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Behavioral Insomnia in Infants

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By Edited Jul 12, 2016 1 0

The child often wakes up at night crying and doesn't  until you  take it on your hands and shake. Another situation is the inability to fall asleep at night alone – a baby needs the presence of adults to fall asleep, which can take several hours. The cause of these disorders is the formation of abnormal associations of sleep - the environmental conditions under which the child feels comfortable, calms down and falls asleep.

If the first months of baby's life he gets used to sleep on your hands,  respectively, the baby will continue to "defend" its right for such organization of sleep - because it doesn't know other options. Therefore, you should create the conditions for the formation of the "right" sleep associations. This is facilitated by adherence to the same ritual of laying : bathing, feeding, adult stays for a short period near the child's bed, afterwards leaving him alone.

These days, due to the emergence of numerous devices for surveillance (baby monitors, video cameras), parents can know what is happening in the child's bedroom and they do not need to go there once again.

To the wrong associations belong: falling asleep in the arms of adults, in the parent's bed, with rocking, the shuffling of hair, while feeding, with a bottle in his mouth, with his finger in his mouth, etc.

Why are they wrong? Because waking up at night, the baby will cry for those required things to create an environment in which he had been taught to fall asleep. It is interesting that, strictly speaking, a violation of the association is not a sleep disorder,  as if a timely approach to the quantity and quality of sleep is not disturbed, but for parents such behavior turns into a daily nightmare , which may last up to 3 years of age.

To correct associations of sleep belongs the so called "objective mediator" . This is some kind of thing, which is located next to the bed of the child during his/her sleep. For infants it can be a diaper that keeps the smell of the mother,  and for older children - a favorite toy.

These items help to feel the connection with  parents and therefore calm awakenings during the night when the kid is alone.

Treatment of sleep disorders comes to replacing the "wrong" associations by "right" ones.

One needs to teach a child to sleep in a crib, with a minimum participation of adults. At night time you should not hurry  to him, and your behavior must  emphasize the difference between night and day:  minimize the contact with the child during your  approaches to the crib.

What if the wrong associations were already fixed, and changing conditions of sleep will cause the active protest of the baby?

Studies show that a change in conditions of sleep is not a "transcendent" stress for the child (it is more stressful for other family members) and after some time, usually about a week, a child resigns himself to the newly established regime. In order to facilitate the transition to the new rules, the light sedatives on the basis of valerian and motherwort are used. In difficult cases, doctor's help is needed.

There are special techniques of behavioral therapy in case of sleep disorders, which contain a specific plan of actions to change the associations of sleep. For example, one of them, a method of "testing and exposure," recommends that if the child wakes up, come to his call to check if everything is in order, wait until the baby falls asleep again and then leave and not return until the next wake-up (I.e., how many times per night the child awakes, as much you come).

To other types of behavioral insomnia in childhood belong disorders of sleep facilities. This is a problem in older children, after a year, who may already be getting out of bed and verbally express their discontent.

The symptom is that a child refuses to go sleep in time, comes up with various excuses to postpone the trip to bed, or comfortable with hysteria. Being already in bed, he resigns himself to the imposed regime and there are endless "hikes" to the toilet,  requests to have a drink, eat, sit next to you, etc. Communication with parents is extended for 1-2 hours, after which the baby at last goes to sleep.

Another form of sleep disorders facilities are night visits to parent's bed. Of course, the majority of children are more comfortable to sleep under the mother's or father's side. The quality of sleep of the child is not suffering, which cannot be said about the parents.
Often the wrong sleep associations and sleep installations appear together. For example, the baby gets used to sleep in the parental bed, then waking up at night in his crib, wants to restore the "status quo" and goes back to the parents' room.

In the treatment of this type of sleep disorder a major achievement is the internal agreement of the child with "imposed" regime.

This is achieved, firstly, by the steady observance of the laying ritual and a place to sleep. It often happens that the parents have one regime for a child, and  a loving grandmother - the other. A year old child has no understanding of time, respectively, it is necessary to make the ritual of laying clear , with temporal reference points, which will unconsciously prepare a child for a time of separation with parents.

- The most common definition is a number of read fairy tales (one or two).

- You should try to achieve a formal agreement with the baby by proposing to go to sleep for half an hour later, but in return he or she should not require parent's attention.

- You can back up this agreement by the promise of certain goods in the future under these arrangements (it works only with older children).

- There are some methods of behavior therapy designed to ease the transition to the new routine, such as method of "positive ritual" when first child can be laid to sleep when he wants, and then imperceptibly shift the lying down for 5-10 minutes earlier.

Using sedatives, as well as in the previous case, makes sense only for the time to change the stereotype of sleeping, reducing the pain of that period for the baby and parents.



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