The Effects of Sleep Deprivation - Babies and Toddlers

This is the first in a series about the effects of sleep deprivation on different groups and ages of people. Today we will be looking at young children.

Babies - though most people's perceptions of young babies is that they sleep all the time, it is in-fact possible (though rare) for babies to be sleep deprived. This can have a negative impact on their health and their growth, also with the suggestion that sleep deprivation can lead to babies being overweight. Research has also shown that babies who get enough sleep are more easy going and approachable.

In my years of working in day care I have noticed that babies who struggle with their sleep and do not get enough are more grumpy and irritable. They find separation from their parents difficult and are more easily distressed during the day. Once we had set up a good napping schedule for them, they found the day more easy going, were able to engage in activities and were happier and more content.

One of the problems in diagnosing sleep deprivation in babies is that all seem to have different sleep needs and habits. One baby may sleep happily anywhere at the drop of a hat, while another needs a more organized routine and environment to sleep. A baby who once slept through the night may suddenly start waking two or three times. As a rough guideline this chart shows the ideal times of recommended sleep through childhood. For babies and toddlers this is spread across daytime naps and nighttime sleeping.

Age                    Hours Of Sleep
0 - 2 months       10.5 - 18
2 - 12 months     14 - 15
1 - 3 years          12 - 14
3 - 5 years          11 - 13  
5 - 12 years        10 - 11

If you can recognize the signs of tiredness in your baby and act straight away by putting them to bed, then you will be setting them up for a good sleep pattern for life. These signs may include (and this list is not exclusive)-
pulling their ears, their eyelids looking red, rubbing their eyes, a glazed look in their eyes and a far away expression on their face, yawning, starting to cry for no reason and not being comforted or distracted by stimulation, lack of interest in toys or stimulation.

As babies grow their sleep needs change and things such as teething, growth spurts and starting daycare can affect their sleep patterns.

Toddlers still need plenty of sleep and like all age groups suffer from the affects of sleep deprivation. I am sure that most parents have a picture or two of a tired toddler who has fallen asleep in a strange place! However a lack of sleep can affect their learning and social skills, as well as their growth. Again sleep deprived toddlers can gain weight - but weight gain has many causes, not just sleep deprivation.

Toddlers are far more mobile than babies and conversely the signs of a tired toddler include running around and wild behaviour, this is a last stand against the tiredness that is growing in their bodies and not a sign that they have loads of energy left to burn. A toddler will naturally be energetic when they wake from a sleep but if they are running around in the late evening before bedtime it is that they are overtired, not full of energy that needs to burnt off.

Sleep deprived toddlers are also more likely to have moods and tantrums - but then this is also typical toddler behaviour!

In order to work out if your toddler is sleep deprived observe and record their behaviour, if they are having more tantrums and wild behaviour in the evenings or before nap time it points to them being tired. Also have a bedtime routine that allows for a wind-down, the last hour before bed should be calming and restful with quiet activities such as a bath and time for stories. Download a good bedtime routine here.
Though it may take a few days (or nights) of effort, establishing a good bedtime routine at this early age will help your child be bright, alert and ready to learn important life skills.

If you are having problems settling a baby or toddler into a sleep routine then please contact a professional for correct advice and sleep training.

It goes without saying that young babies and sleep deprivation of new parents goes hand in hand - and I will address meeting the sleep needs of parents in a later post. 

Getting tough on insomnia

If, like me, when you are suffering from a lack of sleep you are searching continuously for the magic pill that will help you sleep normally'. I tried most things in my quest for a magical night's sleep - acupuncture, over the counter remedies, prescribed pills, aromatherapy, massages, exercise etc. I tried different sleep routines from waking earlier, to trying to reset my bodyclock by going to bed two hours later each day.

Some had a slight effect, improving my sleep a little (bedsocks), some worked during the course of treatment but stopped when I stopped (acupuncture), some had no affect whatsoever - Valerian supplements, some seemed heartily boring - going to bed and getting up at the same time every day, and others seemed a little extreme.

However, one of the extreme ones did actually work and so I will recommend it.

Initially it seems counter-intuitive, you actually sleep less and spend less time in bed. When you stop to think about it, it does make sense. As an insomniac I was spending longer and longer in bed in search of that elusive thing called sleep. At the weekends I could easily spend 10 or more hours in bed - trying to sleep, but actually only getting about 5 or 6 hours. Even on weekdays the amount of time I spent in bed v the amount of time sleeping was quite different.
This leads to a point where the brain stops associating bed with sleep, and instead associates it with lying awake.

In order to stop this and turn it back to the association of bed = sleep, you need to spend less time in bed! A favourite behavioural therapy solution to this is to work out how much time you are actually sleeping and then go to bed for that amount of time.

It works like this -

Keep a sleep diary for a couple of weeks and record each night how much you are sleeping in total. If you sleep in several smaller blocks add these together to get your nightly total.

After two weeks work out your average sleep time. In the this example let's say 5 and half hours.

Work out what time you need to wake up and then count back your sleep time. Again let's say 7am is your wake up time, so in order to get 5 and half hours sleep you need to be in bed at 1.30am.

Go to bed at this new time until you are sleeping through from 1.30 - 7am. This needs to be done 7 nights a week with no lie-ins or naps!  these times can adjusted to your body clock, if going to bed in the early hours of the morning feels alien to you then go to bed earlier but wake up (and get up) 5 and a half hours later!
If your average sleep time is less than 5 hours then set your sleep time for 5 hours - his is the absolute minimum amount of time to be aiming for.

After you have been sleeping through for a week, then go to bed 15 minutes earlier at 1.15am. Then when you are sleeping through again, slowly build up the amount of time you spend in bed in 15 minute increments.

If this process is done correctly then within a couple of months you wall be sleeping through, night after night and with in a few months you will have a normal sleeping pattern of 7 to 8 solid hours of sleep a night.

I call this techniques sleep condensing, as it retrains the brain from a fragmented sleeping pattern into a solid sleeping pattern. It needs to be done slowly and built up over time, so that you remain in a state of solid sleeping.

The efforts are worth the rewards and after a few months it is possible to then re-instate a couple of sneaky lie-ins and the occasional afternoon nap. It does need to be closely monitored and if night time waking starts becoming a regular feature of your sleep again, then you may need to cut back a little of your time in bed to re-establish a solid night of sleep again - just as someone who watches their weight may cut back on their calories after an over indulgent holiday!

Sleep condensing may also have to be combined with other sleep essentials (such as reducing caffeine, switching off electronic equipment an hour before bed
etc) in order to work well.

If you want to try this, then good luck and let me know how you go!

Sweet dreams.

If you would like more help with achieving overcoming insomnia and other sleep problems then please contact me at charlotte@charlottewelply.com and we can set up a free introductory coaching session.

Sleep Gadgets

I'm not sure what you're like, but I know that in my quest for a perfect night's sleep I tied out a few gadgets and gimmicks in the hope that they worked.
Most of them did not.

It's a minefield out there, trying to distinguish the hype from the truth and the fact that, as more and more people are reporting that they are sleep deprived, it is becoming a big business sector with many brands jumping on the bandwagon.

These are a few things that I have tried over the years, the list is not exhaustive and are only my feelings, but it would be good to start a discussion. I have not included herbal or alternative medication in this post.

Mattress - There is now a plethora of mattress types out there, all proclaiming to help you get a good night's sleep. They are a huge investment so which one do you choose?
The general advice is to replace them every 10 years and I would support this. In my backpacking days I slept on many a poor quality mattress and had a poor night's sleep. Sagging springs do not support the body and therefore will decrease the quality of your sleep.
As for the style of mattress - this is more a personal choice. A good bed showroom will let you lie on the mattresses and try them out. What is comfortable for one is not for another. If you are a couple that prefer different mattresses then look into getting the style where two different types can be zipped together. I personally find the foam mattresses very hot yet others swear by them. Take your time and try different shops and styles till you find one you like, do not be rushed into buying the first you come across.
Be wary of internet bargains - you can not try them out, what may seem like a good price may result in a low quality mattress. Also be wary of second hand, not only do you not know how old they are, they will have been 'shaped' by someone else's sleeping style. Also there are reports of bed bug infestations spreading through the use of second hand beds and furniture.
I have had a good quality orthopedic mattresses for a long while, it cost more than the basic mattress but was not overly expensive.

Pillows - again this is very much an area defined by personal preferences. I have been converted to the contoured pillows that give you neck support. I started using one because of a lot of tension in my upper back, I found it a little odd at first but now find it difficult to sleep with out one and end up bunching a 'normal' pillow under my neck to recreate the feeling of support.
Fortunately pillows are not as expensive as mattresses so a little trial and error will not cost the earth. Good bed shops will also have different pillows that you can try.

Magnets - A few years ago there was some hype around using magnets in pillows and on undersheets to help improve your sleep. I invested in a small sheet to try it out. I could feel a difference in my circulation (it improved that) but it did not really improve the quality of my sleep.
Magnetic therapy is also claimed to help those with arthritic and joint pain, and of course pain can stop you sleeping well and is a well know cause of insomnia. If you were in this category and wanted to try magnetic therapy, perhaps try a wristband to see if there is any improvement before making larger investments. Also look out for money back guarantees.

Massage machines - again there are certain types of massage machines on the market that claim t help improve sleep quality. The benefits they offer can be debateable. If you are stressed then yes, having a massage can help you relax and then sleep better, so they can help in the treatment of sleep problems rather than effectively cure them.

Sleep monitors - there has often been a huge difference in the amount of sleep that people think they get and the amount of sleep they do get. Traditional methods to show this have mainly revolved around keeping a sleep diary or going to a sleep centre and being 'wired up' for the night. Recently, with the improvement in technology there are some sleep monitors that you can buy and use at home. These, however do not always give accurate results with people reporting that the monitor bands slip off during the night, or register periods of inactivity as sleep, when the users report they were awake but just not moving. Also these monitors just record the amount of sleep you get, they do not improve the quality or length of sleep.

White noise/sound machines - these play background noises and music to either block out other noises or to provide a constant noise to help you fall asleep. I have to say that sometimes I have listened to music or meditations before going to sleep as this helps switch of a racing brain, though have not needed a special machine to help me do this. If you are sharing your bed then it is possible to buy headbands with inbuilt speakers and pillows that you can plug your ipod into so that your partner is not disturbed. If listening to music helps you sleep, it maybe worth checking these out.
If you want to see if white noise could help you sleep, then try running a small electric fan in your room to see if that helps before investing in a special machine.

After many years of trying different approaches, and finding some that helped a little or not at all, the only one that worked long term was following a structured behavioural therapy approach to actually retrain my body in the art of falling asleep and staying sleep. It was an effort at first but it was only for a few weeks and the benefits have been longer lasting than anything else I have tried. 

Teenagers and sleep

The other night I did an overnight babysit and the apartment had the heating programmed to be on all night. I found it way to hot to sleep and seemed to spend the entire night adjusting the radiator and opening/closing the window.

I did only get about 2 hours sleep - and it was in two different blocks. I got the children up and took them to school and returned home and straight to bed.
I have not slept that badly for years and when thinking about it I remembered that this was my norm when I was a teenager. In those days I would sleep for about 2 hours one night and then the next night about 5 hours, and kept repeating this two night pattern until I went to the doctor about my sleep.

Seeing how tired I felt the other morning, and how I was incapable of doing anything other than going to bed made me reflect on how this must have affected my studies at school and college. Nowadays if I do an IQ test I'm up around 140, yet my school teachers thought I wasn't coping with the work. Some of this was due my dyslexia (which is fortunately much better understood these days) but I now think that my insomnia severely affected my studies.
When revising for my A levels I would spread all my books around my room, and because my Mum would leave me alone 'to study', I would end up with droopy eyelids and falling asleep. I ended up with average results.

So, what to yo do if you are a teenager, or a parent of a teenager with sleep problems?

Firstly teenagers sleep is naturally different from an adults and they become Night Owls and naturally go to bed later, finding it hard to sleep before 11pm. They need at least 9 hours sleep and some need more. School and college hours mean that they are not getting enough sleep.

In order to help try and establish a good evening routine that means homework is finished earlier in the evening, allowing time to unwind before bed.
Encourage having a shower or bath before bed, to send sleep triggers to the brain.
Have a no screen time guideline for the last hour before bed, this includes ipads, laptops, smart phones etc.
Reduce the amount of caffeine in the diet  remember a lot of soda drinks contain caffeine.
Encourage regular sleeping hours to train the body to sleep but do allow for a small lie-ins at the weekend/holidays for catch up.
Strategic napping can help - as long as it is not for too long nor too close to bedtime.
Make the bedrooms as sleep inducing as possible.
Encourage plenty of exercise - again earlier in the day and at least 3 hours before bedtime.

Discuss sleep with your teenager like an adult. Telling them they need to sleep more and enforcing strict rules may well end in resentment and a lack of co-operation. Give them the facts about sleep and how important it is and what the benefits are. Also point out that getting enough sleep helps with weight control and skin conditions such as acne. Let them come to realise the impotence of sleep themselves. Ask if they want to keep a sleep diary to track the amount that they are getting.

Remember - if you treat sleep and sleep issues with respect, encourage discussion and ask them what they would like to do to improve their sleep, they are far more likely to take it on.

Keep an eye on their sleep patterns and if you suspect that their lack of sleep goes beyond normal teenage patterns then get an appointment with their doctor and discuss the possibility of other sleep problems such as insomnia or sleep apnea.

If you have any concerns and want to discuss them further then please contact me for a free consultation.