Bermuda Parent Bermuda Parent Spring 2020 | Page 11

• • • • Newborns typically start to produce melatonin (sleep hormone) at 8 to 10 weeks old. This helps to estab- lish sleep cycles, lengthens naps and can make attempts to con- solidate sleep (transition from one cycle to the next without interrup- tion) easier. The duration of your child’s sleep cycle will increase as they get older. It will start to resemble that of an adult as they approach their 3rd or 4th birthday. REM and non-REM sleep dura- tion will change as your child’s nervous system matures. The younger the child, the longer their brain will remain in the active (REM) stage of sleep. Why is this important? REM sleep (when we dream) is lighter and easier to be woken up from. ‘Premature’ babies (those born before 30 weeks of gestation) may initially spend up to 70% of their sleep in the REM stage, while infants born ‘on time’ may initially spend only 50% in the REM stage. Five year old children however, will typically have a 70/30 distribution between Non-REM and REM sleep. Best practices for parents of newborns and toddlers include: Manage Awake Time If you are struggling with short naps and frequent night time wake ups, you may be keeping your child awake for too long. Common symptoms of an overtired child include waking up after 30 mins from a nap and waking up fre- quently, even as often as every 45 mins after falling asleep at night. The table below shows average recommended awake-time duration (time between naps / bed) for various age ranges Wait before you rush in Children tend to be quite vocal in their sleep, particularly when transitioning between sleep cycles. They may cry out, moan, grunt, squeal, thrash about, etc. and though it may seem they are awake or distressed, they may actually be in an Age in months Average recommended awake-time duration (hours) 1 – 2 0:45 – 1:00 3 – 4 1:15 – 1:45 4 – 6 1:45 – 2:00 (3 naps) 7 – 15 2:30 in the AM and 4:00 between 2nd nap and bed (2 naps) 15 – 18 4:30 – 5:30 (1 nap) 18 – 24 5:30 – 6:30 (1 nap) active sleep stage. Your well-intentioned efforts to go into their bedroom and help may actually wake them up. Devel- oping the ability to discern the signs of true wakefulness as well as the patience to wait before intervening, will be ben- eficial in the long term as it can help your little one learn how to resettle on their own. Optimise the Sleep Environment Another behaviour you may have noticed is the propensity of your child to wake up in the early morning hours (between 4am and 6am). For adults and children alike, each consecu- tive sleep cycle (from night to day) increases the proportion of time spent in REM sleep. With the REM stage the more active phase of sleep, it becomes easier to be woken up the longer we have been in bed. You can decrease the likelihood of your child waking too early by taking steps to restrict external noises and light from disturbing your child, as well as providing a proper room temperature. Allow your child’s internal clock to recalibrate Finally, say your beloved child decides to start their day at 5.30am. You go in, turn on the lights, crank up the radio, serve breakfast and play with them. Their circadian rhythm, or internal clock, thinks its morning. A bit early, right? External modulation through social interaction, light, food and temperature affect the internal clock, which regulates the sleep-wake cycle. By progressively delaying your response to their morning wakefulness, you will allow their internal clock to recalibrate to a more desirable setting. Dorothy (Wysocka) Brad- shaw is passionate about helping families get the sleep they need. In addition to her Masters in Public Health, she is trained as an infant and child sleep consultant. She has helped families with sleep related issues ranging from multiple night time wake ups, to developmental sleep regres- sions, to moving from bed-sharing to their own crib, to establishing healthy sleep asso- ciations through cat-napping, to nap-refusal, to staying in bed all night, to early morning wake ups and the list goes on. She invites you to visit her website www.the41stwink.com or contact her via email at [email protected] “If you are feeling exhausted, helpless, overwhelmed, or just don’t know how to help your little one get the sleep they (and you!) need, please reach out to me – together we will find a solution that works for your family.” Sources: Jodi A. Mindel, Judith A. Owens. A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Kushida C. Encyclopedia of Sleep. Goodlin-Jones BL, et al. Night waking, sleep-wake organization, and self-sooth- ing in the first year of life. J Dev Behav Pediatr 2001 Aug;22(4):226-33. Sadler S. Sleep: what is normal at six months? Prof Care Mother Child 1994 Aug-Sep;4(6):166-7. Armstrong KL, Quinn RA & Dadds MR. The sleep patterns of normal children. Medical Journal of Australia 1994 Aug 1;161(3):202-6 mybermudaparent.com 9