Agatha and Dr. Greene delve into the circadian rhythm, ways to create sleep rituals, and even explain how we’re affected by zeitgebers. (Hint: That’s not a type of alien). With a little discipline, it’s possible to cultivate good sleeping habits from even the earliest days, encouraging deep rest and relaxation so children are primed to be their most healthy and happy.
Below is a transcript of the episode, modified for your reading pleasure. For more information on the people and ideas in the episode, see the links at the bottom of this post.
Full Episode Transcript
[00:00:00] Agatha: Hi, I'm Agatha Luso, mother of four.
[00:00:08] Dr. Greene: And I'm Alan Green, pediatrician.
[00:00:10] Agatha: Welcome to Bambini Fortuna Podcast. Moms driven.
[00:00:13] Dr. Greene: Dr Aligned.
[00:00:14] Agatha: So, today's topic of conversation will be sleep.
[00:00:18] Dr. Greene: And sleep is so important. From a medical perspective, it's one of the most important health issues for kids. And from a parent's perspective, it's one of the biggest headaches often.
[00:00:28] Agatha: Yes. So, sleep for me has always been important. My husband and I, we sleep- trained our children since they were babies and learned about sleep. And sleep is a learned thing for children. Isn't that right?
[00:00:40] Dr. Greene: Kids do need to learn. In the wild, if you look at animals, you don't see sleep problems. They're in sync with the cues around them that help them sleep.
[00:00:49] But in the modern world, many things disrupt those cues and so kids need to learn.
[00:00:55] Agatha: Right. And so how is the best way for parents to teach their children to go to sleep?
[00:01:01]Dr. Greene: For a brand new baby? Or where would you like me to start?
[00:01:04] Agatha: Maybe perhaps for a brand new baby.
[00:01:06] Dr. Greene: Sure. So, for a brand new baby, they tend to sleep a lot, like 16 to 18 hours a day, sometimes even more than that.
[00:01:13] But they often have a day night reversal when they're born. They are awake a lot during the night and they're asleep a lot during the day. And so, one of the things do you want to do to help them fit into the family's schedule and get better quality sleep is establish a rhythm where they sleep more at night and they're awake more during the day.
[00:01:29] And there's a few ways that you can do that. One of them is with playing with their feet. When you play with the kid’s foot, a baby's foot, it tends to signal to them that is the day part of the day. So, during the day, play with their feet a lot at night, uh, try to avoid touching their feet when you're with them.
[00:01:47] Another way that's really powerful is eye contact. Whenever you lock eyes with your baby, the heart rate goes up. They're a little bit more alert. It's a, they get this little surge of energy and delight. So during the day when you're playing with them and when you're nursing, make eye contact. But at night when you're feeding, um, look off just a little bit to the side.
[00:02:07] You don't want to let them feel abandoned, but just cuddle close and rather than eye engagement particularly. Another thing that helps is temperature. Throughout almost all of human history, the temperature was warmer during the day and cooler at night and inside. Now we tend to have the same temperature night and day, and many nurseries are kept pretty warm.
[00:02:27] Parents are afraid of them getting cool, but they'll actually sleep better if it's cooler at night; sometimes seven degrees cooler.
[00:02:33] Agatha: And what if you're just starting to sleep train your baby around ten months old when you finally realize that sleep routine is so important.
[00:02:43] Dr. Greene: I should say that 10 months is a tough time to do it for many kids because one of the most difficult times to sleep in all of childhood is right next to one of the biggest developmental milestones.
[00:02:55] And that's learning to walk. And when kids are on the verge of learning to walk, which is often about 10 months, when they wake up at night and all of us wake up at night, we just usually forget most of the brief wake ups, but when they wake up, they're so excited about learning to walk, they'll often think, is this the day? Can I do it? And if they're in a crib, they'll pull themselves up in the crib and then they will have separation anxiety, they'll wonder, where's mom? Where's dad? They won't be able to get themselves back down comfortably. They haven't figured out how to get down as well as they have to figure up and they cry and it's tough.
[00:03:29] Once kids have been walking for just two weeks, everything changes. Separation, anxiety changes to wanting to be independent. They tire themselves out from toddling all over the place, and when they do wake up, there is no urgency to stand up and get in an awkward position. So that's a really easy time to sleep train. Or, before they learn to pull themselves up to stand.
[00:03:51] Agatha: Okay. So then if you're wanting to sleep train right during, then you suggest waiting just until they start walking a little bit.
[00:03:57] Dr. Greene: It's easier.
[00:03:58] Agatha: It's easier.
[00:03:59] Dr. Greene: Yeah.
[00:03:59] Agatha: Okay. And, uh, what do you think about letting a child cry it out? What are your thoughts on that?
[00:04:05] Dr. Greene: So, I know many people do that and that it can work well. And the kids that I've seen that that's work where the parents have done that, the kids end up happy and it doesn't seem to be a big problem, but it's not my favorite way, or at least not to let them cry it out alone. There is one stage, and it can be if you're trying to sleep train during the time where they're pulling themselves up, uh, where your child is crying and you go in and you gently unclench their hands and get them back lying down again and pat them and stay with them. Maybe sing a lullaby, or easier, play a recording of your having sung a lullaby and just stay with them even though they cry until they fall asleep and do that every night for three or four nights in a row. Often they will learn that they're not going to get up, are not going to get held or fed during the night and you can sleep train that way; and they do cry, but they know you're there and you know, they know you care and they're not afraid. They're not alone. So, if you're going to cry out, that's my favorite way to do it.
[00:05:03] Agatha: Right. That's a great suggestion. And what is a preferable time for going to sleep for children in general?
[00:05:11]Dr. Greene: Yeah. It varies a lot throughout childhood and a lot from family to family. I mean, I love it when kids go to bed right after dinner, um, that it's early in the evening. I know you put your kids down at seven o'clock and that's just been beautiful. Uh, and watching them, they all know it's bedtime.
[00:05:26] They get ready, they go, and it's a powerful thing.
[00:05:28] Agatha: Right. But as babies, I used to put them down to sleep at six and sometimes even at, I know some will say that, I'm, you know, a little kooky, but at 5:30, depending on, you know, how tired they were around four o'clock. So, if they're extremely tired and the nap wasn't sufficient, then sometimes they'd even start the bedtime earlier because sleep begets sleep, right? The more sleep you get, the more sleep you'll need.
[00:05:53] Dr. Greene: And the more consistent it is, the more you'll get sleepy at that time. I do see parents a lot of times keeping kids up later than is ideal, just because they're afraid or they don't want to go through the hassle of a bedtime battle of one kind or another. And that's one of the reasons that that sleep routines, sleep rituals, can be so powerful.
[00:06:14] Kids learn early on what are the cues in the environment that it's time to fall asleep. And a lot of that has to do with routine. So if you have a ritual is the same things in the same order, and if you do the same steps, it could be depending on the age of the child, brush the teeth, read a story, read two stories, um, and then turn off the lights.
[00:06:35] Or there may be a bath that's in there, or another way to connect. But if you do the same things every night at the same time, then sleep begins to overtake them.
[00:06:43] Agatha: Yes. So ritual is so important. One of our daughters will not go to sleep without using our Sleepy Hush-Time roll-on oil from Bambini Fortuna. She just loves it, loves the smell. It's just, you know, embedded in her ritual.
[00:06:59] Dr. Greene: And botanicals can be a powerful part of the ritual and aromas of botanicals can signal this is the moment to go to sleep.
[00:07:06] Agatha: Yes.
[00:07:07] Dr. Greene: One thing I should mention is that rituals happen or can happen whether you want them to or not. So, if you always rock your baby at bedtime, then that becomes a ritual even if you didn't intend it. Or if they fall asleep in a particular setting, that can become a ritual even if you didn't intend it. I'm a fan of conscious rituals. Decide what you want falling- asleep experience to be like.
[00:07:30] Agatha: Yeah. That's so important to think about. I mean, as a parent, you have to really think about your actions and the consequences that will happen because you don't want to rock your baby to sleep every night. I did that with our daughter, rocked her to bed, and then I had to go in six times a night to rock her back to sleep, and that's when I figured out, okay, sleep.
[00:07:49] Dr. Greene: It's time.
[00:07:50] Agatha: Yeah. It's time to come up with a ritual, a different ritual and routine for her to get used to. So, um, that's great. And then, also, when kids, you know, come back from vacation or it's the beginning of the school year, sleep can be thrown off when families come back into town. I know that when I am traveling or I come back into town, I never look at the time of where I came from, but I look at the time where it is at the present moment and I put our kids to bed and keep them on the same schedule, no matter what time it is elsewhere.
[00:08:24] Dr. Greene: Yeah.
[00:08:25] Agatha: I mean, do you have any suggestions of, to parents of how to get, you know, adjust sleep and resetting sleep.
[00:08:32] Dr. Greene: That's a great question, I get that the circadian rhythm is something that we're coming to understand is extraordinarily important in sleep and in health overall and what that is, it's the set of signals in the body that rise and fall on a daily basis, and that includes body temperature and blood pressure and alertness and sleepiness and hunger.
[00:08:51] They all are on the same track together, synchronized by lots and lots and lots of clocks in our body. And it's called circadian because it's circuit (inaudible) it's about a day long. There was an experiment where they had a guy go into a cave and without any cell phone or watch or any signal from the outside world and just ate when hungry and slept when sleepy.
[00:09:14] And they tracked over time how that changed. And it turned out that his natural circadian rhythm was about 25 hours. So, he gradually got completely off sync of everything else. But the reason that our circadian rhythms aren't exactly a day is so that they can reset seasonally by environmental cues every day and the things that set that day's rhythm are called zeitgebers and zeitgebers may be a word you haven't heard.
[00:09:40] But zeitgebers are parents' friends because they can help you have this powerful melatonin surge at night to help your baby or child's sleep and vitamin D surge during the day and to be able to get you the energy and immune function that you need during the day.
[00:09:56] So how does it work? The most powerful zeitgeber is light and if you're going to want to control one thing, it's light. And that's because we're creatures, like other mammals that have our sleep weight cycle scheduled by the sun. And for almost all of human history, when the sun went down, the only light we
had was fire light or candle, or later gaslight.
[00:10:15] But it was all a warm yellow kind of light. The modern light bulbs in most homes are blue light and screens are blue light, and they are seen by the melanopsin receptors in the retina of the eye and stop the melatonin from rising at night. So just keeping it very dim and especially without the blue wavelength of light in the evening is by itself a powerful way to reset the clock, and you can do that wherever you're traveling. You can do that by getting outdoors in the morning, wherever you are, and getting real sunlight. You can do it with light bulbs. You can get the pulled the blue wavelength out. You can have kids wear cool fashion, blue blocker sunglasses after sunset and they'll get tired an hour or two later.
[00:10:56] Agatha: That's so important. And then I just wanted to touch on a subject of sleep and the brain and how important sleep is for a developing brain, because I know that if a child has a lack of sleep, sometimes there could be similar symptoms with ADHD. What are your thoughts on that?
[00:11:18] Dr. Greene: Agatha? That's a fabulous question. Yes, absolutely. During the time that we're asleep, the brain does so many important things and one of them is to prepare for the next day, solidifies memories from yesterday. Learning happens better when you sleep after you've learned something, and we know that kids who are chronically a little bit sleep deprived can get all of the symptoms of ADHD.
[00:11:45] In fact, there's many kids that are diagnosed with ADHD and have problems with focus and hyperactivity at school that it's not true. ADHD is just sleep deprivation. So, getting better sleep can erase it. And even for those kids who do have real ADHD and they need medications for some reason because of it, they will likely need smaller doses of medications and have fewer symptoms if they get great sleep.
[00:12:09] Agatha: Yeah, so sleep is so important. And, also, I just want to really quickly touch upon sleep apnea for a second.
[00:12:16] Dr. Greene: Sure.
[00:12:16] Agatha: Cause two of my children had obstructive sleep apnea, and I know that for one of the children, it was easier to detect than the other child because he would just stop breathing. But a child can sleep throughout the whole entire night and you can think that he had a great, or she had a great night of sleep, but they do still have sleep apnea.
[00:12:37] What are symptoms of sleep apnea and how can a parent detect if their child has sleep apnea and when should they become worried or bring it up to their pediatrician?
[00:12:49] Dr. Greene: Oh, sleep apnea in kids has gotten more and more common in recent years, and there are a few things to pay attention to. If your child's getting enough sleep and still seems tired during the day, think about sleep apnea, and especially for any child who snores. Think about sleep apnea. Now, some kids snore and it's just snoring, but many kids who snore, the real underlying problem is obstructive sleep apnea where the passageway for air to go in and out is blocked temporarily at night, and then that results in sleep, it's not as good, and then they don't get all the benefits of sleep.
[00:13:21] Agatha: Right?
[00:13:21] Dr. Greene: So if your child snores or if they have daytime fatigue, either of those two, I would talk with your pediatrician about it.
[00:13:27] Agatha: And what about sweating at nighttime?
[00:13:30] Dr. Greene: So at nighttime, sweating can be a signal of that. Um, and, uh, kids may sweat for other reasons, but if they do have sweating at night, that can be the adrenaline rush from the airway closing.
[00:13:39] So that's another good reason to check.
[00:13:40] Agatha: Right. And then it could also be signs of something else going on. So it's always good to bring up these things to your pediatrician and, and to talk to your doctor about it. So our take away, what are the three most important things you think for today?
[00:13:56] Dr. Greene: So, if I had to narrow it down, three things to give parents about sleep, number one would be to make consistency a priority. That is really powerful to have the same bedtime and wake up time every day if you can do that.
[00:14:11] Number two is to create the sleep ritual that you want, engaging the senses, smell and sight and touch and sound and words, whatever it is, and whatever order to make a sleep ritual that works for your family.
[00:14:24] And then number three is to strengthen the circadian rhythm for your child.
[00:14:29] Agatha: That's amazing. Thank you so much. So parents, let's please remember, consistency, ritual, and the circadian rhythm. And once again, I'm Agatha Luso, mother of four.
[00:14:41]Dr. Greene: And I'm Dr. Alan Greene, pediatrician.
[00:14:44] Agatha: Thank you all for joining us on the Bambini Fortuna podcast.
[00:14:47] Mom driven.
[00:15:30] Dr. Greene: Dr. Aligned.