pediatrics
Sleeping Behaviors in Infants and Children
Treatment
Options for parents Measures to help children fall asleep on their own The clinician’s role in treatment is to present explanations and options to parents, who must implement changes to get the child on an acceptable sleep schedule. Approaches vary with age and circumstances. Infants are often comforted by swaddling, ambient noise, and movement. However, always rocking infants to sleep does not allow them to learn how to fall asleep on their own, which is an important developmental task. As a substitute for rocking, the parent can sit quietly by the crib until the infant falls asleep; the infant eventually learns to be comforted and to fall asleep without being held. All children awaken during the night, but children who have been taught to fall asleep by themselves usually settle themselves back to sleep. When children cannot get back to sleep, parents can check on them to make sure they are safe and to reassure them, but children should then be allowed to settle themselves back to sleep. In older children, a period of winding down with quiet activities such as reading at bedtime facilitates sleep. A consistent bedtime is important, and a fixed ritual is helpful for young children. Asking fully verbal children to recount the events of the day often eliminates nightmares and waking. Encouraging exercise in the daytime, avoiding scary television programs and movies, and refusing to allow bedtime to become an element of manipulation can also help prevent sleep problems. If stressful events are the cause, reassurance and encouragement are always ultimately effective. Allowing children to sleep in their parents’ bed in such instances almost always prolongs rather than resolves the problem. 