Rock-A-Bye Baby

Think back to a night when you had a lousy sleep. How did you feel the next day: Groggy? Sluggish? Cranky? Unable to concentrate the way you normally could? Children are no different. In fact, because they need a lot more sleep than adults do, not getting enough "Zs" can have a dramatic impact on their overall health. And left untreated, poor sleeping patterns can become difficult to break over time.

Adrienne MacQueen and Allison Naidu-both with BscPTs-found there was a tremendous need for a community-based program to help children with sleep problems after speaking with many parents (mostly mothers).

"It seemed that everyone had a story about sleep-related difficulties." They stated. "It also seemed that because there wasn't anyone or anything saying what was 'normal' or what to expect for their children, most parents were accepting that their children, and, therefore they, shouldn't be sleeping soundly. In addition to this, having worked in the schools, Allison witnessed firsthand the effects of inadequate sleep-inattention, obesity, poor behaviour, learning difficulties as well as social issues. Also, having gone through the local prenatal programs through the health district, she knew firsthand that there was no mention of sleep information; this was also lacking in the New Mom's Groups."

On a personal note, Allison and Adrienne shared that each of their first-born babies cried a lot during the first three months of their lives. They said that although their children were able to sleep through the night, they struggled with their babies' daytime sleep. With all of this background knowledge in hand--professional and personal--they knew that it would be useful and less stressful to have had some information prenatally so parents would have an idea of what to expect at different ages. That's how their program Sleep Matters was born.

Sleep Matters is a program these ladies built to assist children and families with sleeping difficulties before they become larger than they need to be. There are many areas Allison and Adrienne help with: Night waking, no naps or napping poorly, inability to fall asleep alone, transitioning from family bed to crib/bed, transitioning from crib to bed, older children getting out of bed, and early wakings.

Each of them does their own consults but work together on the more difficult cases. Because each of them brings different work experiences to their practice, working together can help provide more options to get to the core of the problem. The two ways they deal with clients is through telephone assessments and group classes.

"The assessment process includes a verbal questionnaire which assesses the child/baby's/family's sleep environment, routine and daytime activities." Allison and Adrienne began. "It also includes a medical screen. If we feel that the sleep concern(s) is/are a result of a medical condition not yet diagnosed, we have contact with a physician who specializes in sleep disorders and to whom we can refer."

The group classes give parents valuable information and teach them techniques they can try at home. They have a detailed explanation of the classes on their website but, basically, it consists of a two-hour presentation of various sleep problems and includes a handout that discusses various sleep principles to use as a guide.

The ladies added that: "The class consists of a power point presentation, with handouts of the material discussed. The presentation consists of two parts: The first being an information session on various sleep topics (please refer to our website) and the second being a discussion using case studies, followed by specific strategies to solve the sleep problems. We also like to encourage the class, if they are comfortable, to discuss their specific problems and what they did to correct them, how to avoid them, etc. We have found this to be quite constructive and helpful especially because the parents' children are different ages."

Their telephone consultations consist of a 45-minute discussion that starts with clients registering with Sleep Matters on their website and setting up a convenient date and time. From there, one of the consultants will contact the client and begin with a questionnaire to find out things such as current family and child's sleeping environment as well as any/all routines in place. They also do a complete medical screen. Once they have all of their information, the consultants are able to determine the best-suited plan to assist the family with their sleep problems.

"The consult is followed up with an email complete with the information and plan we discussed during the phone call. Often both parents will be on the line during the consultation, as we firmly believe that the parents/caregivers must be on the same page in order for the plan to be implemented successfully.
The client is also provided with a follow-up phone consult, consisting of a 15-30 minute call. During this call, we will typically review the plan, find out what worked and what didn't and why, fine-tune the sleep plan and answer any questions the client might have. It is suggested that the follow-up occur within one month's time, but clients have up to 60 days to book the follow-up consult."

It sounds like a long process; however, they are thorough and must cover every aspect of the current situation in order to offer the best course of action. Parents would most likely feel the time and effort is worth it if, in the end, everyone in the house is finally getting a descent night sleep!

There is a cost for their services but the amounts are reasonable when you consider everything these ladies do and the length of time they spend with their clients. The classes are $75, consults are $105 and consult with the class (if client took the class) is $75.

Allison and Adrienne stated that, "People can register for the class and consults online. Classes are in the evenings, usually once a month on either Tuesdays or Wednesdays. Consults are at a variety of times and dates, including mornings and evenings."

What about clients who need their services but may not be able to afford it on their own? Adrienne and Allison said that because they are both registered physical therapists with the College of Physical Therapists of Alberta, clients may be able to submit their receipt to their insurance companies under Physical Therapy Services.

It's so important to seek help as soon as possible so poor sleeping patterns don't become habitual. Adrienne and Allison recommend that parents seek help when sleep difficulties go on longer than a month. They stated: "After one month, if a sleep problem has not been resolved, the situation can lead to an expectation of poor sleep from the family and the baby/child, as well as the formation of poor sleep habits. In addition, sleep issues becomes more difficult to correct as time marches on. Usually following one month of poor sleeping, parents may find their child/baby to be fussier, unable to fall asleep without the parents, the parents are having to go into the child's room several times per night to sooth the child/baby, or the parents are exhausted in the morning. These are all signs that the 'temporary' situation has become habitual."

I asked Adrienne and Allison if they had some final "Pearls of Wisdom" to share. Here's what they said:

"Watch for drowsy signs and make sleep a priority for your baby/child. Put them to bed when they are tired, not exhausted! We feel parents would benefit immensely from education before birth to prevent the formation of major sleep issues. This is key for a healthy generation, as lack of sleep has been linked to obesity, behavioural difficulties, learning difficulties and maternal depression."

As someone who hasn't slept through the night since she was in her single digits-and the Mom of one child who has a multitude of sleeping problems stemming from her special needs and another who has trouble sleeping alone-I feel their service is invaluable. When I saw their pamphlet at my local YMCA, it screamed to me to share with everyone what they are doing.

If you have tried everything in vain to help your child sleep properly; if you are so exhausted from being woken up from others who can't sleep; if you are at your wits end over what to do about a loved one's suffering, please...contact the ladies at Sleep Matters.

SIDEBAR:

I asked Adrienne and Allison if they had any techniques that parents can try at home. Here are their suggestions:

For temporary sleep issues, we must preface this by saying that there are many problems and the techniques recommended depend on the problem, of course. However, some general advice:

A. Set a bedtime routine
B. Reduce stimulation prior to bedtime i.e. Not going outside after supper, not watching TV, limiting physical activity
C. Have a consistent early bedtime

We will provide you with a specific situation, along with some strategies:

Baby, aged 14 months, used to nap well twice a day, is now napping poorly and is very tired by supper time.

Solution: At this age, it is common for babies to transition from 2 to 1 naps per day. Therefore, during the transition, you may need to adjust naptime to late morning and make bedtime earlier. The earlier bedtime will allow baby to get increased hours of sleep at night in order to make up for decrease daytime sleep. It will also decrease baby's chance of becoming overtired as he adjust to being awake for longer periods of time. The very early bedtime will be temporary, lasting at least until baby's nap is gradually pushed closer to noon and the nap lasts 2-3 hours.