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For peaceful sleep, figure out what time to go to bed

Introduction

This article discusses how to help anyone from baby to adult fall asleep and sleep peacefully through the night.  Suggestions in this article are based on the sleep science that it is easier to fall asleep and sleep deeply when simply tired, than when over-tired.  Babies up to age one should have an average of 16 hours of sleep daily for good health (Weissbluth, 2015). Think of these Recommended Daily Hours of baby sleep as the Recommended Daily Allowance of vitamins. There can be some flexibility in hours daily, just as with flexibility in diet on any day. A little too much sleep, like a little too much of a vitamin, won’t do harm. Even so, the body cannot store extra sleep just like the body cannot store some vitamins, like C, and continual sleep insufficiency or sleep deficit, like vitamin deficiency, will keep the body from functioning at peak performance.

Of these Recommended Hours for a baby, about 12 hours should be at night and about 4 hours during the day (approximately a 2.5 hour morning nap and a 1-2 hour afternoon nap). These times are averages and each child is an individual, but the time intervals are useful for planning. The closer a parent gets to the time intervals that match a baby’s sleep cycle, the fewer tears and the easier it will be for the baby to fall asleep.
Sleep must be of good quality, which entails sleeping soundly until the end or near the end of the body’s sleep cycle, preferably with wake-up that is natural. Waking the baby at beginning or middle of sleep cycle is like taking a half-eaten meal away: it might be upsetting as well leaving the body hungry for more. Night or day, sleep at the beginning of a sleep cycle may be more essential than sleep at the end of the cycle. This overview explains how to set the stage for good sleep, and how to help the baby “catch up” on sleep.

Specifics in this article cover how to help parents determine the baby’s sleep hours, and how to help the baby achieve sleep that is high quality — falling asleep quickly and sleeping through the night. It concludes with a section on what to do when the baby does not sleep well despite the parents’ good preparation. This article is based on the science of human sleep, with suggestions derived by induction by generalizing from a small sample size.

Recognize tired vs over-tired

Tired is the natural result of concentration and physical activity, whereas over-tired is continued fatigue and leads to feeling bad. Both can result in baby tears, but the bad feeling is worse for over-tired so the tears are more and it takes longer to fall asleep. Following many of the suggestions here will prevent a baby from going into “over-tired” mode.   When the baby gets a little older, over-tired becomes hard to recognize because many toddlers go into over-drive. They get quite active, but are not able to concentrate well, and have a lot of difficulty falling asleep. Toddlers can – and do – get out of bed by themselves. Handle this by encouraging sleep in secured-chair spots like a stroller, car seat or end-of-meal snooze in a high chair.

Sleep duration

• Most important for parent planning are the baby’s intervals of wakefulness. Because interval of wakefulness is more important than to stick to a set clocks times, it is helpful to remember when the baby woke up to determine the next going-to-sleep time.
• Expect the natural intervals between times asleep to be uneven: nap 1: about 2 hours after morning wakeup, nap 2: about 2.5 hours after nap 1, and bedtime: about 2.5 or 3 hours after nap 2. The first interval tends to be shorter because attention tends to be sharpest in the morning, and therefore the need to relax the brain, and the need for sleep, is greater. The length of the second nap might be a bit shorter than the first nap, and of course the night sleep is much longer than a nap as it runs the duration of multiple sleep cycles.
• There is some flexibility in intervals of wakefulness

o Try not to put the baby to sleep more than about 20-30 minutes late for morning nap, and more than about 45 min late for the afternoon nap or bedtime
o Probably there will be no tears if you lengthen the interval a little, with the baby’s longer wakefulness – this is because cortisol kicks in, especially if the baby is entertained — and the baby will appear wide awake. Tears will come when the baby has difficulty falling asleep on account of the extra wakefulness.

• Definition: When this article suggests that the baby be put to sleep early, that means that the interval of wakefulness should be shorter. So if the baby is showing signs of fussiness in the afternoon, put the baby to bed only 2 or 2.5 hours past afternoon nap rather than waiting 3 hours.
• The intervals of wakefulness will change when the baby is about 11 or 12 months old because the rate of growing is less and the need for sleep is a little less. At this point, the baby will be ready to transition from 2 shorter naps to 1 longer nap in the middle of the time he is awake.
•  How will you know when to make the transition? A well-slept baby might waking up late from an afternoon nap or else wake late from a nap later than usual in the afternoon and then have difficulty falling asleep in the evening (so tears will increase) and the bedtime will be effectively later. Alternatively, the baby will cry more before afternoon and might not fall asleep at all in the afternoon. Either of these happening many days in succession indicates that the baby is ready to move from two naps to one possibly longer nap. It might be better for the child if nap 1 is gradually made later as nap 2 is phased out.

Sleep quality: Wind down before bed

• A baby with food in his stomach typically will sleep better, whether at naptime or evening bedtime.
• It might take about 10-15 minutes to wind down before a nap, and 20-30 minutes to wind down before bedtime. The wind-down time, which is the amount of parent intervention to help the baby relax, depends upon whether the baby is “caught up” on sleep or over-tired.
• Routines around bed time are useful because they are familiar, and therefore relaxing. In addition, a sequence of preparation activities such as putting on pajamas and then reading a book and finally having a bottle while sitting in a particular chair and sets up expectation that sleep time will be next.

Sleep quality: Night interactions with the child

• Try not to turn on a light, talk with the baby, or change diapers during the night. Even extended eye contact can be the equivalent of dialogue with a baby so limit this, too.
• Give slightly larger meals at the end of the end of the day to last until morning, since a night wake-up can be the result of hunger. One or several night wakings can also be a sign of light sleep that results from on-going sleep deficit or just going to sleep too late that day.

Sleep quality: Environment

• White noise is useful to drown out sudden claps of noise that might wake the child.
• A darkened room is less stimulating than a brightly lit room. But children are lulled to sleep in a car during the day when they are tired, so darkness is not strictly necessary.
• A night light is unnecessary: babies do not fear darkness.

Relax rituals to help the baby fall asleep

A baby getting the sleep he needs daily can be woken up, or have a less night sleep without much fuss (this is the meaning of “sleep begets sleep”). Also, when the baby is getting the daily sleep he needs, the relax rituals can be shorter. Conversely, the more over-tired and “wound up”, the longer the relax rituals should be. That is because a baby running a sleep deficit will have more trouble falling asleep and achieving sound, quality sleep. Relax techniques should help soothe a tired child. An over-tired child should be put to bed early several days in succession.   If the child continues to cry, the kindest solution might be to put the child to bed and leave the room. That is because the act of crying will help him fall asleep. Furthermore, going out of the room and re-entering, and leaving again might frustrate the baby and interrupt the good that the baby’s is doing for himself by tiring himself enough to fall asleep. Little ones cannot tire themselves physically by running around, so tiring themselves emotionally through tears will help them fall asleep.

To soothe the baby, here are some things to try alone or in combination:

If you hear light crying, keep the child in bed . . .

• Offer a pacifier, soft toy or blanket
• Smile at him
• Pat him gently or rest your hand on his shoulder
• Say “sh…, sh…, sh…” rhythmically
• Close your eyes while looking at the baby

For stronger crying, pick up child …

• Hug him close to your body
• Make the baby laugh: tickle under the chin and make a funny noise, for example
• Hold baby vertically in case he needs to burp
• Rock in a chair or in his crib, or walk around the room with him
• Hum or sing a “sleep” melody (repeat the same melody so that it becomes associated with sleep)
• Offer a bottle or snack
• Ride in a car or walk in a stroller

As the child becomes sleepy during out-of-bed relax techniques, put him back into the bed and switch to light crying relax techniques. This is because, should the child fall asleep while out of bed, it will probably not be a deep sleep and so the chances of re-wakening the child upon transfer back to bed are high.

Worried that there is too much crying? Test if the child is ill: Return to his bedside and pick him up. If he smiles when you return to the room or is quiet in your arms, it is likely that the cries were to summon you back. But if the cries continue, the child might be ill or otherwise uncomfortable – so try some of the techniques above.

How to handle inevitable problems in sleep quality or duration

A parent or caregiver can help a child fall asleep and stay asleep by shortening the time interval and putting the child to bed early.

For the problem of tears without seeming cause (these might be from feeling bad due to fatigue)

– Make bedtime earlier than the suggested wakefulness interval both because it will take the baby longer than usual to fall asleep and also because he needs to make up sleep. Remember that sleep at the beginning of the sleep cycle is potentially deeper and “worth more” than sleeping later in the morning
– For the problem of skipped or very short nap, or insufficient night sleep, or night sleep with one wake-up with a lot of time awake, or multiple wake-ups
– Make bedtime earlier than the suggested wakefulness interval. Continue with earlier-than-usual bedtime until the baby has made up the sleep deficit – which is usually apparent when the baby wakes in the morning alert and in a good humor.

For the problem of an afternoon nap that lasts long or is too close to bedtime

– Do not wake the child. It’s better to complete the natural sleep cycle (artificial wake-ups can affect sleep quality later in the day), and there is no need to delay bedtime much, if at all. Since the child was making up sleep deficit by sleeping naturally, it will be easier for the child to fall asleep at bedtime than if he had not napped. Try to keep the baby relaxed on the way to bed – no bright lights or conversations – and sleep should come again.
For the problem of delayed bed time.
– If the baby cries at this discomfort, try soothing him so that he can fall asleep himself. Otherwise, just put him into his crib crying. He might cry himself to sleep, but this is useful crying. A baby cannot exhaust himself physically by running around as can a toddler, so the crying will tire him out enough to allow him fall asleep by himself.

How early bedtime affects you: When a child is over-tired and you put him to bed early for the night, he will not necessarily wake earlier (or wake you earlier) than usual in the morning. Early bedtime will give him needed extra time to relax so that he can fall asleep at his usual time and repay his sleep deficit with good quality sleep at the beginning of the night. He might wake at his usual time.

References
Ferber, R. (2006). Solve your child’s sleep problems.
Giordano, S. (2006). The baby sleep solution.
Karp, H. (2015). The happiest child on the block.
Weissbluth, M. (2015). Healthy Sleep Habits, Happy Child, 4th ed.