Alice Gregory is a highly respected expert on sleep throughout development. She has been researching sleep for almost two decades and has published more than 100 articles on this and associated topics. She completed her undergraduate studies at the University of Oxford, her PhD at the Institute of Psychiatry, King’s College London, and is currently a Professor at Goldsmiths, University of London.
Does a parent’s perspective determine whether they think their infant has a ‘sleep problem’?
In this extract Alice Gregory, author of ‘Nodding Off’ and sleep expert, explores various factors effecting a baby’s sleep:
While suffering the challenges of night waking, parents of young infants can be tormented further by the way their children’s sleep changes from one night to the next. Night-to-night variation can make the weather look like a paragon of stability. When a parent joyously declares that their young infant has started ‘sleeping through the night’, we have to wonder whether it will last.
One night of uninterrupted sleep doesn’t mean that disturbed nights are a thing of the past, just as a ray of sunshine in March doesn’t forecast a glorious summer.
Anything that can cause pain or discomfort can affect infant sleep. This translates to potentially problematic sleep for any child who has an upset stomach, headache, slight cold, earache, or arm ache from an injection, plus any kid with a wonky nappy, a Babygro that was washed with (or perhaps without) fabric conditioner, or who is placed in a room that’s a little too hot or cold for their liking.
Thinking about it in that way, it seems a miracle that babies ever sleep. Just as our eating habits change day-to-day depending on our activity, we shouldn’t necessarily expect our children’s sleep quality to remain identical each night.
We know that infants are likely to differ in terms of their sleep, which can lead to great parental smugness or to desperation. But when does an infant really have a sleep problem that needs to be addressed? Certainly, a large proportion of parents think their child has a sleep problem. Corroborating this, when parents of babies and toddlers were asked if their child had a sleep problem, a big proportion said yes. This ranged from 11 per cent of those asked in Thailand, to a whopping 76 per cent of those asked in China. But defining sleep problems in babies and toddlers is not always simple.
Imagine an infant who refuses to fall asleep unless they are being cuddled and who wakes up once during the night wanting a hug. Is that a problem? The answer will depend on whether parents want and expect to engage in this.
Some might accept or even like this approach to infant sleep. Ask them if this ritual is a problem and you’ll get a resounding ‘no!’. Others might hope and expect to put their children in a cot and not see them until the morning. They will find a child’s reluctance to settle alone frustrating. Those in the latter camp may find this experience torturous and flag this to friends and paediatricians as a significant problem. Yet the infant has the identical pre-sleep preferences in both scenarios.
AGE IS IMPORTANT WHEN THINKING ABOUT SLEEP TOO. A BABY WHO SLEEPS THROUGH THE NIGHT MAY BE A PARENTS’ DREAM, BUT IF THAT BABY IS NEWLY BORN THIS COULD BE WORRYING.
Different responses to infant sleep are likely to be linked to different approaches to parenting, and perhaps even to life more generally. These discussions result in furious debate. Some parents may be led by instinct, whereas others might want to supplement this with established techniques. It is likely that both groups are making their decision based on what they consider to be in the best interests of their families.
Culture is important here too, and examples of differences include co-sleeping (or sleeping side-by-side or in the same room), which is more common in certain countries than others. For example, in one study of children up to three years old, co-sleeping occurred in fewer than one in ten New Zealanders, but more than eight in ten of those from Vietnam.
Bedtime was also found to show cultural variation, with average bedtimes of around 7.30 p.m. for children from New Zealand and around 10.15 p.m. for those from Hong Kong. As reported in The Atlantic, even the noise we make when snoring is described differently depending on the culture: gu gu in Japanese, chrrr in Polish and de reu rung in Korean.
Age is important when thinking about sleep too. A baby who sleeps through the night may be a parents’ dream, but if that baby is newly born this could be worrying. Certainly, small infants need to wake up: their bellies are tiny and without waking for milk they could become weak and dehydrated. Even older infants and children do not need to sleep for excessively long periods and doing so may at times suggest that there is a problem. Guidelines on how long people of different ages should sleep wisely incorporate the idea that one child’s need may differ from that of another.
Perhaps there is a reason to move away from thinking of certain aspects of infants’ sleep as heroes and villains. There are understandable reasons why infants sometimes refuse to sleep when put down and left to their own devices. Certain theories focus on the need to feel safe in order to sleep, with the common idea that we can ‘sleep again’ after a threat is no longer present.
It certainly is unwise to fall asleep if we don’t feel safe. Sleep makes us vulnerable – our vigilance is low and we are unlikely to spy a lion creeping up, the ceiling falling down or, more likely, an attack from a disgruntled older sibling.
While infants will not be able to consider the complexities of environmental threats, resistance to being left alone might make good sense in this context. Similarly, the persistence and determination shown by a child who will resolutely refuse to follow a sleep training schedule may be the same essence that makes that child go on to obtain a gold medal at the Olympics.
Alice Gregory is the author of Nodding Off (published by Bloomsbury Sigma, £16.99) - Buy now on Amazon: