Whatever Gets You Through The Night

In the midst of winter, having somehow survived the blitz of swine flu panic, we're all ready to see what the wind will blow in next. One of the amazing things I witnessed during this illness was just how powerful a medicine sleep is. My mantra in counseling families became make sure you get enough sleep!

An immune system that stands on high alert needs sleep to regenerate its protective powers. In Chinese medicine the nighttime corresponds to the winter phase of our 24-hour cycle. We must reflect the cycles of the world we live in if we want our health to be harmonious. During the winter months, when it's more dark than light, sleep is all the more vital to our well-being. Lack of sleep is associated with attention deficit disorder, migraine headaches, respiratory problems, increased susceptibility to colds, and poor growth.

This is common sense and everyone knows it, though few really practice it. I spend a lot of time in my practice discussing sleep with parents. Next to food and development, it is the most common topic of discussion. Many parents who come to me yearn for a 'natural approach' to sleep for their child. I often explain to them that I am not here to judge one particular sleep arrangement over another. The first thing to decide is what you want. Remember, a child is much more able to adapt than an adult is. This is "natural." A small plant can actually withstand the wind, make its way through the ground, and deal with sudden environmental changes better than an old hardened tree. The same is true for small children. The younger they are, the more adaptable they are. This is because their brains are still making new connections, finding the most efficient way of surviving.

So my first advice regarding sleep is always to have your baby adapt to your life style not the other way around. I have seen so many parents go to wild extremes in order to get their baby to sleep only to complain that their baby doesn't sleep unless they go through these wild extremes. One mother recently told me she could only get her child to sleep by going on the treadmill with her and now every time the baby wakes up, she has to go back on the treadmill. The whole routine had gotten the mom into great shape, but she was so exhausted she was getting sick and missing work.

This brings up a second important point: After around three or four months of age, we all naturally wake up every two to three hours during the night. This is because we're dreaming. We wake briefly as we emerge from each dream. Back in our caveman days, it was dangerous to sleep too soundly - we needed to wake up to make sure no lion was coming to eat us. Our natural sleep cycles are vital to our survival; so don't expect your child to sleep through the night without waking. We are not meant to sleep like dead bodies in the night. Quite the opposite: sleep is an active time for consolidating the material we've experienced in the day. Sleep is vital to our neuro-immunologic resilience. We actually do deep learning in our sleep.

But beware: When a baby wakes in the night and finds itself in a different place from where it fell asleep this can be very startling. Imagine if you fell asleep in one room and woke up in the bathtub! That's what it feels like when a baby falls asleep in your arms (or on a treadmill) and wakes up in a crib two hours later after a dream. That startling effect alerts the nervous system, making it much more difficult to get back to sleep.

And then there's the whole routine of going to sleep itself. We humans are creatures of habit. It gives us security. The lead-up to sleep prepares the brain for a different kind of activity. The environment in which we prepare - the room, the lighting, the smells, the people there with us - will determine our habit of falling sleep. That's why it's so important to develop a routine as soon as the primitive baby reflexes have disappeared around three to four months of age. In designing a routine for your baby remember that you may have to repeat it every two to three hours in the night so make it as simple as possible.

Remember again that your baby is much better at adapting than you are! Not all babies adapt in exactly the same way. Trust him or her to figure it out. Many times we over-think these situations. Often a baby has already begun adapting to your habits even by three months of age, and will resist any new, conscious changes in routine you introduce.

This makes perfect sense. From his perspective, he's thinking 'Hey, you guys are crazy! That's not how we do things!' and he voices his objections with the only thing he knows how to do, cry. But the younger he is when you decide to develop a healthy training routine, the easier it is for him to readjust to it. Trust this! There is nothing worse than trying to re-train a two or three-year-old child whose habits are already pretty hardwired. Not impossible, it just involves a lot more time, and a lot more crying.

Developing a new sleep routine requires calm, consistency, and confidence in what you are doing. A baby knows when you are ambivalent and will resist all the longer. This brings up the whole idea of what is 'natural' about sleeping arrangements. Many parents know it just doesn't feel natural to have their baby sleeping in another room. So why do we do this? As best as I can figure it, this began as a result of the industrial revolution when we began working nine to five (or more like eight to seven) hour workdays. Before this, we all slept together. Indeed, from cave days until around the 18th century, it was customary to sleep together in one big bed. We kept warm together, bonded together, but don't kid yourself, we didn't sleep more soundly. People were always moving around, elbows in faces, getting up to pee, tossing and turning. But we could always take naps during the day. In fact, in cultures where naps are still a part of the daily lifestyle, sleeping together is much more socially accepted practice. But here in our industrialized society, we have to get up and get to work and stay awake all day long! That's the part that's unnatural, so expecting the nights to be 'natural' but then to live unnaturally during the day simply never works. That's a good way to get fired. And believe me, I have had a number of parents come in complaining to me about just that.

Nothing would make me happier than if we could bring back mandatory nap times for adults. After all, we are all babies at heart.

To summarize:

1. Sleep refreshes us.
2. Sleep is vital to our cognitive functioning, our immune resilience and our connection with the day-night changes in our environment. It literally helps us harmonize with our world.
3. Getting proper sleep is not just about how many hours, but the quality of sleep cycles we get. Waking up is a natural part of the cycle. It's how you get back to sleep where problems arise.
4. Dreaming is an important part of our integration of learning and it only occurs in the deepest levels of sleep.
5. Start early in training your child to sleep. Let her adapt to your lifestyle. (No tiptoeing around the house unless you want to be tiptoeing forever!)
6. Routine is security. Set up a calming bedtime routine that allows your child to prepare for down time. (No videogames and then to bed).
7. Bedtime arrangements are extremely personal decisions. Don't worry about what other people are doing if what you are doing is working.
8. Be consistent from one day to the next. It is the quickest way to show your child what you would like him to adapt to.
9. Be compassionate. Think what it feels like to be your baby trying to figure out how to get through the night.