How is infant sleep different from adult sleep?
The sleep cycle starts to develop in utero. When the baby is born, the cycle is divided into active and quiet sleep. During the active phase sleep the baby may be twitching and breathing irregularly, in contrast to the quiet phase, when we observe deep breathing and little movement. Interestingly, while adults start their sleep cycle with light sleep and reach deep sleep towards the end of the cycle, infants actually go into deep sleep right after falling asleep.
Establishment of a more mature sleep cycle is a process that takes time, as the brain develops. The reason babies wake up frequently is that there is typically a bit of arousal at the end of each sleep cycle, enough to wake them up. The task is to help them learn to fall back asleep on their own.
What is your advice to parents? Also, do your professional views overlap with your views as a mom?
Professionally, I have a lot of respect for Dr. Richard Ferber and his book. It has been simplified as letting your child scream, alone in his crib, all night long. It’s actually not what he argues. He says that all children are able to fall asleep and stay asleep and that the parent’s role is to help children learn how to do it. This is true, with some exceptions, like when there are medical reasons for not being able to sleep (e.g., sleep apnea, fever, and neurological reasons).
I don’t like the phrase “sleep training”. It’s teaching. Setting up the right environment (cool, quiet, dark room), a predictable routine, providing ways for the child to feel secure (e.g. a luvie). Whether or not to let the child cry is decided based on the individual family. But in general, if every time the child wakes up, he expects external help to fall back asleep, it will take him longer to learn how to do it himself.
That said, I’ve done none of this with my kids. My twins were horrific sleepers until they were 2. I have an almost 6 months old girl now and I cannot tolerate hearing her cry. It’s really hard to establish rules when you are sleep deprived and hormonal and your child has not read the book! And it’s okay, too. But my professional opinion is that Dr. Ferber is right. I don’t think there’s any detriment to the child’s brain or child’s ability to bond if you let them cry for a bit and figure out how to fall back asleep. Don’t start until the child is at least 6 months old, though. Until then, I would recommend Dr. Harvey Harp’s soothing methods: swinging, swaddling, a noise machine, feeding on demand.
Do you see a lot of parents who have sleep disorders caused by their children’s sleep problems?
It's not typical. Periodically I would see someone come in with memory problems, but you start digging and they say: “I have a newborn and am doing a PhD and I’m going crazy”. I often recommend finding an underlying reason for sleep problems. You might have too much going on. Many new mothers experience anxiety and depression, even PTSD. I often say “treat that mood disorder and sleep will follow”.
I also recommend having a routine for yourself. Go to bed and wake up at the same time every day, sleep in a cool, dark room. Don’t nap during the day – you are killing the sleep drive. Healthy lifestyle: diet, exercise, no alcohol. No meals at bed time, no heavy exercising 2-3 hours prior to bed time. One hour before going to bed, take the time to unwind: no electronics; take a hot bath or shower. This lets your body know that it’s time to produce melatonin, the sleep hormone.
The body starts producing it 1-2 hours before sleep and releases it when the lights are dimmed. If you skip your bedtime routine, your body doesn’t know what to do.