Sleep training

Sleep training is the process by which babies are taught to sleep for several hours through the night on their own. If they wake up, they soothe themselves and return to sleep. A goal of sleep training is for babies to sleep through the night without needing comfort from someone. There are various ways to sleep train, and some methods state they can help babies sleep on their own in just a few days. Depending on the desired outcome, some methods may take longer. For example, those hoping to minimize crying with their infant can typically expect longer training times.

Although some people may attempt to sleep train a baby as young as a few months old, doctors tend to support a process that begins around six months. The popularity of sleep training has led to a variety of methods, including the cry-it-out method, the 5-3-3 method, the fading method, the chair method, and the Ferber method (named after Richard Ferber). Ferber is a doctor and director of the Center for Pediatric Sleep Disorders at Children’s Hospital in Boston. His book, Solve Your Child’s Sleep Problems, first appeared in 1985.

Sleep training has some critics. Opponents argue that it can be stressful for infants, while supporters defend the methods and point to a lack of research saying otherwise. The Ferber method, in particular, has faced heavy criticism as being damaging to the mental health of infants and, potentially, parents. Worldwide, the idea of training babies to fall asleep on their own is uncommon. However, in parts of Europe, Australia, and North America, sleep training is much more popular and has become a $325 million industry. Sleep training is not the same as "night weaning," though the two terms may be used together.

Background

Sleep training at its most basic level is the process of training babies to learn to fall asleep, and stay asleep, by themselves. This includes soothing themselves back to sleep if they should wake up. The topic is frequently discussed among caregivers because it is supposed to provide more restful sleep for adults as well as their children. Typically, it is recommended that those wanting to sleep train their infant wait until the infant is six months old. At that point, their internal body clock is more developed. This is also called one’s circadian rhythm. Circadian rhythms are responsible for a variety of body processes, including appetite, alertness, and body temperature. The circadian rhythms that involve the sleep-wake cycle are some of the most commonly discussed. They are aligned with daylight and nighttime. In some cases, they are simply referred to as the body’s "internal clock." Because they are associated with daylight and other environmental cues, circadian rhythms may also impact how an individual feels throughout the day. When someone’s sleep-wake cycle is disturbed, sleeplessness may occur. Although there are exceptions to the six-month rule, sleep training guidelines generally address infants six months and older.

Although newborns spend most of their time sleeping, those sleep patterns change as the baby grows. For example, newborns may sleep eighteen hours per day, in four-hour intervals. However, as they grow, their total daily sleep time decreases while the hourly intervals increase. Around five or six months, hours of sleep decrease to around fourteen, with the longest span being around six nighttime hours and the remaining hours being shorter naps. At this point, sleep training can begin. A goal is to help babies put themselves to sleep, particularly if they wake up during what should be their sleep cycle. Another goal of sleep training is to help adult caregivers receive more restful sleep of the longer lengths they are more accustomed to receiving.

A variety of sleep training methods exist, some more widely accepted or criticized than others. Those methods include the cry-it-out method, 5-3-3 method, the fading method, the chair method, and the Ferber method.

The cry-it-out method begins with caregivers following a regular routine to prepare the child for nighttime sleep. Once that process has been completed, the caregivers leave the baby’s bedroom or nursery and do not respond to nighttime cries, should they occur. This is said to teach the child to soothe itself back to sleep, allowing the caregivers to receive a more restful night. However, there are variations to the cry-it-out method. A more lenient version allows caregivers to return if the baby does not stop crying after a certain amount of time. A more stringent version of the method has caregivers not returning until morning, or the desired wake-up time. The Ferber method is like the cry-it-out method. Once the child is put to sleep, the caregiver leaves the room but returns at pre-determined intervals until the baby is asleep. These intervals are lengthened each night. Although the caregiver returns using the Ferber method, they do not pick up the baby. This emphasizes the need for the baby to learn how to re-settle and return to sleep independently.

Another sleep training method is the 5-3-3 method, or 5-3-3 rule. This technique involves setting a specific sleep schedule where a baby is asleep for five hours, awake for three hours, and then asleep for an additional three hours. This helps to establish a more consistent sleep schedule, which potentially improves sleep quality. The 5-3-3 method is designed to be rigid, which could ultimately have an adverse impact on a child. It is also not always convenient for caregivers with fluctuating schedules.

In the chair method, a caregiver sits near the baby’s crib until the child falls asleep. However, they do not pick up the baby or use other soothing methods to help it fall asleep or stop fussiness. Each night, the chair moves further away from the baby until the child is able to fall asleep without the caregiver in the room. The chair method can be modified. For example, a caregiver could soothe the child in the early days of this technique but do less and less as the days pass. A final technique is the fading method. In the fading method, the caregiver first uses soothing techniques to help the baby fall asleep. However, as days pass, the amount of caregiver involvement in the soothing decreases, ultimately requiring the baby to learn to soothe itself. This method of sleep training is one of the gentler ones.

Topic Today

Sleep training is a frequently discussed topic, particularly for new parents. Large amounts of research address the pros and cons of various methods. At least one-third of infant sleep books, however, oppose ignoring an infant’s cries, no matter the duration. Opponents argue that the risk is too great to ignore the potentially harmful problems that may be causing the cries. They also argue that ignoring the cries may be detrimental to the infant’s—and potentially the caregiver’s—mental health. The lack of response to the cries may be viewed as abandonment or a lack of care. Considering some sleep training options do not involve unattended crying, opponents urge caregivers to use those approaches. Ferber, in particular, has been criticized for what many believe to be an overly rigid stance on sleep training. Opponents argue that, as a medical doctor, he neglected to consider the psychological implications that could occur by leaving an infant to cry for extended periods of time. Ferber has said that his method has been misinterpreted, and he does not necessarily believe that a child’s cries should go unanswered. That method, he explained, is for extreme cases where parents need to break a child's bad sleeping habits.

Ferber’s sleep training method is not the only one to receive extensive criticism and wide-spread press coverage. Co-sleeping has also come under fire from opponents. Co-sleeping involves sharing the same space as another individual while sleeping. This could be in a bed or the same room. For infants and their caregivers, co-sleeping often involves sleeping in the same bed. This allows the caregiver to have immediate access to the infant should it wake and need to be soothed. Opponents are critical of co-sleeping due to the risks it carries, including an increased chance of sudden infant death syndrome (SIDS), strangulation, and suffocation. Simply put, an adult bed contains numerous potential hazards for a baby. In 2020, the American Academy of Pediatrics advised against co-sleeping in the same bed as an infant because of the potential hazards. However, the academy supports co-sleeping in the same room.

Bibliography

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Canapari, Craig. “How to Sleep Train Your Baby.” The New York Times, 18 Apr. 2020, www.nytimes.com/article/how-to-sleep-train-baby.html. Accessed 4 Sept. 2023.

Dumaplin, Cara. “When to Start Sleep Training.” Taking Cara Babies, 25 July 2023, takingcarababies.com/when-to-start-sleep-training. Accessed 4 Sept. 2023.

“Safe Sleep for Newborns.” Hopeful Beginnings of St. Mary’s, 13 Nov. 2021, www.hopefulbeginning.org/blog/safe-sleep-for-newborns/. Accessed 4 Sept. 2023

Suni, Eric and Nilong Vyas. “Sleep Training.” Sleep Foundation, 8 Aug. 2023, www.sleepfoundation.org/baby-sleep/sleep-training. Accessed 4 Sept. 2023.

“When and How to Sleep Train Your Baby.” Health Essentials, 3 May 2021, health.clevelandclinic.org/when-and-how-to-sleep-train-your-baby/. Accessed 4 Sept. 2023.