I’ve been asked to write a guest blog for Bumps, babies and beyond about sleep tips so here we go! For more info visit https://www.yourlocalbabyshow.co.uk/

What is sleep?

“If sleep does not serve an absolutely vital function, then it is the biggest mistake the evolutionary process ever made.” 

Allan Rechtschaffen 1978

Sleep results from a complex cascade of hormones in the brain which initiate and maintain the state of sleep throughout the night. The main sleep hormone is melatonin – this starts the hormone cascade working and keeps it going through the night. Melatonin is released by a body temperature drop – i.e. after a warm bath and is also promoted by certain foods- e.g. oats, milk and cherries.

Sleep is also controlled by the body’s circadian rhythm, of which melatonin plays apart. Our circadian rhythm is the ebb and flow of hormones throughout the day and night and is influenced by light. Babies do not perfect their circadian rhythm until 4 months old, hence we can teach them good sleep associations but cannot expect them to sleep through the night reliably.Young children have an earlier circadian rhythm than adults – i.e. an earlier sleep and wake time, whereas teenagers have a much later circadian rhythm than adults.

Adults have a more individual circadian rhythm and can be ‘larks’ i.e. early to bed and early to rise, or ‘owls’ and prefer a much later bed and wake time. There is growing evidence to suggest that the ‘owls’in society are suffering the effect of sleep loss due to the pressures of working patterns and school day timings.

As we age our circadian rhythm moves earlier again hence some of the problems that older people face in getting enough sleep.

Consistent routine and timings for bed and wake time keeps the brain and body calm and the sleep process on track, whether you are a baby, toddler, teenager, parent or grandparent!

What is normal sleep?

Normal sleep is characterized by an initial period of deep sleep from which pain and discomfort are the only things likely to wake your child. This is then followed by mostly lighter rapid eye movement (REM) sleep interspersed with brief wakings designed for our body to check that we are safe i.e. the environment in which we fell asleep at bedtime has not changed. Therefore, settling your child in their own sleep space at bedtime is crucial in teaching your children to sleep!

How can we promote sleep?

Melatonin influences the circadian rhythm, starts the sleep hormone cascade and is halted by the body’s stress hormones. Therefore, a calm consistent bedtime routine promotes sleepiness.

Melatonin is switched off by cortisol (one of the stress hormones) therefore an overtired stressed child will not sleep as well. A high level of melatonin is needed to maintain sleep throughout the night therefore these overtired children tend to be the early risers!

Melatonin is also destroyed by blue light emitted from screens; children and teenagers are even more sensitive to this than adults. Thus, a child having screen time too close to bed (i.e. within an hour) will start their night with much less melatonin. This means when they wake briefly (remember this is normal) they may struggle to return to sleep due to their reduced melatonin level. This is also seen in children with additional needs such as ASD who tend to have a lower level of melatonin than their peers.

In addition to the above, all of us use sleep associations to tell our brains when to start the sleep hormone cascade.

These sleep associations can be appropriate, for example reading a story and saying set night-time phrase. However, they can also be inappropriate, such as requiring a feed, rocking or a parent in the room (or even their bed) to fall asleep.

Why is a bedtime routine so important?

Remember a bedtime routine starts the cascade of hormones for sleep. It needs to be short, calm, consistent, and at roughly the same time each night.

How does this link to a daytime structure?

Daytime structure and consistent bedtime routine allows the brain (and therefore child) to predict and release melatonin and thus start the cascade of hormones for sleep.

Why is consistency so important?

We learn from the moment of birth not to sustain a behaviour that does not reward us! It can be hard for a parent to work out which parental behaviours are sustaining the child’s behaviour. Inconsistency from a parent will maintain habits in your child as intermittent rewards are the most motivating of all!

Imagine bringing your child into your bed on a weekend morning after saying ‘no’ to this all working week. This is akin to an adult playing the lottery week after week in the hope that they will win the jackpot! Occasional rewards are the most powerful of all – consider – does your child know whether it’s Friday or Saturday morning when you are saying ‘yes’ or ‘no’? 

What are the most common sleep problems for parents?

Parents come to me with a variety of sleep problems but by far the most common are inappropriate sleep associations – namely feeding or needing a parent nearby to sleep. Another common problem is not settling, usually resulting from intermittent rewards. I use sleep diaries and questionnaires to identify what the child is finding rewarding from their behaviours.

Other problems include early rising (think melatonin) and frequent waking at night (again due to inappropriate sleep associations), remember normal waking and bedtime environment.

Sleep disorders can include sleep apnoea’s, restless legs syndrome and night terrors (technically a parasomnia). Contact me for a sleep assessment or see your GP if concerned about any of these.

How do we solve these sleep problems?

We implement a flexible daytime structure and a calm bedtime routine. Once your child is in bed you can try a consistent teaching method to keep them there! For individual family support please contact me for more information.

How do parents ensure a good night’s sleep for themselves?

All of the sleep hygiene and routines discussed above will be suitable for teenagers and adults. Consider your bedroom environment, switch off the screens late evening and stick to a consistent bed and wake time. Remember sleep promotes sleep as the melatonin can work without the influence of cortisol from being overtired.  

For help and advice contact me at http://www.goodnightsolutions/contact