Article Review Day 11: Rythmic Movement Disorder

Rythmic Movement Disorder is dyssomnia.

I am just going to tell you what the article states on this issue. It is beyond me.

"Rhythmic movement disorder involves the rhythmic movement of large muscle groups, such as the head and neck, and occurs when the child is drowsy, attempting to fall asleep, and can continue into stage 1 sleep. The first incidence usually occurs before the second birthday; headbanging and body-rocking are the most common types seen in practice. Polysomnographic monitoring during an episode can rule out a medical cause such as seizure activity. The disorder is usually transient and self-limited and seldom requires treatment."

Article Review Day 4: Limit-Setting Sleep Disorder

Limit-Setting Sleep Disorder is a dysommnia.
Does anyone have a demanding preschooler? Does anyone has a preschooler who resists bedtime? Does anyone give into their preschooler? We all give into our kids at times- even the best parents have weak moments... consistent inconsitency can lead to this disorder.

The most common form of Limit-Setting Sleep Disorder is the preschooler who makes excessive (some requests may be normal but excessive is key) demands at bedtime to delay sleep. It looks pretty much the same in all homes: another story and another, water, potty again, another show, a parent going to sleep with the child or laying with them while they fall asleep. Whatever the demands may be, they make bedtime later, sleep time shorter, and bedtime and bedtime routine become inconsistent (ew! inconsistent).

"Bedtime resistance often leads to delayed sleep onset, which is classified as requiring longer than 20 minutes to fall asleep after going to bed. The degree of sleep loss depends on the actual length of time children require to fall asleep but is often enough to result in behavior and learning problems during the day."

How do I combat Limit-Setting Sleep Disorder you ask?:
-set up an appropriate bedtime where they get enough sleep. Figure out that appropriate bedtime based on how much your child's age needs.
-make sure your child is getting the needed amount of day sleep if that is appropriate for their age.
-create a bedtime routine. It may consist of: bath, book, PJs, teeth... What does your routine look like? I like to encourage a simple routine.
-help your child feel safe and secure in their sleep environment. You may also want to spend some fun time in their room during the day. You may also want to give children the chance to help arrange and decorate their own room. These things will help them feel comfortable being alone in their room.
-parental firmness- set limits and expectations and be consistent in them- both day and night.

Article Review Day 3: Sleep-Onset Association Disorder

Sleep-Onset Association Disorder is a dyssomnia (remember last Thursdays post?).

Night wakings are normal in infants and preschool children. They may wake up as many as 5 to 8 times a night. You may be thinking, my child sleeps all night (or at least most of the time). Or, you may be thinking, yep, they wake up about 5 to 8 times a night. Well, according to this article (I have been reviewing over the past few Thursdays) "the difference between children who are 'good sleepers' and sleep through the night and those who are 'poor sleepers' and wake frequently is their ability to self-soothe after awakening." So, even if you have a good sleeper that doesn't wake up they are probably just waking up and soothing themselves back to sleep. Self-soothing is wonderful and necessary. It sometimes means letting a child cry for a short period of time to discover how they will self-soothe. Many children are never given the opportunity to learn how to self-soothe. What does your child do to soothe themselves back to sleep? Do you soothe them back to sleep?

You may wonder why it is necessary for children to learn this skill. Well, if you soothe your child to sleep at bedtime with rocking or nursing or bottle feeding (this doesn't mean you skip a nighttime routine or if they fall asleep nursing they are going to be poor sleepers) they may learn to expect these as the way to go back to sleep when they wake during the night, and then you do these things to soothe them back to sleep during the night. "These children are unintentionally trained by their parents to expect these conditions and can experience many disruptions in their nighttime sleep leading to sleep loss. Parents also experience stress and a profound sleep deficit themselves because of night waking, resulting in potential for a negative impact on overall family functioning."

So, what do you do if your child has Sleep-Onset Association Disorder:
-Keep reading Lullaby Luna- informing yourself as a parent is a great way to help your kids get a new sleep routine.
-As a parent, you need to learn how "to help your children fall asleep in their cribs or beds and return to sleep during the night with minimal parental intervention."
-You may try "crying it out" or "graduated extinction" where you check on the child during episodes of nighttime crying- you make scheduled checks on the child and slowly increase the time between the checks. "During the checks, the parent should not hold or rock the child, as this will reinforce the crying and the need for parental intervention to return to sleep. By simply checking on the child, the child is reassured that his parents are still present but learns self-soothing techniques and often will accept that he is safe, his parents are near, and that he can fall asleep without the help from his parents."
Note: In my experience, crying will be part of this training, this training is necessary to create good sleepers, the younger the better (I like to do this by 5-6 months old), if your child is older it will take longer and probably be more difficult- not impossible, just more difficult.
-If you struggle to do this on your own or feel overwhelmed hire a sleep consultant.

Article Review Day 2: Normal Sleep and Sleep Problems

Definitions:
Normal Sleep-"After the newborn period, normal sleep can be defined as the quantity and quality of nonrapid eye movement (NREM) and REM slee necessary to refresh the child."
Sleep Problem- "A sleep problem is any sleep pattern that interferes with the refreshing nature of sleep or that appreciably disrupts the sleep of others."

Courtney interjected thought: I think that too many children do not receive "normal sleep". We need to make sure as parents that we make the strides necessary to get our children the sleep they need- that may mean cutting errands short, hiring a babysitter, staying in more often, saying no to your child as they try to temper tantrum their way out of bedtime. PLEASE make sure they get the sleep they need!!

Sleep Problem Examples:
-"Any sleep problem that interferes with the child obtaining the optimal amount of sleep required for normal growth and development, emotional and psychological health, and proper immune function."
-Minor sleep problems: awakening a parent for a drink every night or to go the bathroom or waking up at the crack of dawn(if this is a behavior the parent wants to stop) or if this is inhibiting the quality of the child's sleep or making it so the child does not get enough sleep

Types of Sleep Problems:
-Dysomnias "are problems in which the child has trouble falling or staying asleep at night, or experiences excessive sleepiness during the day."
*They are the major cause of "disturbed nighttime sleep and daytime sleepiness..." Most common of these problems include: sleep-onset association disorder, limit-setting sleep disorder, inadequate sleep hygiene, insufficient sleep syndrome, and obstructive sleep apnea syndrome.

-Parasomnias "involve behaviors or physiologic events that interrupt sleep after sleep onset, and include disorders of arousal, partial arousal, or with transition between the stages of sleep."
*They are frequently between the ages of 3 to 8 years old, "and children who experience one of these problems are likely to experience symptoms of another sleep problem. They are typically a developmental phenomenon and tend to subside as the child matures. In general, parasomnias are exacerbated by poor sleep schedules and inadequate sleep."
**"Parental education regarding proper sleep hygiene is essential for these children." (Great start visiting Lullaby Luna)
Examples of parasomnias: confusional arousal, sleepwalking, sleep terrors, nightmares, and rhythmic movement disorders.