Breaking sleep habits and encouraging self-settling

Children of all ages seek comfort in movement (rocking, car, carrier), sucking (breast, bottle, pacifier) and closeness (touch, holding, parental presence) to fall asleep, and back to sleep when they wake from a nap or overnight. Although these actions are helpful when satisfying neonatal reflexes during the fourth trimester, a child’s ability to sleep independently can be compromised when these actions become needs for sleep or for comfort ongoing -  commonly presenting as long-term sleep and behavioral challenges.

To understand why children experience difficulty linking sleep cycles unassisted when they are reliant on something to fall asleep; it is important to first understand a baby’s sleep cycle. Babies have a shorter sleep cycle and spend more time in a lighter stage of sleep (REM) than older children or adults. On average, a baby’s sleep cycle is 45 to 50 minutes in length and they cycle through stages of light and deep sleep throughout this time.

Stage one (non-REM): The first 10 minutes of a baby’s sleep cycle is typically when they would be held, rocked or fed into a drowsy state. Their eyes may be closed and they appear relaxed, however, may occasionally twitch and would easily awaken with noise - or if placed into their sleep space.

Stage two (non-REM): Between 10 and 20 minutes, a baby transitions into a deeper sleep. Their heart rate, blood pressure, and temperature drops. Although still considered a light stage of sleep, it becomes much harder to wake a child during this stage. This is often the stage when a breastfed child will fall off the breast, or otherwise appear still and relaxed and parents will transfer their sleeping baby from their arms to the crib. This stage of sleep lasts between 15 to 20 minutes.

Stage three (non-REM): This stage typically starts 20 to 30 minutes after falling asleep. A child will be in the deepest sleep at this point in their cycle and be most difficult to awaken.

Stage four (REM): Approximately 30 minutes after falling asleep, the child cycles into a lighter stage of sleep again and will either a) transition into another sleep cycle on their own (provided they have the skills and opportunity to do so and there has been no immediate change to their environment since they fell asleep) or b) they will wake-up completely and call out for a parent to comfort them back to sleep or bring them out of bed.

There are usually two reasons that will cause a child to wake and be unable to settle back to sleep once they awaken from this light stage at the 30 to 40-minute mark: 1) Environmental changes such as; temperature, noise, and light or 2) They did not self-settle at the beginning of the sleep time – i.e. they were fed, rocked, held or patted to sleep – or fell asleep with a pacifier. If a child is reliant on a particular action (movement or sucking) or object (pacifier or comforter), it is highly likely that they will seek this same action (or ‘thing’) repetitively in order to fall back to sleep day – and night. Consequently, frequent overnight waking and catnapping often ensues.

• Connect. With the exception of medical conditions, at the core of most sleep difficulties is fear – often disguised as insecurity, anxiety, grief, withdrawal and/or aggression which often peak at times of transition, during developmental leaps and milestones, and when a child is faced with change to their sleep routine, habits or patterns. The most effective antidote to fear is to create safety through connection tools such as; play, Special Time, and listening. 
• Play. Promoting laughter through play builds trust, connection, and confidence; consequently, releasing stresses, fears, and tensions from the day – which may otherwise cause our children to wake overnight or be less adaptable to changes in routine. Ideas include pillow fights, jumping on the bed, hide and seek, role play with toys and horseback rides.
• Introduce Special Time into your daily routine. Remember; quality, not quantity. Just five to 10 minutes per day of child-led Special Time can work wonders to build connection, trust, and confidence for children of all ages - effective in reducing off-track behavior during the day, and disturbed sleep overnight. This is also a great way to help your child feel safe when making changes to their sleep routine, helping them transition to independent sleep with greater ease and cooperation.
• Follow an age-appropriate routine to avoid overtiredness. Any settling attempts will be futile with an overtired baby, especially toward the end of the day. The same applies if your baby is not tired enough. Either end of the spectrum, they will require more intervention from you to fall asleep, and back to sleep. A well-rested child will rarely fall asleep on the breast or bottle and may, in fact, become more overstimulated if they are rocked, patted or held.
• Try an earlier bedtime. A bedtime between 6:30 pm and 7:30 pm is ideal for most ages. Bringing feed times earlier (ideally 20 to 30 minutes before bed) can also help to remove the feed-to-sleep association.
• Introduce positive sleep associations. Regular wind-down time with consistent sleep cues such as a dark room, swaddle (especially for babies under three months), a sleeping bag and white noise will help replace you as the main sleep association.
• Optimise the sleep environment. This can work wonders for sleep by making your child feel comfortable, safe and secure. 1. A dark room signals to the brain to release melatonin (sleep hormone) and helps avoid distraction (babies will keep themselves awake looking around if their room is too light); 2. Most children will wake prematurely or have difficulty settling if they are cold, so maintaining a room temperature between 19-22 degrees is optimal; 3. White noise is also beneficial to block out any external or household noises that may otherwise distract your child from falling asleep, or wake them prematurely.
• Place your baby down awake to encourage self-settling. All babies wake overnight, the difference being their reliance on you to get back to sleep, or whether they have the skills to fall back to sleep on their own.
• Try gradual withdrawal. You don’t need to stop feeding, rocking, patting or holding entirely ‒ these can be great comforting tools at times ‒ but if you wish to encourage self-settling, try gradually reducing the degree to which you assist your child to fall asleep, and be sure to revoke your intervention slightly every three days (as this seems to be the “magic” amount of time where habits can form). An example of this may be to transition from rocking to holding without movement (day one to three), to a hand resting on their tummy or side in their crib (day four to six), to kneeling beside their crib with just a hand on the mattress beside them without touch (day seven onward).
• Be prepared to listen. Babies and children will rarely give up their favorite things without a protest. Often, when we take away a child's control pattern (or sleep need), they will cry intensely to express the discomfort and fear, which is inextricable with breaking sleep habits  - irrespective to whether we maintain a loving presence beside them. Listening to your child as they cry in your arms - or as you remain at their bedside offering reassurance or alternative comfort communicates that they are safe, loved and accepted. Provided that a child's primary needs have been met, effective listening enables a child to heal and recover from heavy feelings - both past and present (which are inescapable when breaking sleep habits). Listening enables children to adjust with greater ease and resilience at times of change and transition, improving sleep ability, optimising physical and cognitive functioning, and restoring overall confidence and their ability to cope with everyday stress.
• Choose your timing wisely. Commit to changing such patterns when you have support from your partner/spouse/family, your calendar is relatively free of social engagements and you and your child are in a good space physically and emotionally. Avoid making these changes when your child is unwell, or when they are already feeling insecure as an outcome of other life transitions e.g. starting childcare, introducing a new sibling, or toilet training.
• Communicate all changes with your child in advance to gain their cooperation. Communicate precisely what you will be doing on that night and how their routine will be different. Acknowledge any feelings of uncertainty that your child may have as they arise, and encourage the release of any fear, sadness, frustration, dependency and/or grief they may experience during this transition by listening.
• Persistence pays. Babies are fast learners and more adaptable than we give them credit for ‒ you may just be surprised at how uncomplicated this process can be. In my experience, it is usually the parents who are more attached to the behavior than the children!