As a health visitor who has undertaken additional training in child sleep disorders, I often work with sleep deprived parents who have sought support to manage their young child’s sleep problems. Poor infant sleep is recognised to be a leading cause of parental stress and has associated negative impacts on the child.
The most common sleep problems in the under 5 age group are behavioural in nature and include sleep onset association disorder, limit setting disorder or a combination of both.
- Sleep onset disorder is most common in children aged between 6 months and 3 years and describes children who need specific conditions to fall asleep, such as a dummy, being rocked, parental presence or music. This becomes especially challenging for parents as their child needs the same conditions to fall asleep when they wake overnight as they did at bedtime.
- Limit setting disorder occurs in early to mid-childhood, often when the child moves from a cot into a bed, and describes children who refuse to go to bed, either through stalling or making multiple requests, such as needing the toilet, wanting a drink or being fearful, with their parents struggling to maintain consistent boundaries.
- The final disorder comprises of a combination of sleep onset association and limit setting disorders. This most commonly starts as limit setting disorder and can make bedtime a battle ground, with exhausted parents then offering a strategy to their child, such as their presence to help them settle (sleep onset disorder).
When supporting parents with infant sleep issues, it is important to be aware that they may have already have tried strategies at home with limited success and this could potential effect their willingness to try to implement sleep programmes. It is important the health visitor undertakes a full assessment of the child’s sleep issue and works with the family to design a sleep programme.
Sleep programmes or behavioural interventions, such as controlled crying or gradual retreat, along with implementing a bedtime routine, are the recommended approaches to infant sleep problems. I will explore each of these interventions in more detail over the next few blog posts.