Children who resist going to sleep may need a calm and careful parent

By Mari-Jane Williams
Washington Post Staff Writer
Thursday, August 5, 2010

It's late. After a tiring day of learning, playing and exploring, your little boy or girl should be able to toddle off happily to bed with a yawn and a kiss.

Yet, every night, something goes wrong. As you climb the stairs for the umpteenth time to answer the cries or squelch the horseplay, you wonder why bedtime has to be bad time.

Bedtime battles are exhausting for parents and kids alike, and they are increasingly common: 52 percent of children between about ages 3 and 5 stall at bedtime, according to a 2004 National Sleep Foundation study. But new research by Douglas M. Teti, a professor of human development, psychology and pediatrics at Pennsylvania State University, shows that if you stay calm and are attentive to your child's needs at bedtime, it can pay off at all times of the day.

Teti worked with several other researchers over a span of about 18 months, using cameras to study bedtime behavior in 45 homes with children ages 6 to 24 months. They visited each family for a week and found that children of parents who were good at detecting drowsiness, were not hostile and structured bedtime well were more likely to fall asleep easily and sleep through the night. While Teti's research was on very young children, the same approach can also benefit older children, he said.

"Try to be sensitive and warm," Teti said. "What's the alternative? To lose your temper? I don't see that helping anything."

Staying calm amid nightly bedtime battles, when parents might be as exhausted as they believe their kids should be, is usually a solvable problem.

We recently spoke with Teti and other experts on sleeping and child psychology, and they offered these tips for establishing a truce with your midnight monsters and helping them get the 11 to 13 hours of sleep each night that the National Sleep Foundation recommends for ages 3 to 5.

Establish a calming routine. In the last hour before bed, turn to quiet and relaxing activities, and make it the same each night. A soothing bath, a snack, some favorite books, cuddle time, soft music and quiet conversation can help nudge a child toward the greatest of Z's.

"The more routine and structure there is, the more kids fall into line," said Bhavin Dave, a child and adolescent psychiatrist and the associate director of the Infant and Toddler Mental Health Program at Children's National Medical Center in the District. "When there's less routine and structure, it provides more opportunities for kids to be oppositional. Even if they don't necessarily like [the routine], it helps them feel more secure to know, 'This is what we do now.' "

Unplug, especially at the end of the day. The nighttime schedule should not involve television, computer games or surfing the Internet, says Judith A. Owens, an associate professor of pediatrics at Brown University and author of "Take Charge of Your Child's Sleep" (Marlowe, 2005).

"There are multiple studies which have suggested strongly that kids who watch TV just before bed get less sleep, get poor-quality sleep," Owens said. The American Academy of Pediatrics agrees and recommends that parents keep televisions and computers out of kids' bedrooms.

Give up the afternoon nap, or shift bedtime a little later to better suit your child's internal clock. Children often stop napping sometime between ages 3 and 4, experts say. If they are having trouble getting to sleep at night, they might be ready to kiss the afternoon siesta goodbye.

If skipping the nap leaves them cranky in the early evening, one option is to delay bedtime so they are actually tired when they go to bed. Then gradually move bedtime back up, Owens said, to reach the desired time. This is called bedtime fading.

Issue a hall pass. To eliminate the curtain calls for one last drink of water, hug or trip to the bathroom after lights out, Owens suggests giving your child a cardboard pass to get up once. Take it away after it has been used.

"It's a very tangible, concrete message that this is the limit on what you're allowed to do," she said.

Use positive reinforcement. Sticker charts and other small rewards, especially verbal praise, can go a long way toward easing bedtime woes. Aim for two or three uneventful bedtimes in a row, and keep increasing the goal.

"You want to strike a balance between allowing the child to be successful but making the goal challenging enough so it's not a piece of cake," Owens said. "As they get better at it, you might want to up the ante."

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