 Infants, toddlers and preschoolers aren’t the only ones who struggle with sleep. Especially when sleep issues in those earlier age groups aren’t fully resolved.
Other high risk (for sleep challenges) populations are children diagnosed with autism and/or ADHD (they often occur together) as well as children diagnosed with anxiety, depression, obsessive compulsive disorder and similar diagnoses. And of course, many children with autism/ADHD (I’ll refer to them as ND or neurodiverse) are at higher risk for depression, anxiety, and OCD. In the case of one family, the nine-year-old boy had always fallen asleep in his mom’s bed and then been transferred to his own bed later in the night. Recently he started waking up in his own bed and not surprisingly, needing to return to his mom’s bed to fall back to sleep. This might be fine except it was wreaking havoc on his mom’s sleep, which made work and parenting doubly hard. And this child’s anxiety made falling back asleep in the middle of the night especially difficult, because he would worry about his inability to fall back asleep. Here are some tips I offered this mom and other parents in similar situations: 1. No screen time in the hour before bed except if your ND child can’t wind down without it. There are some kids who have this paradoxical effect from screen time. You’ll know if you have one of these. Some NT kids simply can’t wind down without screen time. Their brains are just too wound up. 2. Keep bedtime and awake times incredibly consistent. I know it’s tempting to keep your school aged child up later on weekends – I am guilty of the same – but consistency is especially important for kids who struggle with sleep. This means not letting them sleep late on weekends, either. Yes, I said to wake your sleepy child. 3. Get them outside or at least exposed to natural light as quickly as you can on weekends. This helps their body clocks, too. Please don't let them hang out on screens first thing in the morning. Movement is greatly beneficial for regulating the body clock, too. 3. Ask your doctor about melatonin. Some ND kids simply can’t fall asleep without it, or not until hours later than they need. I otherwise do not recommend melatonin… but if the only other option is chronic insomnia, it may be the best choice. This should only be considered as a long term strategy if all sleep hygiene options have already been exhausted, no pun intended. (As a short term strategy to deal with challenges like jet lag, I have fewer concerns.) If your school aged child struggles with sleep, whether neurotypical or neurodiverse, it’s not too late to change things up! You can still create great sleep habits. Schedule a free consult and let’s talk about how we can get your family well-rested and feeling great.
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Help! My Eight-Month-Old Twins Are Stuck In A Early Waking, Long First Nap, Short Second Nap Cycle4/8/2024  Hi Abby,
My twins are stuck in this crazy cycle. They wake up at around 5:10 am, take a long first nap around 7:30 am, and then there afternoon nap at 2 pm is only about 45 minutes. We gave up the third nap a few weeks ago because it was hit or miss anyway. Then they are cranky and miserable by 5:30 pm but I don’t want to put them to bed too early and perpetuate the cycle. We are all exhausted! Please help! Mary These twins are caught in several reinforcing negative cycles. The first is overtiredness. As you have probably heard me say, in the same way that sleep begets sleep, overtiredness creates more overtiredness. That’s because when children are overtired, the production of a stress hormone, cortisol, makes it harder for them to fall asleep at the right time, sleep all the way through the night without wakings, and wake up at at the appropriately restful time in the morning. The second issue is nap timing. The first nap is too early and too long. It is reinforcing the early morning wakings. (But without it, the twins are exhausted!) The third is the transition from three naps to two. Nap transitions are never easy. And the fourth, well, not issue but challenge, is that fraternal twins often have very different sleep needs. So while it’s ideal to have them sleeping at the same times, we can’t always expect them to sleep the same amount. Here’s what I suggest:
If the details are making your head swim because, you know, you’re tired… the TLDR: don’t move naptime too early (after about 6 months) to compensate for an early waking. A too-early first nap will reinforce the early waking. Likewise, avoid a too long first nap, because that can also reinforce the early waking cycle. And finally, fraternal twins’ can have very different sleep needs. If you’re family is struggling with too-early wakings, schedule a complimentary sleep consult and let’s get you back on track so you all wake up feeling amazing.  Valentina just learned to pull herself up to standing the other night. Well, technically at 4:30 am. What better time, right? Well, the problem was that she didn’t know how to let herself back down again. So she was stuck yowling at the crib bars. It reminded me of the many questions I have received over the years about if babies can get head injuries in the crib. What if they fall asleep standing? What if they deliberately head bang? What if, like Valentina, they don’t know how to let themselves down? Many parents spend a lot of time going back and forth to the crib. And babies, of course, like to just pop back up again. Well, Valentina eventually figured it out. Either her legs sort of buckled or she consciously decided to let go (I was watching on the monitor but didn't interfere). She landed in a sitting position, none the worse for wear. I have never, in all my years of pediatric practice and then child sleep coaching work, heard of a child hurting themselves in their crib (since drop side cribs were abolished). Babies and toddlers have well designed skulls to withstand falls without causing brain damage. So while I know it’s nerve wracking to watch their hikinks in the crib, no, you don’t need to worry about crib safety. A safe crib is safe for your healthy child, without reservations. Want some help getting your little one to stay in the crib all night long? Schedule a free consult and let's get your little one sleeping all night, every night. Guaranteed. |
AuthorAbby Wolfson is a pediatric nurse practitioner, certified child sleep consultant and certified life coach for parents. She divides her time between Brooklyn, NY and San Miguel de Allende, Mexico. Archives
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