Marc Weissbluth's Blog, page 4

"Sleep Consult" featured in Today's Parent Magazine

Today's Parent featured our book, Sleep Consult in a piece covering some common sleep myths. Here is a link to the article. Have a great day!

-Marc and Dan

Six Sleep Problems and Solutions

Infant Nap App for iPhone/iPad

Filed under: Announcement

When is the Bedtime Too Late for 3-5-year-old Children?

Naps are disappearing in this age range but there may be a few naps per week. Another variable is that here are more scheduled activities but not nesessarily every day or at the same time every day. Children have more viral infectons in this age range and some may disrupt sleep. Also some of these children have baby siblings that naturally may disrupt the sleep routines of the older child. If the child has an older sibling, the older child's scheduled activiites might make naps or reasonably early bedtimes problematic for the 3-5-year-old. Can you think of other major variables that affect sleep in this age range?

Given these variables, how do you accomplish a reasonably early bedime for the 3-5-year-old child? When is the bedtime too late?

Marc

Filed under: Uncategorized

Great Video about Digital Media

For our readers that are interested in the effects of digital media on learning and parenting, I highly reccommend this video- It is an hour long panel discussion with some of the strongest voices in this field of research and it is fascinating.

Enjoy the first day of Spring!

-Daniel Weissbluth

Filed under: Media Topics

When is the bedtime too late for children 1-3 years-old?

I often do sleep consults for families in and outside the practice. A common problem is that when the child goes from two naps to one nap, they develop a sleep debt because the bedtime, which might have been a little to late with two naps is now way too late for a single nap. Sometimes the child is falling asleep around 8PM and getting up in the morning around 7-7:30AM. So the duration of night sleep is ample but the parent(s) complain of new bedtime battles, long latency to sleep at night, night awakenings, deterioration of naps, or some combination of these problems. Usually, the child is beginning to show signs of sleep deprivation around 6PM and sometimes these signs are masked by the hypnotic effect of screen time or parents coming home from work. I often suggest a temporary super early bedtime to repay the accumulated sleep debt and then a shift to a range of betimes based on how the child looks between 4-5 PM (e.g. 5:30-6:30PM). I explain to families that there will be some trial and error to find their child's best range of betimes because of the individual variability between children and the within child variability of naps. Another variable is the wake-up time. When the wake-up time is later, around or after 7:00AM, do you think it is fine for the child to go to bed laer?

What do you suggest is the optimal bedtime range for well-rested children in this age-range who are taking a single nap?

Marc

Filed under: Uncategorized

"Healthy Sleep Habits, Happy Child" is now in Mandarin!

Ni Hao!!!

We are very excited to anounce the Mandarin translation of HSHHC- unfortunately, we do not have a link to the Chinese bookseller. Have a great day!

-Dan and Marc.

Filed under: Announcement

Sleep Smarts #5

1. The single most important fact to remember is that the time when sleep occurs is more important than the duration of the sleep period. You can't fight circadian rhythms! We all have internal clocks that are genetically controlled. These clocks create an internal timing mechanism for sleep. These clocks evolved from dark (night)/light (day) cues. This signal is very primitive because it is based on the rotation of the earth on its axis. Sleeping in synch with circadian rhythms is more restorative, of better quality, than sleeping out of synch with circadian rhythms. Jet-lag syndrome is an example of sleep not in synch with circadian rhythms.

Additionally, a bout of sleep that is continuous (consolidated) is much more restorative than a bout of sleep that in interrupted (fragmented).

2. The Myth of Total Sleep Duration

Some parents observe that their child is getting 12 hours of sleep (e.g. 9pm to 7am plus a 2 hour nap) and therefore they think that there is no problem. Sleep duration is probably less important than sleep quality (intensity, consolidated, and in phase with circadian rhythms).

3. When the Bedtime is Too Late

What occurs when children are allowed to fall asleep too late at night? They wake up short of sleep in the morning. When you are short on sleep, then, even without caffeine, you get "keyed up" because your body produces stimulating chemicals such as cortisol, adrenaline, and noradrenaline. Then, if you suddenly go on vacation, it takes you a few days to "unwind" or dissipate the effects of the stimulating chemicals. This burst of energy is a primitive biological adaptive response so that early man could fight harder, hunt longer, or flee faster for survival. It's like a turbo boost that we often call a "second wind". When present, you are in a state of higher neurological arousal. When the bedtime is too late, he wakes up in the morning in a state of higher neurological arousal which causes him to have difficulty or inability to nap well.

The consequences of not napping well means that by the end of the day his sleep tank is empty and he is in an even higher state of arousal so it becomes more difficult for him to easily fall asleep and stay asleep at night. Parents might not see bedtime battles, long latency to sleep, or night waking resulting from a bedtime that is too late. But of course, he eventually crashes late at night. But this is preceded by an unhealthy state for the child, stressful interactions with him, and stressful interactions as a couple, and stress for each parent as an individual.

Sometimes the naps are very long and late (e.g. 1-4pm) because the bedtime is too late and the child's sleep deprivation is masked by parents returning home from work and playing with the child.

4. Healthy Sleep is Like Healthy Food

Consider the similarities between food and sleep. Let's first think about food and food quality. Food is a biological need. Food is energy for the body. Poor quality food –junk food – damages the body by causing all manner of medical issues including malnutrition, anemia, diabetes, heart disease, and obesity. A little junk food is O.K., a lot is not.

Now let's think about sleep and sleep quality. Quality sleep means consolidated sleep occurring in phase with circadian rhythms. Sleep is also a biological need. Sleep is energy for the brain; poor quality sleep harms the brain. Think of poor quality sleep as junk sleep. Junk sleep is just as bad for our children as junk food. Just as you read labels on food to determine quality, think of sleep quality for your child. You would not starve your child by withholding food; try to not let your child get short on sleep.

Junk sleep causes many problems. All of these points are based on peer-reviewed published research. These are not my opinions.

• Exhaustion, and we all know what that feels like!

• Impaired mood. Children become more irritable, angry, and easily upset; later on, junk sleep can cause or exacerbate depression and marijuana use in adolescents. Less able to regulate emotions.

• Impaired social and academic performance. Kids who are lacking sleep will be more hyperactive, oppositional, and aggressive. Less able to accurately recognize human emotional expressions

• Impaired cognitive development. Sleep incorporates learning into permanent memory, sleep causes memory consolidation, sleep enhances organizational skills, planning, multi-tasking, and executive functioning.

• Impaired personality. Children become fussy, more intense, more frightened, and less adaptable.

• Impaired hand-eye coordination (which impacts a whole host of functions like athletic performance and fine motor skills).

• Systemic inflammation, increased blood pressure, increased stress hormones, increased susceptibility to infections.

•Impaired glucose control which is a factor in diabetes, obesity.

•Maternal depression.

5. Sleep and Brain Development

Never Forget: Sleep Helps the Brain Develop

1. The sleeping brain is not a resting brain.

2. The sleeping brain functions in a different manner than the waking brain.

3. The activity and work of the sleeping brain are purposeful.

4. The process of falling asleep is learned.

5. Providing the growing brain with sufficient sleep is necessary for the ability to concentrate and an easier temperament.

Sleep is the power source that keeps your mind alert and calm. Every night and at every nap, sleep recharges the brain's battery. Unlike a light bulb that shuts down completely when it is turned off, your child's sleeping brain is active and purposeful. Providing your child's growing brain with quality sleep is necessary for its development. Sleeping well increases brainpower just as weightlifting strengthens muscles. Sleeping well makes your child physically relaxed and mentally alert; he is at his personal best. Sleep is not a luxury, sleep is a biological necessity.

Filed under: Healthy Sleep

Repost: Daylight Savings Time

If your child's bedtime is 6pm, then after we change our clocks, still put your baby to sleep at 6pm. We eat, play, rest, and bathe around the same clock times and these social cues help tell the child when bedtime is coming.

Sweet Dreams!

Marc

Filed under: Bedtime

Good Advice?

We have a full-time certified Lactation Consultant (who wrote the chapter in HSH,HC) in our office and she and I meet weekly with all new parents as a group. After breast-feeding is well established, I often discuss how feeding drives sleeping off the radar and it is now time to think a little about sleeping.

My advice, at 1-2 weeks of age, is to experiment with putting the baby down to sleep drowsy but awake within one hour of awakening in the morning only. I gently explain how this will allow self-soothing skills to develop and why this is important. I emphasize that if the baby makes sounds that are not really crying to wait and see but to pick up their baby immediately if she cries. I encourage Dad to try this when available on week-ends. I inform them that this might not work or work only 10% of the time now. And I reassure them that if they do not feel comfortable trying this that it is fine to not do this.

Some mothers try this and others do not. No one is made to feel uncomfortable if they choose to not do this. As we know, there are so many variables within the mother, the baby, and the family.

How do you feel about this advice?

Marc

Filed under: Uncategorized

Sleep & Breast Feeding #3

Other than the suck swallow pattern, how can you distinguish breast-feeding that is nutritive from non-nutritive breast-feeding? How can you prevent non-nutritive breast-feeding from interfering with the development of self-soothing skills? When and how, if ever, is breast-feeding to soothe, which I agree is natural, to be discouraged in order to encourage the development of self-soothing skills to fall asleep drowsy but awake?

Marc

Filed under: Uncategorized

Sleep Consult Projects…

Spanish Cover

¡Hola The Spanish translation of "Sleep Consult" is in the works- we are very excited. In addition, we are having "Sleep Consult" made into an audiobook! We hope everyone here in Chicago is enjoying the weather!

-Marc and Dan

Filed under: Announcement