The first thing to fully understand is that for children six months to five years of age, sleep is actually a learned skill. The act of learning to sleep includes two important life skills: self-regulation and self-soothing. It is important for parents to acknowledge and feel empowered that there are several ways to gently and safely coach their children on how to develop these skills so that children can independently and peacefully go to sleep and stay asleep without the need of multiple negative sleep associations.

Why teach a child how to sleep, you ask. Children six months or older can typically become highly dependent on negative sleep associations, also known as ‘sleep crutches’. A sleep crutch is defined as something that needs to be done to, or for, a child in order for the child to fall asleep or go back to sleep. Sleep crutches work really well… until they stop working. If your ‘old tricks’ no longer have that same ‘magic’, then this is a signal that your child is showing readiness to learn the all-important life skills of self-regulating and self-soothing to sleep. Hence, it may be time to consider ‘sleep coaching’ your child. However, please note that in the world of sleep science, the newborn/infant stage is considered 0 – 6 months, and it is typically not recommended to sleep coach a child under 6 months of age.

What is sleep coaching

Sleep coaching is the methodical process of behavioural modification in which your child develops the skills of self-regulation and self-soothing in order to improve the quality and quantity of sleep. Sleep coaching your child can be considered one of the first big parental decisions, and thus, parents should take time to educate themselves on sleep science and research the methodological options before making any changes. Parents succeed in sleep coaching when they find a methodology that matches their parental values and goals as well as meets the needs of the temperament of their child.

For children six months to five year of age, there are several sleep coaching methodologies. In each approach, the key goal is to replace sleep crutches by instilling positive sleep associations, along with the new skill set of self-regulation and self-soothing. Parents can educate themselves by reading and following sleep plans in sleep-training books, or they may seek individualised guidance from a trained and certified paediatric sleep consultant/sleep coach. The first step is to choose a methodology that meets your values, the goals of your family and the temperament of your child. The second step is to create and implement a detailed sleep plan based on your preferred methodology.

Coaching methodologies

The methodologies differ dramatically, particularly regarding the amount of parental involvement as well as the extent of parental verbal assurances and physical contact. Before starting any sleep coaching programme, it is paramount to visit your paediatrician to confirm there are no underlying medical conditions causing the sleep disturbances and to receive approval that sleep coaching is appropriate for your child’s age and development. Also, if your child is breastfeeding, there needs to be much care and consideration given in the sleep plan in order to honour and maintain the nursing relationship. Remember, sleep coaching is not recommended in babies under six months of age.

The common methodologies are:

• Extinction [also known as “Cry It Out”]
• Controlled Crying [also known as Modified Extinction or Timed Checks]
• Fading [also known as “The Shuffle”].

The next step is implementing the sleep plan with loving patience, consistency and joint parental agreement.

The keys to sleep coaching success are:

1. Understand that your child will be learning and mastering two new life skills of self-regulating and self-soothing to sleep. The easiest time for a child to learn this skill is at bedtime, at the appropriate ‘sleep window’ after excellent daytime sleep. With proper coaching, a child will also learn to self-soothe in the middle of the night after an arousal. Nap training typically takes place after a child is successfully soothing at bedtime and sleeping through the night.
2. Recognise that change is a process, not an event. Thus, be patient with the process as night-time sleep coaching realistically takes 2 – 6 weeks of consistent effort to achieve your sleep goals. [Older children typically take longer to sleep coach.]
3. Honour your child’s age-appropriate sleep requirements, both for daytime and night-time. The quantity of daytime sleep affects the quality and quantity of night-time sleep. Keeping a detailed sleep log will often provide important clues on how to improve your sleep situation. A great resource for age appropriate sleep expectations is the American Academy of Pediatrics. A child’s daily and nightly sleep expectations are dependent on his or her age and stage of development.

Loving consistency is the key

In summary, feel confident that there are many safe and gentle ways to improve sleep for your children. But before you make any bold changes to your bedtime and night-time activities, do the research in order to feel truly emotionally and intellectually comfortable with the process of sleep coaching. Then, take the time to create a detailed sleep plan.

Parents who work as a team to implement the sleep plan create an environment of confidence, thus putting the child at ease during the process, which in turn reduces protests from the child. Successful sleep coaching is about employing a loving, methodical and consistent approach to behavioural modification. Done in this manner, sleep coaching truly works and ultimately brings harmony back into your household. It is all about patience, consistency and the right timing for parent and child alike. May you soon enjoy a peaceful house where all family members experience healthy sleep habits.

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Paul sleeps at similar times as his friends and co-workers in the U.S. but his employees sleep out-of-sync with their families and friends in India. Reporting to work at 9pm and working 10 hours often means going to bed when family members are eating breakfast, ergo waking up in the early evening. Although many people are able to acclimatise to this kind of socially desynchronised sleep, about 10 per cent of people develop ‘shift work sleep disorder’, which is characterised by intense insomnia despite being tired.

But even when people are able to adjust to these unusual sleep demands, they become estranged from their friends and family, which can lead to feelings of social isolation and depression.

Imperative need

Changing sleep patterns around the world might be one of the least discussed effects of the global integration of the economies, information technology and high-speed travel. Between the 1970s and 1990s, economists and social scientists imagined that we were moving toward a 24-hour society, a world in which anything would be available to anyone, at any time of the day. In some sense, they were right—with the internet, the whole world is now accessible at any time.

Another example: since the 1930s, American homes have been built with a room for every family member—and in wealthy homes, sometimes two or more rooms for each family member. So, Paul sharing a bed with his wife and young son, is a recent development in the U.S.

Understanding research on baby sleep habits

New ways of getting children to sleep have started to become popular. This has led to what’s referred to as the Cry It Out method [CIO] where infants would be placed in a crib by themselves with the expectation that they would ‘self-soothe’ and eventually be able to put themselves to sleep. Meanwhile, anxious parents would brace themselves for hours of their child crying and would be awoken hours later to the child crying once again, laying in bed alone in his or her room. But after 50 years of crying infants, American parents have come around to bedsharing. Rather than placing an infant in her or his bed, in her or his own room, most parents have started to sleep with their children. Part of this change has been facilitated by the science around Sudden Infant Death Syndrome [SIDS], which claims the lives of thousands of American babies each year. SIDS is marked by parents finding their infant child dead in its sleep, often without explanation. By moving children into their parents’ beds, scientists at the University of Notre Dame found that SIDS risks were significantly reduced. Around the same time, interests in ‘Attachment parenting’ ­forwarded by paediatrician William Sears—have reintroduced parents to a style of sleep that people around the world practise without hesitation. Americans are still unsure about bedsharing, and many paediatricians and parenting experts also crticise it. But the evidence from James McKenna’s laboratory at Notre Dame is fairly clear: careful parents, who take the necessary precautions, might receive up to two extra hours of sleep each night.

For those parents who are still wary about sharing their beds, placing the child’s bed in his or her parents’ room is recommended, often referred to as co-sleeping. While this doesn’t stop parents from being woken up in the middle of the night, it does seem to ease some parental anxieties—and infant anxieties—about being in separate rooms.

Moving from opinions to recommendation

Styles of sleep, like bedsharing, co-sleeping, and desirable sleep, like eight hours of consolidated nightly sleep, are all heavily informed by social norms and reflect ideas about what makes a good worker and family member. American sleep patterns have long embraced the idea that everyone should be able to self-soothe, that being an individual who can take care of oneself is the most important outcome of one’s training in sleep—an idea often reflected even in the bedtime stories read to children.

Today, as Indian families too enjoy the luxury of more space in their homes, and more space for each family member, they may also find themselves confronting parenting advice that would make their sleep much more American. In other words, sleeping less with children and more in isolated beds. But, if the American experience with the past century of children’s sleep is any guide, Indian families might be better off skipping to the end of the story and preserving bedsharing and co-sleeping to avoid a century of sleep-related agony.

When our wellbeing and the wellbeing of our children are at risk, it might be worth articulating a future of sleep that is both more thoughtful and more restful.

This was first published in the March 2013 issue of Complete Wellbeing.

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