Beat those bedtime battles with 'sleep training'

The American Academy of Sleep Medicine has found, following a review of 52 studies, that behavioral strategies can help children learn to fall asleep, and stay asleep.

The new study will be good news for parents battling to get their children to go to sleep without making a fuss.

The strategies include teaching children how to 'self-soothe' themselves back to sleep when they wake at night, and creating quiet bedtime rituals that children enjoy.

A panel found by reviewing the studies that more than 80 percent of children who received sleep training showed significant improvements in their bedtime behavior.

The study's lead author, Dr. Jodi A. Mindell of St. Joseph's University in Philadelphia says they know that sleep training works and parents have access to plenty of resources which will help them.

Dr. Mindell says with young children, 'bedtime refusal' is often the issue and they will use a range of behaviours to 'stall' the process, crying, clinging and repeatedly asking for food, a drink or a story.

She says babies will wake frequently at night well past the first few months of life and need to be re-settled.

Dr. Mindell says defining what is 'problem' behavior is personal, and parents have to decide if their children's bedtime habits are affecting daytime behavior by making them irritable or inattentive for example, or is affecting the rest of the family.

Their review found that a technique termed 'extinction' had particularly strong evidence to back it up; in its most strictest form, extinction has parents putting their children to bed at a particular time each night, then ignoring their crying and tantrums until a set time in the morning.

A variation of this strategy is 'controlled crying' where parents gradually let their child's crying go on for increasingly longer stretches before checking in on them. When they do check, the visit should be uneventful with no lights, and no playing.

Mindell says it is significant that they found that preventive measures such as educating new parents on how to instill good bedtime, were highly effective.

Mindell believes it is possible for parents to prevent such problems from happening, and she suggests that expectant parents ask their doctor about ways to form healthy sleep habits early on and also access the many books and other resources on the subject.

Mindell says parents must dismiss any notion that it is 'selfish' for them to want bedtime to go smoothly, as their children may benefit even more than they do from a good night's sleep.

The research is published in the journal Sleep, October 1, 2006.