Sleep training is a hotly debated topic. Advocates and opponents have set up camps on two opposing sides of the sleep training divide with seemingly no middle ground. Proponents of sleep training argue that it does not harm the child and has benefits for the child and family. Opponents say that “cry-it-out” techniques are cruel to children and cause long-term problems. Unfortunately, much of the debate is propagated by misinformation. This is unfortunate since there is a great deal of knowledge about sleep in children based on scientific studies. Let’s sort through fact and fiction based on our scientific knowledge behind sleep.
First, what exactly is “sleep training”? Simply put, it’s the process of teaching an infant to fall asleep without any caregiver assistance. Why do children need to learn to fall asleep unassisted? Older infants are very aware of their surroundings when they transition from wake to sleep. Infants begin to associate the process of falling asleep with whatever is in their environment during the process of falling asleep. These parts of the environment are called sleep associations. For example, a child that is rocked to sleep learns that the transition from wake to sleep involves rocking. Rocking is the sleep association. Adults often have similar conditions. An adult who says, “The TV must be on for me to fall asleep” has developed a sleep association with the TV.
How do sleep associations cause problems for infants? If an infant has learned to always fall asleep when he is being rocked, or fed, or patted, he has not learned to self-soothe, or fall asleep unassisted. And during the night, every child wakes up multiple times. It is a normal part of sleep. An infant that knows how to fall asleep unassisted will simply go back to sleep with each small awakening. An infant that relies on a sleep association to fall asleep will cry instead of falling back to sleep in order to have the association put back in place.
As a parent, it is hard to decide what is right for your child unless you know the facts. Let’s discuss some of the common myths regarding sleep training.
Myth #1: If I let my child cry, they will hate me.
Fact: Multiple studies show that there are no negative consequences in parent-child bond due to sleep training. In fact, some studies actually show an improvement in security between parent and child following sleep training.
Myth #2: I love holding my child at night and singing to her. If I sleep train, I can’t do that anymore.
Fact: Sleep training does not mean giving up the activities you love to do with your child. You can continue to do any and all of these activities as part of the nighttime routine. Sleep training simply involves avoiding these activities just at the time of transition from wake to sleep.
Myth #3: Sleep training means I can’t share a room with my child.
Fact: It is completely fine to sleep in the same room as the child during sleep training. Being close to your child may be more convenient for breast feeding and provide you with reassurance that your child is well. If you want to keep your infant in the same room, the infant should have her own sleep location that is separate from the parents, such as a crib or bassinet. Sharing the same bed with an infant has serious safety risks.
Myth #4: Sleep training is for the benefit of the parents, not the child.
Fact: Although adults do tend to sleep better once the child is sleep trained, it is not for the parent! It is for the child! When a child needs caregiver intervention to fall back asleep each night, this is frustrating. Imagine waking up multiple times each night and having to cry in order to get put back to sleep. This is not easy on the child. Learning how to self-soothe is an important skill for infants to avoid crying nightly.
Myth #5: There are long-term risks and benefits to sleep training.
Fact: Scientific studies have not found long-term risks or benefits to sleep training. There are multiple studies showing short-term improvements in both sleep quality for children and maternal mood.
Myth #6: After I sleep train, my child will sleep through the night.
Fact: No human being actually stays asleep the entire night. We have multiple arousals every hour in which we might fidget or turn over. This movement is actually protective for us. Infants are no different. Even after sleep training, children will wake up multiple times each night, and may roll over, move briefly, or make vocalizations. The key is that after sleep training, they will be able to put themselves back to sleep after these short awakenings.
Myth #7: I don’t need to sleep train because my child will grow out of it within a few months.
Fact: While it is true that most children will eventually stop needing the caregiver’s help to fall asleep, the timing varies greatly. It is not unusual for 5 and 6-year-olds to still wake up multiple times and want to be fed or rocked to get back to sleep. I know of teenagers that still insist on sleeping next to parents to fall asleep. Will the child outgrow it? Yes, eventually. But in the worst case scenario, it might be when they leave for college.
Myth #8: Sleep training always involves “Crying it out”.
Fact: Most of the debate around sleep training stems from the process of allowing an infant to cry. For those that are adamantly opposed to letting a child cry, but are frustrated by the lack of consistent sleep, there are other sleep training techniques that don’t involve simply leaving an infant in the crib to cry endlessly. Two examples of such methods are fading and scheduled awakenings. Explore your options before avoiding sleep training.
Sujay Kansagra, M.D. is the author of the book “My Child Won’t Sleep,” a step-by-step guide for parents that presents ALL of the scientifically-proven techniques to sleep train your infant. He is the director of the Pediatric Neurology Sleep Medicine Program at Duke University in Durham, NC