SLEEP Q & A

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1. Lately I find that my four-year-old girl’s sleep has been plagued with nightmares which leave her screaming in her sleep. She often talks about her dreams, most of which seem to be filled with fighting and violence. Could this be due to the fact that she has just recently started preschool?

It is quite likely that starting school which is a major milestone in a child’s life, is unsettling your daughter. At this age you child cannot see the line which divides dreams and reality. The next time your child screams in her sleep, give her a drink of water and reassure her that it was just a dream and that she is alright. Let her go back to sleep in her own room and try to refrain from making a big fuss about the whole incident. If you do, soon enough the waking up at night may be used as a ploy to gain your attention. Allow your daughter to talk about her dreams. However keep reminding her that it was just a dream and not a reality. Some children may take their dreams very seriously. If your daughter tells you of her guilt for acting in an aggressive way in her dreams tell her that she did not really do it, it was just a dream. If however her dreams persist and you find them disturbing, try talking to her teacher to find out how she is settling down in school.

2. My five-year-old has developed the habit of sleeping late. She often watches television with my husband until about 11 o’clock. Her excuse for not going to bed earlier is that she cannot sleep so early. What can I do to get to go to bed at a suitable time?

When faced with such a situation, the combined efforts of both you and your husband is necessary to enforce some rules. Both of you should insist that her bedtime should be at a certain hour. If she senses differing opinions between the two of you, she can use that to her advantage. It could also help if the television is switched off earlier. You should establish a routine for bedtime. For example a glass of milk followed by changing into her pajamas, going to the bathroom, brushing her teeth followed by a bedtime story before lights out. With such routines established your daughter should be able to go to bed at a more appropriate time for her age.

3. My son is five years old. He usually sleeps very soundly through the night and I find that this could be the reason he wets his bed sometimes. On someone’s advice I have taken to bringing him to the toilet at least once a night. This however does not seem to be working out for two reasons, firstly I have to carry him to the bathroom since he refuses to wake up and secondly, it disrupts my own sleep.

Expert opinion on waking a child up in the middle of the night to use the bathroom seems to be divided. While some believe that it is unwise to do so, others believe that the benefits of a child staying dry throughout the night outweighs the minor inconvenience. The trick to this is to wake your child up such that he is at least semi-conscious. Soon enough waking up at a certain time every night should become a habit to him. You should ensure the following, that your child is kept warm in the night and that he empties his bladder before he goes to sleep. You should also ensure that your child does not take in too much fluids before he goes to bed.

4. How do I let my baby know it is time for him to sleep?

Little babies are creatures of habit. Routine provides them with a sense of security and you with a degree of order to your day. If you follow the same routine every day, baby will automatically adjust his body clock to that routine so that he will eat and sleep according to it. You can help your baby know it is time for bed by following a bedtime ritual at fixed times of the day. At night, a warm bath followed by milk and a few lullabies will soon have your baby ready for bed. You could have a set of night clothes which your baby will come to recognise as his bedtime dress. Change him into his daytime rompers before he leaves his bedroom in the morning. Such a baby will be more willing to go to sleep than one who has no fixed schedule. If you change the routine every day, your baby may be confused about his nap times. Stick to fixed timings and your baby will stick to it too.

5. My six-month-old is up before the sun. Help.

Babies are notoriously early risers and sometimes there is little you can do about but get up with your little sunshine. But you could try a few of these tricks to see if it works. Firstly, is your baby getting too much sleep during the day? Try cutting down on the number of hours she spends napping. A baby that age requires about 14 hours of sleep and if she's having long naps in the day, she will be less ready to stay in bed at night. Put your baby to bed a little later at night. Push back his bedtime by a few minutes till he's sleeping about an hour later. Make sure the blinds in his room are drawn and the room is kept as dark as possible. This may keep your baby dozing a while longer. Keep a stash of safe toys in his crib so that baby is distracted for a while and is not screaming for your company. Do not rush to greet him the moment he squawks. Keep him waiting and boredom may get him playing with his toys

Your child’s refusal to go to bed could be due to several factors, one of which could be fear. Having very active imaginations, children of about four or five, may lay awake in bed for several hours due to their fear of monsters under their beds or in the cupboard. This fear could have come from the television programmes that they watch. So ensure that your son does not watch programmes which may scare him. Also ensure that the bedtime stories that you tell him are amusing and cheerful. Save monster stories for the day. Another factor could be anxiety. At this age, your child needs a lot of love and reassurance from you. His conscience is beginning to develop and he begins to understand relationships between people. At this age, the child feels that everything that happens around him is because of him so if he were to overhear an argument between you and your spouse he may feel that it was his fault. He also fears that you may not love him anymore if he has been naughty. So hold your serious discussions out of his earshot and try not to punish him just before bedtime. Routines also reassure a child. So try to establish a bedtime routine for your son and since he is just beginning to understand the concept of time, having a play clock which he can adjust himself may help him to get to bed on time. Always remind him 15 minutes before bedtime to adjust the hands of his play clock and once he is ready to crawl under the covers, he can adjust the clock back to his actual bedtime.

7. How do I get my baby to go to sleep? I dread bedtimes.

Before putting baby to sleep, make sure he is comfortable. A dry diaper, fresh clothes and a drink of water or milk will help soothe and comfort baby. Make sure the temperature in his room is not too hot or cold. Once you have checked these essentials, you could try a variety of tactics to get your little nipper to hit the sack. But first, have a fixed routine for your child. A half hour before his bedtime, sit down for some quiet play. No more rough-housing . An overexcited child cannot be dumped in bed and expected to sleep. Make sure you are not putting your child to bed too early. If he is really not sleepy, he will object to being put in bed and will view his crib as a punishment site. Also, check to see if your child is sleeping too much during the day and is therefore not ready to go to bed at the scheduled time. 

To bed, to bed, alone -- Those mothers who subscribe to the so-called western method of child raising, believe that babies should learn to sleep independently. The mother puts the baby to bed, drowsy but not asleep, and leaves the room. If baby protests, watch the clock for say five or seven minutes. Do not go into the room within the time you have set yourself. If baby continues to protest, you could either return, pat and reassure baby, and leave again. Or if you feel that seeing you will only aggravate the situation, steel your heart and let baby cry it out. Abort proceedings if baby turns frantic or refuses to stop shrieking. Try again after a few days. A few days of this and baby should start falling asleep on his own. But before you leave the room, make sure baby is in a safe environment and there is no possibility of his hurting himself. Leave a few safe toys in the crib which baby can amuse himself with until he falls asleep. Also, a comfort object may help baby deal with being alone. 

There are other less "drastic" methods. Lullabies have been a time-honoured way of putting babies to sleep. Sing a few of baby’s favourite tunes or put on a cassette. You could also introduce your baby to some classical music. Some babies prefer lively tunes, even at bedtime. Cassettes which contain soothing sounds that try to stimulate the environment in the womb are also said to be effective in lulling babies to sleep. For older babies, read a bedtime tale. A bit of hugging, cuddling, a cookie and a bottle of warm milk, and your little one will be snug as a bug in bed. Babies love things familiar and they will love you to read the same animal or baby tales, or rhythmic verses to them, over and over again. 

One of the most ancient ways of putting baby to sleep is to rock them. Rocking a baby comes instinctively to mothers. Rocking seems to soothe babies. Some like to be rocked from side to side, some prefer an up and down sway -- find out what your baby likes. Invest in a rocking chair, cuddle up and sway your way to the land of dreams. Patting works well for older babies but just remember to be gentle. Go baby’s way when it comes to inducing sleep. Does your little one like to be hugged tight or held loosely in the arms? Does he like his back stroked or his head? May be a light massage will relax baby? Find out what your baby likes and sleep times will be a time of togetherness and love, not dread.

8. My seven month-old still wakes up in the middle of the night to nurse. Could he really be hungry?

If your baby is eating a good dinner and perhaps a small snack before she goes to sleep, there is little reason for her to be hungry at night. If your baby is in the habit of falling asleep with a nipple in her mouth, the reason could well be that once she wakes up she is unable to fall asleep by herself without the comfort of nursing. Once you start feeding her when she wakes up crying at night, she will carry on doing that as babies are creatures of habit and she loves your presence next to her. To give yourself a night of sleep, you could try letting her cry it out, but that will probably leave you as distressed as your baby. The alternative is trying to let her go back to sleep without feeding her. Pat her, rock her, sing a lullaby, give her a drink of water but do not nurse or offer food. Also see if you can get her to fall asleep at the beginning of the night without a nipple in her mouth. Feed her in advance and then bed her down with some songs, a light massage, a cuddle. Once she is sleepy, put her gently in bed with a comfort object if she has one. Do not rush to her at the first wail. Wait it out a little at a time and baby will soon learn that it is all a wasted effort and drift off to sleep.

9. My active three-year-old daughter is always reluctant to go for her afternoon nap. Does she still need it? What’s the best time for her to take her nap?

Although children stop taking naps around the age three or four, most of them still need a rest period of some quiet play until they are about five or six years old. Do not assume that a child who is rushing around the house or playground is not tired. You should observe her physical coordination. A tired child will manage her body less and less well. Do intervene before she gets overtired because physical tiredness, tension and excitement can build up to a point where she no longer knows she is tired and does not know how to stop and rest. An overtired child is more prone to temper tantrums and refusal of food. If you would still like your daughter to keep a routine nap time, you can. It is best arrange just after lunch, before she gets absorbed in play. Children, like adults, are most sleepy after a good meal. Alternatively, suggest some quiet activities for her at a regular time each day. Read to her or play a record or video tape. Craft work and jigsaw puzzles are absorbing and offer an interesting alternative to active play.