Nap resistant toddlers
A sleep association is an action that helps your baby to fall asleep. It is usually the last thing that your baby remembers before drifting off and acts to signal that it is time to sleep. Sleep associations can be both positive and negative and can often be hard to change.
To fully understand sleep associations, it is important to understand exactly how babies sleep.
When babies get to around 4-6 months old, the way in which they sleep drastically changes. Newborn and very young babies find falling asleep easy, as they go straight from being awake to being asleep. As they get older, falling asleep becomes harder. They are no longer able to ‘flip a switch’ and go from awake to asleep in an instant; they now have to battle through many different sleep stages in order to get into a deep sleep. As they cycle through these stages, they re-enter a lighter sleep phase again, which is usually when night awakenings happen. (see graph below)
As adults we sleep in exactly the same manner, except we very rarely remember these night awakenings as we usually just roll over and go straight back to sleep.
The difference between how we sleep as adults and how children sleep is largely down to how we fall asleep. When we fall asleep, the last thing we remember is lying down in our comfortable warm bed and gently drifting off. This means that when we enter that brief awake-period at the end of one sleep cycle and the beginning of another, we are in exactly the same place that we fell asleep. This means that our brains can carry on sleeping without any need for alarm.
In babies, however, this isn’t so straight forward.
Imagine you fell asleep in your bed as normal, and then woke-up on the sofa. Your brain would immediately switch back into a fully-awakened state of alarm as you tried to figure out how in the world you ended up downstairs. This is almost exactly what happens to babies. If your baby is rocked to sleep, then the last ‘association’ that they had before falling asleep is rocking. When the baby then comes to the top of their sleep cycle (usually around 45-90mins after first falling asleep) they will experience this brief awakening. When they wake, they are no longer being rocked. This causes them to wake fully and panic as their brains try to figure out where they are and why they’re not still being rocked. This is where the issue with sleep associations occurs. This baby’s sleep association is not sustainable, and as a consequence, they are experiencing frequent waking throughout the night.
In order to change a child’s sleep association, it is essential to fully identify what that child associates with sleep. This sounds really obvious and straightforward, but often it can be quite complex. I always ask my clients to think about both their physical actions (rocking, stroking, shhh-ing, feeding etc) and any external factors (i.e. things in the child’s room). Often things such as nightlights or snuggling with a certain teddy/blanket get overlooked as sleep associations, when actually they are just as important. I also ask my clients why they want to change an association; Is it unsustainable? Has the child grown out of a certain phase (like needing to feed during the night)? Is the association having a negative effect on the child and their family? Etc.
Once we have established what we need to change and why we need to change it, we can look at how.
Changing a sleep association can be done in a number of ways and can be done as quickly or as slowly as you feel comfortable with. It is important to keep in mind that, as is often the case with changing something that a child is reliant on, the quicker you make the change the higher the chance of tears. I like to look at making changes as a journey; we know where we are now at the beginning and we know where we want to end up; the tricky part is figuring out what comes in the middle. As a sleep consultant using gentle sleep techniques, I work in a holistic manner to decipher what the best approach is for each child individually. It would be almost impossible to outline a ‘one-size-fits-all’ method as each child responds differently to change and there can often be hiccups along the way. To put what I do as simply as possible, I break down the issue into little manageable, bitesize, chunks and focus on each little chunk at a time.
Case Study – Baby A
baby A is 10 months old and will currently only fall asleep when being shhh-ed by his mum or dad. He will happily fall asleep in his cot but wakes frequently during the night. Baby A is a healthy baby with no health issues and no longer needs night feeds. He wakes every 90 minutes and will only re-settle when he is shhh-ed although doesn’t require physical comfort.
For baby A our baby steps could look a bit like this…
Beginning- Shhh-ed to sleep every time he wakes (every 90mins).
Step 1– Introduce pink noise* to be played all night, but still use shhh-ing when waking.
Step 2- Reduce the length and time of shhh-ing at each wake up.
Step 3- Reduce the length and time of shhh-ing even more so that there are longer gaps of just pink noise.
Step 4- Very quietly shhh when he wakes using long gaps of just pink noise.
Step 5- Leave baby A for a few moments when waking before quietly shhh-ing if needed.
End- Baby A is able to fall back to sleep easily using only the pink noise as comfort.
*pink noise is more effective than white noise at achieving deeper sleep (although the sound exactly the same).
The above is an incredibly simplified example but, hopefully, it shows how a sleep association would be changed.
Personally, I find sleep associations fascinating and love working with clients to change and improve them. As mentioned above, there is absolutely no easy way to change a child’s sleep association and it can be hard work for parents, sometimes involving a few days of less sleep before improvement. My role as an infant sleep consultant is to help parents make this difficult change, to be there to offer advice and support, and to ensure that the child is happy and comfortable at all stages throughout the process.
If you have any questions at all please do feel free to contact me at elizabeth@elizabeththompsonsleep.com or give me a call on 07725 650 551
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