Wednesday, May 30, 2012

I love my child, but I don't want to see her at 5am!


I recently posted a question on Facebook asking everyone for their biggest kid sleep challenge, and more than 2/3 of the answers came down to the same issue – early rising.  For children between 6 months and 6 years, an age-appropriate wake-up time is anytime from 6 to 8am, with the majority falling somewhere in the 7 o’clock hour.  Early rising is trying to start the day earlier than that, usually around 4 or 5am, and it’s no fun for any of us.  As adults, our bodies are secreting large quantities of hormones to keep us asleep a little longer so that we can reach our required 8 hours of sleep, and most kids haven’t gotten their 11 or so either.  So, what gives?  Why do they wake up, and more importantly, how can we make it stop?!

To get to the bottom this troublesome phenomenon, you have to start by understanding a little bit about sleep.  When a child “sleeps through the night,” he doesn’t actually stay asleep for 10-12 hours.  A sleep cycle, for anyone over 4 months old, is about 3 to 4 hours long, so he actually wakes up 2 or 3 times each night and has to fall back to sleep.  For most of us, this happens pretty seamlessly; we find the cold spot on the pillow or roll over, and we’re back to sleep without ever noticing we were awake in the first place.  However, that doesn’t always happen.  Think about when you wake up about 30 minutes before your alarm and just can’t get back to sleep.  For a lot of our kids, that’s exactly what causes early rising!    

Early rising is actually the first thing to go wrong when a child’s sleep starts to deteriorate and the last thing to improve when their sleep schedule is on the mend.  Here are the most common reasons we see our kids in the wee hours of the morning:     
  • Going to bed too drowsy (or asleep) – The easiest time for a child to fall asleep is bedtime.  She has social cues, a calming bedtime routine, and even darkness to tell her it’s time.  Plus, her body is releasing melatonin that makes her calm, relaxed, and ready to sleep.  As the night progresses, each time she falls back to sleep is more difficult than the one that preceded it.  This is why it is SO important for your child to fall asleep independently at bedtime!  (That means, it should take her 10 to 15 minutes to fall asleep after you put her in her bed or crib!) If she doesn’t practice at the easiest time, it’s very likely she won’t be able to apply the skill at the most difficult time, 4 or 5 am.
  • Going to bed too late – I know this is counter-intuitive, but keeping a child under 6 up late will only lead to an EARLIER wake up.  As we discussed before, your child’s body releases melatonin as his natural bedtime approaches to help him fall asleep.  (For the vast majority of kids between 6 months and 6 years old, that is between 6 and 8pm.)  Unfortunately, if you miss that time, the body releases cortisol to counteract the melatonin.  That hormone is what causes the overtired behavior that we all know too well (crying, hyperactivity, crankiness, inflexibility, unstable mood, etc).  It also makes is VERY difficult for your child to fall asleep, and it makes it even more difficult for him to fall back to sleep throughout the night.  For a lot of kids, that’s enough to make it TOO difficult in the wee hours of the morning!
  • Staying awake too long between last nap and bedtime – This is very similar to the late bedtime problem.  For children under 15 months who are taking two naps a day, the time between waking up from the afternoon nap and falling asleep for bed should be no longer than 4 hours, and many younger kids are better with an even smaller interval.  Older toddlers and preschoolers who take only one nap can often go a bit longer, but it still should not exceed 5 hours.  Otherwise, you get that cortisol.
  • Nap deprivation – This is another one that goes against a lot of the advice parents get.  Keeping your child awake during the day WILL NOT lead to better sleep!  In fact, it’s the complete opposite; nap deprivation can, and will lead to cortisol release, and completely disrupts nighttime sleep.  Plus, it usually makes for a really unhappy child and parent!
  • Unintentionally reinforcing the early rising – Of course, none of us would do anything to encourage our child to wake up at 4am on purpose!  However, I’ve talked to many parents who go into desperation mode and “do whatever it takes” to get back in bed.  This has includes feeding, turning on the TV, bringing the child to the parents' bed, and giving high interest toys.  When we are half-asleep, this makes perfect sense because it lets us finish sleeping.   Other parents have decided to choose their battles and just get up for the day (and usually provide the aforementioned food or high interest toys).  Unfortunately, both of these strategies end up rewarding our child for waking up early.  Instead, it’s important to treat the early rising wake ups exactly the same way we treat a middle of the night waking.  I usually tell parents to pretend it’s 1am :-)
If you know that none of the reasons above apply to you, you may want to investigate medical conditions that affect sleep such as acidreflux, obstructive sleep apnea, and uncontrolled allergies, eczema, or asthma.  Any of these conditions can make it simply too difficult to fall back asleep that final time of the night.  If you suspect a medical cause for your child’s sleep difficulties, PLEASE consult with your pediatrician!