About 30% of children up to the age of five suffer from behavioral sleep problems. In infancy these problems are manifested in the need for prolonged anesthesia accompanied by restlessness, and awakenings during the night that are accompanied by crying. Among toddlers sleep problems are manifested in the refusal to go to sleep, the need for prolonged presence of one
The parents until falling asleep, and wandering into the parents' bed during the night.

In the past it was common to think that the main sufferers of children's sleep problems are the parents - because their quality of sleep is impaired and with it the ability to function during the day - and that babies are characterized by light and fragmented sleep, today it is known that the babies really suffer.

First and foremost because deep and continuous sleep is essential for the cognitive development and proper functioning of the immune, digestive and growth systems. In addition, fragmented sleep also has emotional consequences for the child because it is an expression of a chronic experience of panic, frustration and suffering. Many studies such as that of the late Prof. Avi Sadeh, one of the leaders in the field of sleep research in children around the world, show that toddlers who suffer from behavioral sleep problems show difficulties on the emotional-social axis.

Why do babies and children have difficulty falling asleep and are unable to sleep continuously until morning without waking up?

The main reason is simple - those babies / children do not continue to sleep in the conditions in which they were put to sleep. Many parents will surely be happy to hear that effective sleep and continuous sleep occur naturally and spontaneously at any age, from infancy, if only babies are allowed to sleep in the conditions in which they fell asleep. That is, sleep problems are created because there is some change in stimuli in the baby's environment after falling asleep.

To understand this one has to distinguish between spontaneous awakenings and awakenings. Spontaneous awakenings are defined as waking flashes that last up to 30 seconds and are intertwined during (spontaneous arousals) are the elongation of spontaneous awakenings beyond sleep awakenings naturally. In contrast, awakenings to 30 seconds as a result of difficulty returning to sleep.

Spontaneous awakenings appear during sleep at any age and their surviving role - they are designed to preserve the old person's basic sense of security. The instinct to daydream stems from the fact that sleep itself is considered a risk state of loss of control. In each spontaneous awakening, the brain makes a comparison between the sensory input burned into the memory from the time of falling asleep, and the sensory input in the current state. If no change in sensory input is detected - that is, all the stimuli that were in the sleeping environment are in place in the environment even now - then a sense of security is in place, which allows you to fall back asleep without distress and easily. But if there is a change in sensory input at the time of awakening it is perceived by the baby as a potential threat, which evokes a sense of urgency, that "something is wrong".

In light of this explanation, a baby who is accustomed to falling asleep in the parent's lap and lying in her bed is always asleep, will feel distressed whenever she wakes up during her sleep spontaneously, as she will recognize the change in the sleeping environment. Her reaction to the feeling of distress will be crying - while the parents' reaction will be to pick up the baby in their arms to restore the conditions of the anesthesia to her again. This chronicle will perpetuate the baby's sleep problems.

What is a sleep training process?

In recent years we are seeing more and more parents aware that this is not a fate, but that difficulty falling asleep and fragmented sleep in infants are an expression of suffering and not a "characteristic of infants", so they turn to treating the problem, sometimes with professional advice. The process of sleep training is in fact imparting "independent sleep ability". During which the baby is placed awake in the conditions in which they are supposed to sleep - that is, in their bed - and encouraged to fall asleep in these conditions.

Encouragement is done in a controlled manner. Repeatedly returning to the baby and infant and giving them a sense of repeatedly the new conditions, and practicing with them in practice (reassurance) confidence, confirming the parent's departure and return. Only when relaxation begins, release the baby to relax and fall asleep alone in the new conditions.

The initial reaction of infants placed under these conditions is to burst into tears, as until the sleep training these infants awoke in their bed surprised and expected to be “rescued” from it by their parents. Another reason for crying is fatigue, an urge to sleep that is not immediately satisfied.

Later in the sleep training process, while consistently encouraging the babies to fall asleep in the new conditions and bringing them to a state of relaxation until they fall asleep in these conditions, the sense of urgency gradually disappears and the conditioning of relaxation and relaxation in the new conditions develops. The advantage of these conditions is their stability - whenever the baby wakes up and examines the new conditions, nothing changes in them.

Babies who have undergone a process of sleep training thrive on many levels and especially on the emotional-social level. Many studies, which have examined not only the effectiveness but also the safety and emotional and functional consequences of short- and long-term sleep training, have concluded that there are no negative consequences to the process of sleep training, only positive ones. These conclusions are also reflected in the recommendations of the American and European Pediatricians' Associations. In contrast, there are increasing studies talking about the link between sleep problems in infancy and emotional problems and even the development of childhood psychiatric problems among those who suffered from sleep problems in infancy.

The author is a psychologist and sleep consultant

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source list:

Behavioral Interventions for Infant Sleep Problems: A Randomized Controlled Trial.

Gradisar M, et al. Pediatrics. 2016. PMID: 27221288 Clinical Trial.

Sleep and Social-Emotional Development in Infants and Toddlers.

Mindell JA, et al. J Clin Child Adolesc Psychol. 2017. PMID: 27492858

Infant sleep and its relation with cognition and growth: a narrative review.

Tham EK, et al. Nat Sci Sleep. 2017. PMID: 28553151 Free PMC article. Review.

Price AM, Wake M, Ukoumunne OC, Hiscock H. Five-year follow-up of harms and benefits of behavioral infant sleep intervention: randomized trial. Pediatrics. 2012; 130 (4): 643-651. doi: 10.1542 / peds.2011-3467

Sadeh A, Tikotzky L, Scher A. Parenting and infant sleep. Sleep Med Rev. 2010; 14 (2): 89-96. doi: 10.1016 / j.smrv.2009.05.003

Cook F, Conway LJ, Giallo R, Gartland D, Sciberras E, Brown S. Infant sleep and child mental health: a longitudinal investigation. Arch Dis Child. 2020; 105 (7): 655-660. doi: 10.1136 / archdischild-2019-318014

Halász P, Terzano M, Parrino L, Bódizs R. The nature of arousal in sleep. J Sleep Res. 2004; 13 (1): 1-23. doi: 10.1111 / j.1365-2869.2004.00388.x

And

Treatment of Preschool Sleep Disorders: A Review and Presentation of a Multidimensional Treatment Model

A. Sadeh and L. Tikotsky, Talks, 9, (2005)

And

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