AN EXPERT GUIDE TO TODDLER SLEEP FOR HEALTH CARE PROFESSIONALS
Healthcare Professionals play an important part in helping parents of toddlers (1-3 years) establish healthy and restful bedtime routines
- Stress the importance of planning. Parents must establish a bedtime routine that sets out where bedtime happens as well as how, and for how long.
- Parents must remain consistent. Toddlers are adept in finding ways to stretch bedtime out for hours. When parents establish new routine, they must stick to it.
- Patience is essential. Getting a toddler’s co-operation at bedtime can take a while. But when parents get the timing right and stay consistent, success is possible.
THE FRONTLINE ISSUES Dealing with a strong-willed toddler determined to practice the word ‘no’ at bedtime is a strain for any parent. Healthcare professionals regularly hear of the difficulties bedtime struggles create within a family.
Typical bedtime strategies employed by toddlers include:
- Calls for extra attention
- Toilet runs
- Looking for drinks
- Looking for another ‘last’ cuddle or story
- Requesting that one parent stays
- Requesting that the other parent comes back… Parents report that their toddler’s bedtime sleep routine can take up to three hours. This is a serious problem that your expertise can help resolve.
1. Overtiredness- The solution: Encourage parents to aim for their toddler to be asleep again within four-to-five hours of their daytime sleep finishing. Within this time frame, allow for 20-30 minutes of the bedtime routine and a further 20-30 minutes of falling-asleep time. It may take a while for this routine to fall into place, but this is where they need to begin. If parents spot sleep signals earlier in the evening, they should follow them. This is particularly important for parents whose toddlers have recently given up their daytime sleep, or who routinely wake at night. A very early bedtime (6pm onwards) can provide a great temporary solution to the night-time battles. A toddler should be asleep again within four-to-five hours of the end of their daytime sleep.
2. Location, location, location- The solution: Recommend that the room is dark, cool and comfortable for sleep. Remove distractions that may over-stimulate the toddler, such as items hanging from the ceiling or too many toys. The entire bedtime routine should happen in the bedroom. A dim environment helps enhance the sleep hormone melatonin.
3. Continuity- The solution: Suggest parents follow the same sequence of events every night. This will ensure continuity from a behavioural context and reduce last minute objections. Suggest a specific bedtime area in the bedroom where the bedtime routine should happen. For example they could put down a rug, cushions, fairy lights, or have a tent or a canopy. The bedtime routine must happen outside of the bed. Only when it is time to sleep should the child then get into bed and pull up the covers. If the bedtime routine is provided on the bed, this can cause an objection to the parent leaving. This can upset the toddler and in turn create inconsistent behaviour on the parents’ part. Keeping the routine separate from the going-to-sleep space promotes the ability to leave while the toddler is awake.
QUICK TIP FOR PARENTS
Be warned! A toddler who is parent-dependent at bedtime can be more inclined to wake at night than one who is not.
FOUR FACTORS THAT CAN IMPACT ON NIGHT-TIME SLEEP
In addition to these issues, there are other factors relating to a toddler’s day which can contribute to night-time sleeping problems. Discuss with parents whether any of these are at play in their situation.
- Adequate nutrition? The child may not sleep well if they are not having three balanced meals a day, with the required milk and water and healthy snacks that you advise.
- Too much milk? An over-reliance on milk directly before bedtime can often result in biologically unnecessary night-time feeds. This can reduce a toddler’s appetite for solid food during that day, which only further increases the cycle of night-time activity…
- Too much screen time. Too much exposure to television and electronic media throughout the day (and specifically within the final couple of hours before bedtime) can make it hard for a toddler to switch off and get enough deep, restorative sleep.
- Adequate activity? A toddler who doesn’t get enough outside activity and fresh air may not sleep well. Recommend a minimum of an hour a day.
QUICK TIP FOR PARENTS
An hour’s activity and fresh air during the day go a long way to helping a toddler sleep.
HELP PARENTS WIN THE BATTLE
Use a light timer. A timer signalling the end of the bedtime routine can be a positive way to tell a toddler that it is now sleep time.
Plan the process. Suggest that parents get their toddlers involved in the planning of the bedtime process. They could make a booklet, photo album or check list that plots the routine one-by-one:
Sample Check List
‘My name is _____ and at bedtime I….
- Have a drink downstairs
- Clean my teeth and have a bath
- Go to my bedroom
- Put on my sleep clothes
- Read two books
- Chat about my day & have a cuddle
- Turn out the lights & climb into bed
- Go to sleep!
Suitable articles for parents on this topic are available at www.toddlebox.ie/behaviour