensitive and Sensible Approach to Solving Your Child’s Sleep Problems

Avi Sadeh
Copyright Date: 2001
Published by: Yale University Press
Pages: 224
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  • Book Info
    Sleeping Like a Baby
    Book Description:

    "Why doesn't my baby sleep better?" weary parents ask. "How can we get more sleep?" There are as many answers to these questions as there are babies and families, says Dr. Avi Sadeh in this helpful and reassuring (some may say indispensable) book. Based on his years of research with sleep-disturbed babies and their sleep-deprived parents, Dr. Sadeh suggests a wide variety of practical solutions to babies' and young children's sleep problems.

    Other experts may recommend one strict approach to changing a baby's sleep habits, but a single remedy fails to take into account a baby's uniqueness and the dynamics of his or her family, Dr. Sadeh contends. He helps parents first to understand the natural sleep patterns of babies, and then to consider their own family's situation and needs. In an accessible style designed to ease anxious parents' worries, Dr. Sadeh describes the various sleep problems of early childhood, outlines treatment possibilities, and details the pros and cons of each of these choices.

    This book will appeal not only to sleepless parents seeking relief but also to those who are curious about the most recent findings in children's sleep research. Dr. Sadeh addresses a full range of questions: What is the importance of sleep to a baby? How do babies in different cultures sleep? How is sleep related to development? What causes Sudden Infant Death Syndrome? How do babies calm themselves? What are the advantages and disadvantages of communal sleeping? With up-to-date answers to these questions and more, Dr. Sadeh offers parents and professionals all the information they need to help babies-and their families-sleep better.

    eISBN: 978-0-300-12922-9
    Subjects: Psychology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-x)
  3. Preface
    (pp. xi-xii)
  4. Acknowledgments
    (pp. xiii-xiv)
  5. I Sleep and Development

    • 1 “Why do we sleep?” The Significance and Role of Sleep
      (pp. 3-6)

      The newborn, in the first days of life, spends approximately two-thirds of each twenty-four-hour period asleep. Over the course of a lifetime, the length of sleep decreases until old age, when humans spend only about a quarter of a twenty-four-hour period asleep. Over the course of our lifetime we spend about one-third of our time sleeping.

      There are those who view sleep as a waste of time and those who view it as an unfettered pleasure. Some sleep many hours, and others, few. There are those who awake early and go to sleep early and others who are night owls....

    • 2 “What’s so interesting about a sleeping baby?” What Sleep Is and How We Can Peek into a Child’s “Night Life”
      (pp. 7-17)

      What is simpler than looking at a sleeping baby? Parents do so day and night, to ensure that baby is well, or purely for the pleasure of it. Every experienced parent can report interesting impressions of baby’s sleep: “He doesn’t stop moving,” “She smiles so that you can see the whites of her gums,” “She starts the night on one side of the crib and ends up on the other side,” “He snores louder than his father,” and so on.

      When scientists look at sleeping babies, they do so to understand normal child development and early childhood sleep disturbances. In...

    • 3 “She sleeps when she feels like it, two hours here, two hours there” The Formation of Sleep Patterns
      (pp. 18-33)

      An impressive developmental process that can be directly observed by parents is related to changes in their baby’s sleep-wake patterns. In the baby’s first months, her parents’ lives (in some families, mainly her mother’s life) revolve around her sleeping and waking schedule. Some babies have a relatively predictable and orderly schedule from day one. Others present a real challenge to their parents’ ability to predict when they will sleep at length and when they will awaken and demand care.

      Until the 1940s most people believed that babies spend almost all their time sleeping during their first few days of life....

    • 4 “Why did my child laugh in his dream?” The Significance and Roles of Dream-Sleep
      (pp. 34-40)

      We have learned how to identify the stage of dreaming in a baby. If he is restless, with irregular breathing, if the tips of his fingers move in short, quick or jerky movements, if his eyes quickly scurry from side to side and twitches or smiles appear on his face—then he is in the midst of dream sleep. Does this mean that the child is really dreaming? A baby cannot report on her dreams because of her limited verbal ability. Even young children who do have a reasonable command of language have difficulty relating to the dream experience and...

    • 5 “A child who doesn’t sleep doesn’t grow” Sleep and Physical Growth
      (pp. 41-44)

      The physical growth of the baby (weight, height, and head circumference) is one of the primary concerns of parents, and of professionals who try to detect babies and young children who are at high developmental or medical risk. One standard test done as a followup at well-mother and -baby clinics is weighing and measuring the height of the child and comparing the measurements to the expected growth curve. The growth curve takes the basic data of length and weight development into account, giving the maximum variance among babies according to these measures. The follow-up of the growth curve of the...

    • 6 “He’s hyperactive, and at night he has trouble falling asleep” Sleep, Personality, and Behavior of the Baby
      (pp. 45-53)

      A leading researcher on temperament in infants and young children once said in despair, “When I raised my first child, I believed behavioral theories claiming that what I do as a parent molds my child’s character. With my second child, I was already a geneticist and believed that a child is born with characteristics that are passed on through heredity and that environmental influence is minimal. I barely knew my third child at all . . .” This analysis was, of course, exaggerated, but it demonstrates the ongoing quest of parents and scientists to answer the question, What determines the...

    • 7 “She refuses to go to sleep ever since she awoke from a scary nightmare” Infant Sleep in Stressful Situations
      (pp. 54-60)

      Sleep is the most sensitive barometer of emotional stress, tension, and anxiety. Most of us can retrieve the memory of a past significant event that disrupted our sleep. We may have had trouble falling asleep the night before an important examination or some other exciting event. There have been nights before an important meeting when we’ve awakened several times to make sure the alarm clock didn’t “forget” to wake us up. After these events passed, sleep resumed normal patterns as if nothing had happened. Why is sleep so vulnerable to stressful situations, and how do babies respond to them?


    • 8 “It’s hard for me to abandon him alone in bed” The Meaning of Sleep for Children and Parents
      (pp. 61-67)

      Going to sleep is the most significant daily separation of a baby from his parents. The parents, or significant others, have been in constant contact with the child throughout the day, responding to his every wish and attending to whatever was botheringhim. Suddenly the situation changes: the parents cut off contact and in many cases expect their child to spend the night alone in a separate room, with minimal communication. The separation, which is part of the putting-to-bed and going-to-sleep ritual, has many different meanings for parents and babies. In most cases it is a good separation that manifests the...

    • 9 “She won’t sleep without her ratty ‘blankie’ ” Soothing Techniques and Accessories
      (pp. 68-77)

      A child must develop the ability to calm herself and to attain an inner sense of stability in times of distress. She must do this in order to cope with the periodic absence of her soothing and protective parents. This ability is essential for adaptation and mental health. The lack of such an ability is manifested in stressful and anxious situations, particularly among people who suffer from emotional disturbances. One of the salient expressions of the inability to calm oneself, both in childhood and in adulthood, is sleep disturbance. Many adults who have difficulty falling asleep at night report nagging...

    • 10 “He’ll sleep only in our bed” Communal Sleeping, Separate Sleeping, and Cultural Outlooks
      (pp. 78-83)

      I encountered an amusing case in the clinic related to communal sleeping, or “cosleeping.” A couple came for treatment with their fifth child, who was two years old. They complained that their son insisted on sleeping in their bed with them and that they wanted to stop the practice once and for all. In our discussion, I learned that this couple had a long-standing tradition of allowing their children to sleep with them. The eldest child began the tradition and slept in the parental bed every night. When the second son was born, he joined them in bed. When the...

    • 11 “At night she can scream for hours and her father doesn’t hear a thing” The Father’s Role
      (pp. 84-90)

      When Debby and John arrived at our meeting to treat the sleep problem of their one-and-a-half-year-old son, Ron, they were very hostile toward and estranged from each other. Debby claimed that John was not interested at all in Ron’s sleep problem and left it to her to wake up at night frequently, when she too has to work and function the next day. John countered that he was incapable of helping, for two main reasons: first, he believed that Debby was the cause of Ron’s continual awakening and his insistence that she come to calm him many times throughout the...

  6. II Sleep Disorders

    • 12 “He falls asleep only in the car, and in the middle of the night that’s absurd” Difficulties Putting the Baby to Sleep
      (pp. 93-98)

      Fourteen-month-old Richard usually shows signs of tiredness between seven and eight o’clock in the evening. His parents try to put him to bed. He lies in bed for about ten minutes and then stands up and begins to cry and to call them. They wait about ten minutes to see whether he’ll calm down and fall asleep. The child continues to cry and refuses to calm down. The mother arrives, takes Richard in her arms and tries to calm him by rocking him. After about fifteen minutes of vigorous rocking, the child calms down and seems to be asleep. The...

    • 13 “She awakens every hour on the hour” Nocturnal Wake-Up Calls
      (pp. 99-104)

      The parents of one-year-old Mark put him to sleep each evening at eight o’clock. The process of putting him to sleep is accomplished very quickly: one of the parents gives Mark a bottle, feeding him until he falls asleep. Then Mark is put into his crib. After about two hours, Mark wakes up. One of his parents, usually his mother, takes him out of his crib and gives him another bottle while holding him. This wakeful state continues about ten minutes, and then Mark is returned to his crib. If the parents refuse to take Mark out of his crib...

    • 14 “He wakes up terribly frightened and doesn’t calm down” Nightmares, Night Terrors, and Other Sleep-Time Phenomena
      (pp. 105-110)

      One night when one of my daughters was ten months old, we heard a terrible scream, accompanied by bitter crying, coming from her room. The forceful scream and the tone of her crying testified that something terrible had happened. Our first thought, as we hurried to her room, was that she had become trapped in the crib slats or suffered some other sudden painful shock. We were surprised to find her sitting in her crib, eyes closed, crying terribly, covered with sweat. To our surprise, when we tried to pick her up and pacify her, not only did she not...

    • 15 “She doesn’t eat enough, she’s teething” Physiological Factors That Influence Sleep
      (pp. 111-116)

      Sleep difficulties in infancy are so common that it is easy to understand how various myths about factors that influence sleep arose. Often these explanations contain a kernel of truth, but the factors are usually given exaggerated importance.

      Some of the central topics that parents focus on involve nutrition and breast-feeding, and how they relate to the child’s physical development. In the first months, when the baby’s weight is being continually charted, one of the basic, traditional parental roles is to feed the baby well in order that he grow and be healthy. Many mothers “measure” their maternal competence according...

    • 16 “He suddenly stops breathing and it takes my breath away!” Sleep Apnea and Breathing Disorders
      (pp. 117-121)

      One of the most unpleasant experiences for parents when watching their baby sleep is to see her suddenly stop breathing for a long period of time. Finally, after a sudden lurch or a brief awakening, the baby continues to breathe and sleep as if nothing happened. Sometimes this type of event recurs dozens, even hundreds of times during the night. There is a wide range of events related to sleep apnea, some of which are normal, occurring among many babies and disappearing with time. Others are serious and significant and require immediate assessment and treatment.

      A baby’s sleep disturbances are...

    • 17 “While she slept we took turns standing guard to make sure she was breathing” Crib Death, or Sudden Infant Death Syndrome
      (pp. 122-127)

      It is hard to imagine a more frightening nightmare for a parent than getting up in the morning and finding a lifeless baby in her crib. In the past, infant mortality was a much more widespread phenomenon because of the inability to cope with infectious diseases and with complications during pregnancy and childbirth. Today, with developments in medicine and technology, the infant death rate has decreased dramatically. Nonetheless, SIDS (sudden infant death syndrome) has remained an unsolved mystery to this day and still causes the deaths of babies despite relentless research efforts to understand and prevent it.

      “Crib death” is...

    • 18 “Be patient! He’ll grow out of it” The Stubborn Nature of Sleep Disturbances
      (pp. 128-130)

      A widespread myth, not only among the general public but also among many professionals, is that sleep disturbances in early childhood are necessary developmental pains that disappear by themselves, without a trace, when the child grows up. Parents are advised by professionals and friends, “Wait! Be patient, and the child’s sleep problem will solve itself when he grows up a bit.” Parents sometimes have a particular unconscious reason for resisting treatment of the sleep problem. These parents readily accept the view that the problem requires no treatment or has no solution. But parents who arrive at the sleep clinic exhausted...

    • 19 “To sleep or not to sleep, that is the question!” Difficulty Falling Asleep and Staying Asleep
      (pp. 131-149)

      When parents seek treatment for their child’s sleep problems, they often need to cope with difficult issues about themselves and their baby. They might wonder, for example, whether something is wrong with the baby, or whether they are failing to fulfill their parental role and thus causing their baby to suffer. These questions become more urgent when parents find themselves unable to solve their child’s problem while seeing other parents who have not faced this problem or have solved it easily.

      As in any complex system, a sleep problem may stem from various sources. Its consequences and solutions are similarly...

    • 20 “My child is possessed” Family and Personal Dynamics of the Parents
      (pp. 150-158)

      A baby who suffers from sleep problems creates a lot of “noise” (with all its implications) in the family system. This noise can be expressed by the parents when they feel frustrated and helpless and that they are unfit parents, or when they blame each other for causing the problem and for their inability to solve it. In these cases, parents who consult a sleep specialist expect a mediator who will rule on the question of what to do and on which one of them has the right approach. When the parents’ relationship is problematic for other reasons, the sleep...

    • 21 “Does it really help?” Research on the Efficacy of Treatment and Its Ramifications
      (pp. 159-161)

      When I started work in the treatment of infant sleep problems I realized that it was one of the most rewarding areas for a clinical child psychologist. The combination of the family’s extreme initial distress, the briefness of the intervention, the high success rates of treatment, and the resultant relief for the parents give the practitioner the best possible experience, one that could hardly be matched in any other areas of psychotherapy.

      The rapid, successful interventions also challenge common beliefs, such as the injunction to “let the child grow out of the problem.” In light of the persistence of sleeping...

    • 22 “It’s hard to believe that this is the same child” Changes in the Wake of Treating Sleep Problems
      (pp. 162-164)

      Sometimes during the initial interview, parents describe their great distress stemming from their baby’s sleep problem. I then ask what would happen if the child slept through the night without any disturbances. Some parents doubt that my question is serious, others assert that the problem cannot be solved, still others smile broadly and declare that their lives would change dramatically were the problem indeed to be solved. The parents’ answer to this seemingly offhand question teaches us that in many cases, parents see the baby’s sleep problem as the primary or only source of distress in their lives. At the...

    • 23 “How can I make sure my new baby won’t develop sleep problems?” Principles of Preventive Treatment
      (pp. 165-168)

      Based on existing research knowledge, we can determine that not only can babies’ sleep problems be treated, but some can be prevented. In Amy Wolfson’s study, for example, a group of women received guidance during their pregnancies about how to help their child develop healthy sleep habits. A different group of pregnant women received similar attention but no special information on babies’ sleep habits. The babies of mothers who had received the guidance were much less likely to suffer from sleep problems than were the babies of mothers who did not receive guidance on the subject. Another study in which...

    • 24 “Sometimes even a good parent feels like throwing the baby out with the bathwater!” Parting Words of Encouragement to Parents
      (pp. 169-170)

      Parents often feel responsible for all the baby’s problems. In their frustration with the baby’s nighttime behavior, they may feel guilty about all their feelings of distress, helplessness, and even anger and hate. Here I am assisted again by D. W. Winnicott’s theory of the role of maternal feelings of anger and hate toward her baby. Winnicott addressed the common social convention that the mother, who so anticipated the arrival of her baby and readily programmed her entire existence toward raising him, must feel only positive feelings toward him. (Freud also described idealized maternal love this way.) Winnicott held, however,...

    • 25 “Good morning, sun’s up, new day!” The End of the Night Train
      (pp. 171-172)

      “Mommy, Daddy, let me sleep quietly at night. At night, when it seems to you that I’m asleep, I’m actually doing many things. When you think I’m sleeping deeply and quietly, I’m actually becoming refreshed, and my body is growing, too, so that the nurse who measures and weighs me next time will give me a good grade. My brain works hard to remember all the nonsense that you tried to teach me during the day. I know that there were surely important things that you wanted me to remember, but during the day I didn’t have enough time to...

  7. Appendix 1 Methods of Measurement and the Study of Sleep
    (pp. 173-180)
  8. Appendix 2 A Sampling of Popular Books on Sleep and Nighttime Fears for Very Young Children
    (pp. 181-183)
  9. Appendix 3 Selected Scientific Publications About Infants’ Sleep and Related Topics
    (pp. 184-196)
  10. Index
    (pp. 197-204)