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Daily Dose

Pregnancy & Sleep

1:15 to read

Why is it that as you get further into your pregnancy you sleep less?  I am sure that it is just a factor of being “bigger” and as one mother said to me, “having another human inhabit your body”. It is often hard to find a comfortable position to sleep in, and even if you do, the baby may not want to stop moving when it is your bedtime.

But, I also really think this is all in God’s plan to get a mother (and father who often says his wife keeps him up) ready to be new parents. It is just foreshadowing of the weeks to come when you bring that newborn home from the hospital.  You have already learned to “survive” with less sleep.

The first few weeks at home with that most precious baby is really just about survival. I don’t care what you read or how many classes you take...there really are no “rules” or “tricks” to get thru the first 6-8 weeks of being a new (or seasoned) parent.  

I tell my parents the only “rule” is that the baby MUST sleep on their BACK..other than that try to do the feed, play, sleep routine that you think will just happen, but know at times your baby just does not want to go to sleep when you want them to!! They are not abnormal and you are not a “bad” parent.....they are just newborns with developing brains and sleep cycles. I promise, this too shall pass and longer sleep cycles will come.

So, if you are awake one night toward the end of your pregnancy and reading this, look at the bright side.  Your body is just getting you even more prepared to be a “great” parent....you already know how to survive with interrupted and less sleep.      

Daily Dose

Sleep & Your Baby

1:30 to read

Once a new baby joins a family one of the first questions I am often asked is, “when will my baby sleep thru the night?”.  SLEEP is one thing that all parents crave and for one reason or another many parents with infants over 6 months of age, complain that their baby is still not “sleeping through the night”. If your baby or child is not sleeping well, that typically means that parents are having disturbed sleep as well.   

By 6 months of age a baby should be able to self soothe and fall asleep on their own and the majority of babies are sleeping 10-12 hours thru the night as well.  After many years of practicing pediatrics and dealing with my own children’s sleep issues, I spend quite a bit of time with my patients discussing healthy sleep habits.  Like most things, it is easier to start off with good habits and bedtime routines.

So….when parents come in at the 6 month visit and are concerned about their baby’s sleep and awakenings I typically discuss “letting their baby cry it out”. This advice is met with varying responses.  Some parents are ready to get a good night’s sleep and will do “anything”, while others think I am “a mean doctor” and would “never let their baby cry”.  Like most things it is not always black and white and that is why we have chocolate and vanilla.  But, in my experience, the sooner you deal with sleep issues the faster they seem to resolve…

A recent article in Pediatrics should now reassure parents that they are not “harming their baby” by letting them “cry it out” which is called graduated extinction.  The study done in Australia found that infants whose parents let them “cry it out” fell asleep 13 minutes sooner than a control group and woke up less often during the night, and had no significant differences in stress levels (based upon salivary cortisol levels). The study also found no long term effects on parent-child attachment.  All good news for some sleepless parents who are considering this method to get their baby to sleep through the night. 

The researchers also looked at another behavioral sleep training intervention called “bedtime fading” which some feel is a “gentler” method of sleep training. In this case a baby’s bedtime is delayed with the thought that a sleepier child will fall asleep faster and may not cry as long.  This may be an easier method for some parents who continue to be anxious about “graduated extinction”.  This too showed that infants fell asleep sooner than controls but they showed no change in the number of nighttime awakenings.

Bottom line, sleep is important for the entire family ….all ages.  This article should hopefully go a long way in reassuring sleep deprived parents that a baby’s cries are not harmful and may actually get everyone to sleep faster, longer and more peacefully….you just have to believe the research and hang in there. 

Daily Dose

Kids Who Snore

1.30 to read

Does your child snore?  If so, have you discussed their snoring with your pediatrician.  A recent study published in Pediatrics supported the routine screening and tracking of snoring among preschoolers.  Pediatricians should routinely be inquiring about your child’s sleep habits, as well as any snoring that occurs on a regular basis, during your child’s routine visits.  

Snoring may be a sign of obstructive sleep apnea and/or sleep disordered breathing (SDB), and habitual snoring has been associated with both learning and behavioral problems in older children. But this study was the first to look at preschool children between the ages of 2-3 years.

The study looked at 249 children from birth until 3 years of age, and parents were asked report how often their child snored on a weekly basis at both 2 and 3 years of age.  Persistent snorers were defined as those children who snored more than 2x/week at both ages 2 and 3.  Persistent loud snoring occurred in 9% of the children who were studied.

The study then looked at behavior and as had been expected persistent snorers had significantly worse overall behavioral scores.  This was noted as hyperactivity, depression and attentional difficulties.  Motor development did not seem to be impacted by snoring.

So, intermittent snoring is  common in the 2 to 3 year old set and does not seem to be associated with any long term behavioral issues. It is quite common for a young child to snore during an upper respiratory illness as well .  But persistent snoring needs to be evaluated and may need to be treated with the removal of a child’s adenoids and tonsils.

If you are worried about snoring, talk to your doctor. More studies are being done on this subject as well, so stay tuned.

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Teens Are Not Getting Enough Sleep

2:00

These days, teenagers are running on empty. A new report from the U.S. Centers for Disease Control and Prevention (CDC,) says nearly 58 percent of middle school students in nine states and almost 73 percent of high school students across the country don’t get the recommended amount of nightly sleep they need.

A lack of quality sleep could also have a negative effect on their health as well as school performance, the report states.

"Children and adolescents who don't get enough sleep are at increased risk for obesity, diabetes, injuries, poor mental health, and attention and behavior problems, which can affect them academically," said report author Anne Wheaton, a CDC epidemiologist.

How much sleep should adolescents get at night? According to the American Academy of Sleep Medicine, children aged 6 to 12 need nine to 10 hours of sleep a night, while teenagers aged 13 to 18 should get at least eight hours per night, Wheaton said.

A big part of the problem is that teens stay up late using smartphones and computers, playing video games or watching TV, said Dr. Thomas Kilkenny. He is director of sleep medicine at Staten Island University Hospital in New York City.

Wheaton is also a proponent of schools starting later to help teens get the sleep they need.

In addition, parents can help their children practice good sleep habits. "These are things like having consistent bedtime and rise time, and that includes not just during the week, but on the weekends," Wheaton said. "That's good for everybody -- the adults, too."

Studies have shown that teens that have a set bedtime get more sleep than those that don’t. A media curfew is also recommended by Wheaton to cut down on the amount of light kids are exposed to before bed.

"Adolescents who are exposed to more light in the evenings are less likely to get enough sleep, and using media can contribute to having later bedtimes," she explained.

If your teen thinks that he or she can make up their lack of sleep on the weekend, Wheaton says that ‘s not what typically happens. If they sleep in and then go to bed late on Sunday night, they wind up sleep-deprived on Monday morning when they have to get up early, and the cycle starts again, she said.

According to the National Sleep Foundation, teens that get too little sleep can be become limited in their ability to learn, listen, concentrate and solve problems. It can also make them more prone to acne and other skin problems. When explaining how critical sleep is, you can let them know that they may start forgetting important information like names, numbers, homework or a date with a special person in their life – and that, could get them in real trouble!

Story sources: Steven Reinberg, https://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/sleepy-u-s-teens-are-running-on-empty-730521.html

https://sleepfoundation.org/sleep-topics/teens-and-sleep

 

 

Daily Dose

Why Babies Should Sleep in Their Own Bed

The risks of accidentally suffocating an infant while bed sharing are real and too frequent.I have discussed the dangers of co-sleeping with your infant in a previous blog. The issue was brought to mind again today when I read an article stating that four infants had died in 2009 within 6 weeks of each other in Wisconsin, all who had been co-sleeping with an adult.

The idea of " bed sharing", which in my mind is not the same as co-sleeping, may sound like a great idea for snuggling and bonding with that precious newborn, and especially in those first months when parents are so terribly sleep deprived. Unfortunately, the risks of accidentally suffocating an infant while bed sharing are real and too frequent. No one expects to roll over and suffocate their infant, but we all toss and turn while sleeping and may not realize that you have rolled over on the your-baby. The whole incident is silent, but may be deadly, as the your-baby suffocates underneath the parent or when pushed up against a pillow or headboard. The risk is even greater on a couch or futon. Other risk factors with bed sharing include the use of alcohol or other drugs, which also may cause a deeper sleep. You may not even realize that your infant is in bed with you, and many moms may still be taking a pain medication in the first week's post-partum. The American Academy of Pediatrics officially recommends against bed sharing, but does endorse having the infant in a bassinet (with a firm mattress, and a light blanket) right next to the mother's bed to promote bonding and breastfeeding. But once fed, the your-baby should be returned to the bassinet and sleep on their backs. No tummy sleeping, even if you are convinced that your infant "prefers" that position. The risks are too great to keep that sweet your-baby in the bed. So....back to sleep and in the crib or bassinet. There are plenty of other opportunities to snuggle with that newborn! That's your daily dose, we'll chat again tomorrow. More Information: The Dangers of Co-Sleeping With Your Baby More Information: American Academy of Pediatrics

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Your Baby

FDA Warns that “Sleep Positioners” Are Dangerous for Infants

2:00

The U.S. Food and Drug Administration (FDA) issued a warning to parents and caregivers of infants about the dangers of using sleep positioners. The products are also known as “nests” or “anti-roll” supports.

The two most common sleep positioners include two raised pillows or "bolsters" attached to a mat. Babies younger than 6 months old are placed on the mat between the pillows to keep them in a specific position while they are sleeping. 

But putting babies to sleep on or near soft objects, such as positioners, toys, pillows and loose bedding, increases the risk for accidental suffocation and Sudden Infant Death Syndrome (SIDS), the American Academy of Pediatrics (AAP) says. 

Some babies have been found in dangerous positions next to a positioner they had been placed in for sleeping. Federal officials also reported that infants have died after being placed in one of these products. In most cases, the infants got out of position, rolled onto their stomachs and suffocated, the FDA explained.

The FDA and infant heath experts say that babies should always be put to sleep on their backs on a firm, empty mattress, preferably in a crib.

Babies should never sleep with a positioner, pillow, blanket, sheets, a comforter or a quilt, the FDA advised. Appropriate clothing keeps babies warm enough while they are sleeping.

Some sleep positioner companies claim that their products prevent SIDS. But the FDA noted it has never cleared an infant sleep positioner that promises to prevent or reduce the risk of SIDS since there is no scientific evidence to back up this claim.

Some of the companies also promote their products as helpful for easing gastroesophageal reflux disease (GERD), a condition that causes stomach acids to back up into the esophagus. Others suggest their positioners help prevent flat head syndrome (plagiocephaly), a deformation caused by pressure on one part of the skull.

While it’s true that the FDA has previously approved some of these products for GERD and flat head syndrome, the government agency has asked these companies to stop marketing these items because it feels that the risks outweigh the benefits.

Every year about 4,000 infants die unexpectedly while sleeping due to suffocation, SIDS or another unknown cause, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The FDA urged parents and caregivers to talk to their child's doctor if they have questions about how to make sure their baby sleeps safely.

Story source: Mary Elizabeth Dallas,  https://consumer.healthday.com/kids-health-information-23/sudden-infant-death-syndrome-sids-news-643/sleep-positioners-a-danger-to-baby-fda-727180.html

 

Daily Dose

Sleep

1:30 to read

Bedtime routines are very important!  Many kids are getting up earlier and earlier for some sort of practice (often before the sun comes up) so going to bed on time makes everyone in the house wake up in a better frame of mind and mood for the day ahead.   

 

Bed time battles are typical for a toddler who has learned to ask for “one more book”, or for the elementary school child who swears “they are not tired” but who falls asleep during bath time.  But who knew there would be even more battles with teens and their electronics??

 

Numerous studies have shown that electronics disrupt sleep.  But, trying to convince your adolescent son or daughter that they need more sleep is a daily struggle. While the studies on sleep recommend that teens get between 8 to 9 hours of sleep, most teens are not even close to that!  (90% report less than 9 hours).

 

During the summer teens keep all sorts of crazy hours and many get the majority of their sleep during what we would consider to be “daytime” hours…as they go to bed at 2 or 3 am and sleep past noon.  So, the minute that school resumes after summer vacation they already have sleep issues trying to “re-adjust” their biological clocks…and then you throw in the use of electronics right before bed and you have the perfect storm for sleep deprivation and daytime fatigue.

 

The American Academy of Sleep Medicine found that “adequate sleep duration on a regular basis leads to improved attention, behavior, learning, memory, emotional regulation, quality of life and mental and physical health”.  There isn’t a parent around who doesn’t want happy, rested, studious and healthy kids…of all ages. If you throw in less moodiness for teens who get more sleep most parents would sign their teens up on the spot.

 

Why do we all need to disconnect from electronics in order to have better sleep?  That blue light from the electronic screen…of any shape for or fashion works against sleep. It signals the brain to suppress melatonin secretion, which is the hormone that makes us get sleepy at the end of the day. The light from the screen also confuses the brain of it being daytime and increases alertness which may delay sleep…even after turning off the screen.

 

Try this new family rule, parents included, that all screens (phones, tablets, computers) will be off and docked outside of the bedroom at least 30-60 minutes prior to bedtime. While your teen may insist that they won’t use the phone, it is often too tempting to not “cheat” once you are in your own room and asleep. 

 

While this may initially be hard to enforce, once it is the family routine it becomes less of a battle. Everyone will have an easier time falling asleep and staying asleep, and maybe get a few more hours of “shut eye”.    

 

 

Daily Dose

Getting Your Baby to Sleep!

1:30 to read

Did you know one of the biggest Google internet searches for parents revolves around “how do I get my baby to sleep?”  I guess that any new parent in the middle of the night is online searching for “THE ANSWER”, so of course you “Google it”!

Now that we are grandparents and the baby is about 6 weeks old (although technically she is a week old, as she was 5 weeks early) my son is also looking for answers on the internet to that same question....how to make her sleep, so I can too! He even asked me if their was “magic” to this?

If only there was an answer on Google or in any book. It just takes time and every baby is different.   I guess there are some babies that sleep through the night from the time they get home from the hospital, but I have never seen one.  I think some parents just forget that at some time or another they were up at night with a newborn.

A newborn baby does not understand circadian rhythm and they are really not “trying” to keep parents up at night.  It takes weeks for a newborn to even begin to have some “routine” to their day and I try never to use the word “schedule” when discussing a newborn.  A baby is not a robot, they do not eat every 3 hours and then sleep for 3 more before eating again. They are “little people” and their tummies sometimes need to eat in 2 hours and then later it may be 3 hours before another feeding.  Don’t you sometimes eat an early lunch one day and a later lunch the next? 

But by trying to awaken the baby throughout the day and offering a feeding every 2-3 hours you will hopefully notice after several weeks that your baby is eating more often during the day and suddenly may thrill you and sleep 4 hours at night. it just takes time....YOU cannot make it happen.  I tease new parents that awakening a newborn during the day and prayer is about all you can do....all babies do eventually sleep, but it may not be right after you get them home from the hospital...think several months (as in 2-4) and you will be happy if it happens sooner.

Lastly, with all of the tech in the room, don’t pick up your baby in the middle of the night if they are just “squirming” around. Babies are notoriously loud sleepers and if they are not crying let them be and you may be surprised that they arouse and went back to sleep. If your baby cries you absolutely go get them and console them and feed them too if it is time. An infant should not be left to cry. 

This too shall pass and sleep will come, but there will be new stages down the road that will keep parents up at night, of that you can be assured. Comes with the territory.

Your Teen

Is Technology Sabotaging Teen's Sleep?

2:30

For the first time in history, we have adolescents that have never known an age without cell phones, tablets and computers. These marvels of technology have been a part of their lives from birth and they spend an extraordinary amount of time engaged with them. 

All their texting, posting and web surfing is robbing teens of the much needed sleep they need to think and function clearly, according to a new study.

Experts say teenagers need at least nine hours of sleep a night to be engaged and productive during the day. Anything less can cause daytime sleepiness and interfere with school or daily activities.

How much sleep is today’s teen actually getting? Researchers analyzed a pair of long-term, national surveys of more than 360,000 eighth- through 12th-graders to find out.

One survey asked 8th-10th- and 12th-graders how often they got at least seven hours of sleep. The other asked high school students how long they slept on a typical school night.

In 2015, 4 out of 10 teens slept less than seven hours a night. That's up 58 percent since 1991 and 17 percent more than in 2009 when smartphone use started becoming more mainstream, the researchers said.

"Teens' sleep began to shorten just as the majority started using smartphones. It's a very suspicious pattern," said study leader Jean Twenge, a psychology professor at San Diego State University.

The more time students reported spending online, the less sleep they got, according to the recent study published in the journal Sleep Medicine.

Teens that were online more than five hours a day were 50 percent more likely to be sleep-deprived than classmates who limited their time online to about an hour.

Studies have shown that the light emitted by smartphones and tablets can interrupt the body’s natural sleep –wake cycle.  The bright light can make the brain think that it’s daylight and time to stop producing melatonin, a hormone that cues to the body to sleep. By disrupting melatonin production, smartphone light can disrupt your sleep cycle, almost like an artificially induced jet lag. That makes it harder to fall and stay asleep.

If smartphones, tablets and computers are one of the causes for teens’ sleep deprivation, experts agree that moderate use can help change that. Everyone -- young and old alike -- should limit use to two hours each day, the researchers advised in a San Diego State University news release.

It’s not only the light from smartphones that can disrupt your ability to fall asleep, but the content you’re reading. Social media has a way of pulling teens into a discourse or “following” marathon that can eat up those precious hours of rest.

The best solution for electronic sleep deprivation is to make sure your teen puts his or her phone away and shuts down the tablet or computer at least an hour before bedtime.

Story sources: Mary Elizabeth Dallas, https://teens.webmd.com/news/20171020/smartphones-screens-sabotaging-teens-sleep

Kevin Loria, Skye Gould, http://www.businessinsider.com/how-smartphone-light-affects-your-brain-and-body-2017-7

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