Wednesday, September 5, 2012

Sleep Training

"Is your kid sleeping through the night yet?" "Are they a good sleeper?" "Did you try crying it out?"

These questions, tossed out at the playground like loose change into a deceptively placid fountain cause a sinking feeling each time I hear them. The answers - no, no, yes (me not her) - frequently inspire surprise in others, frustration in me, and a general feeling of confusion. When did the ability to sleep for 12 straight hours (her, not me) become the measure of good parenting - or good children?

Before having a child, I didn't realize how much time would be consumed by sleep: worrying about it, reading about it, talking about it, encouraging it, waiting for it...anything but actually doing it (me or her).

Of course, I should have been prepared. When I was pregnant, I received plenty of ominous warnings from other parents - get ready for everything to change - and alarming prognostications - you'll never sleep again - as well as smug questions delivered with a slightly sadistic gleam in the eye - are you banking sleep? cause you're gonna need it! It was like the prelude to some not-so-secret parental hazing ritual.

But things never go as you expect. My daughter was actually a great sleeper as a baby. She was big - 9 lbs - and able to snooze for long stretches even the first few weeks after birth. When all the dire predictions didn't immediately come true, I thought I had hit the slumber jackpot. I had a great sleeper! It didn't occur to me to worry about her sleep until I joined a playgroup when she was about 4 months old. All the mothers in the group were talking about sleep training. I didn't know what that was, much less what it entailed. It seemed like a lot of work, and sort of superfluous in this whole parenting gig. Wasn't sleep supposed to be something that humans just...did? Kind of like eat and poop and watch too much Project Runway?

Apparently not. Apparently there were a lot of rules about sleep. Things like: don't hold your child while they are falling to sleep, don't rock them to sleep, don't lie down with them, don't do anything that they might come to rely upon to fall asleep that you don't intend to do for the rest of their lives. Always put them down to bed awake. Don't rush in to comfort them if they wake in the middle of the night or they will learn that night time is fun time and start to wake up more just to play with you. If they do wake, rub their back or their belly. Don't talk to them. Don't tickle them. Don't stick thumb tacks in their toes.

Okay. I made that last one up. But it seems like good advice.

There were also a lot of theories, and no shortage of experts peddling advice on websites and DVDs and in magazine articles and a seemingly endless parade of books: The No-Cry Sleep Solution; The Baby Sleep Book; Healthy Sleep Habits, Happy Child; Secrets of the Baby Whisperer; The Contented Little Baby Book; The Happiest Baby on the BlockSleepless in America...the list goes on and on. (FYI: The Happiest Baby on the Block and Sleepless in America were the most reassuring, useful and reasonable book, IMHO.)

I held out as long as I could from either reading about or trying my hand at sleep training, partly because I am lazy, but also because it seemed that the tenor of sleep information aimed at today's parents frequently takes on a pressured, threatening tone enumerating the dire consequences of not training your kid to be a good sleeper - or at least not training them properly. Shirking this critical parental responsibility will apparently lead to a whole range of ill effects going well beyond chronic tiredness and irritability, things like depression, obesity, learning disorders, diabetes, and ADHD. I'm hard enough on myself without taking on that kind of recrimination.

Still, at one point it seemed like everybody's kid was sleeping through the night except mine. Most families I knew had tried one method or another or, more often, a whole variety of methods. The training metaphor still bothered me (why training? and for what? the sleep Olympics? would Ralph Lauren design the team's line of nautical themed footsie pajamas?) but I was ready for my daughter to be a better sleeper and figured I might as well see what the fuss was about.

The "fuss," as expected, drove me bonkers. So many of the authors present sleep as a kind of imperative gift given from parent to child that if not given, or given sloppily wrapped, or only partially opened, will lead few places but jail, illness, despair, or therapy. This seems a bit puzzling - not to mention disingenuous. I'm not a particularly good sleeper. Neither is my husband. And yet, neither of us have ended up as obese, hyperactive felons. Not yet.

Indeed, we have had some of our best conversations and most hilarious giggle fits in the middle of the night, lying in bed, waiting for the return of that elusive gift our parents failed to give to us, and still I am reluctant to see that as evidence of either lack of love or abdication of their parental responsibility.

The "sleep is a gift that parents give their children" metaphor also bothers me because it seems the reverse is actually far more true - sleep is a gift that children give their parents - and also because it is frequently used to justify or gloss over the unpleasantness and struggle that the process of giving this gift can entail. As it turns out, our daughter did not respond well to pats on the back or tummy rubbing. She can out-wail us until she pukes and we do not have the heart to "lock the door, put in ear plugs, and let her sleep in it" as some experts advise. That may indeed help her to learn a lesson about sleep but it is not one I particularly want to teach. Bourbon or Benadryl, not to mention duct tape and a whap on the head with a fry pan, would knock her out and stop all that annoying whining, too. But I still wouldn't necessarily conclude that this is reason enough to advocate any of those particular methods.

What did parents do on the frontier? Or in caves? Or as serfs living in thatched huts? Did they co-sleep? Probably. Did they cry it out? Probably. Did they leave their kids with nannies if they had the means? Probably. I can't ask those mothers how they handled sleep issues, and I don't have the energy to mount a huge search on the history of sleep training through the ages (although if you do, I would be extremely interested to hear what you find). But I did consult with what resources were readily available to me.

In talking with my mother, mother-in-law, and other women of their generation, they do not recall following any particular sleep training methodology - in fact, they do not recall sleep being such a big issue at all. This may just be the normal erosion of parental memories, in which the devil of the details is replaced by the halo of hindsight. It may also be because when we were kids, there wasn't such a big debate about leaving kids to cry it out - our parents did it and didn't fret about it. But there also weren't dozens of books on child-rearing, either. There was Dr. Spock. End of story. (Not to be confused with Mr. Spock, of Star Trek, whose parenting advice would probably not be so different from many of the books I have read.)

With so many methodologies and sources vying for sleep training supremacy, trying to sort out good advice from bad is exhausting, not to mention confusing: so many of the "experts" seem to base their advice on questionably scientific justifications, somewhat rigid schedules, and/or chatty vignettes. I am no sleep expert, but I do know from my former life in the world of cognitive neuroscience that when behavioral modification programs start talking about "brain science" or "neurons," they often get it wrong - in whole, or in part. Just because it takes neurons three days to form new branches doesn't mean that's the window for acquiring any new behavior. Rigid schedules work well for for some families and situations and not so well for others. And chatty vignettes make for entertaining reading but typically highlight the best case scenario, like the before and after photos for weight loss programs, rather than the more typical results.

In talking with other parents, the bottom line seems to be that some kids are good sleepers, some kids are not, and some are sort of in the middle. The good sleepers generally respond well to minimal training, the bad sleepers do not respond well even to intensive training (at least when they are very young), and the ones in the middle (depending on temperament) can usually be swayed by one method or another. So while you might be able to turn a mediocre sleeper into a good sleeper with the right combination of patience and methodology, no matter what methods you use, a good sleeper will probably still be a good sleeper, and some bad sleepers will always be "bad" sleepers.

And even when parents say their kids are sleeping through the night, this can mean a lot of things. Frequently (especially the younger the child) this may mean that they have done this once, or that they do this once a week or a month, or that they can sleep for 5-6 hours at a stretch, not 10-12. And even if you have a good sleeper, just when you get into a good rhythm, things like teething, sickness, vacation, or family visits can set you back. It's like being back in school, with the kind of kids who lied about how much they studied for a test so they seem smarter when they get a good grade. Only sleep isn't a subject and how well our children do it shouldn't be part of any parental report card.

As a child, I remember lying awake in bed, worrying about not being able to sleep until I finally tip-toed downstairs to ask my mom for warm milk with cinnamon. This went on for years. And every night when my parents tucked me in, I begged them not to leave me with a plea of "I'm lonely and afraid." (Looking back, I have to admit that I am sort of impressed with the bleak and manipulative beauty of this declaration, and proud that my 4 year old self came up with it.) It didn't cause my parents to climb into bed with me or to abandon bedtime, but it probably made them feel terrible.

At the end of the day, in every family, there is some kind of sleep training going on. You may have read the books, but you didn't necessarily get the memo: no matter what method you choose, the person most likely being trained Trained to care whether your child sleeps - and when and how much and for how long. Trained to hear their calls in the middle of the night when they are sick or scared, trained to respond to every little whimper or request - or not, trained to do more with less sleep for some stretch of time, whether months or years or decades, trained to be tired.

So put on those jaunty nautical pajamas, parents. You can do it.

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