Solve Your Child's Sleep Problems

Solve Your Child's Sleep Problems

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You've tried everything. Warm milk. Bedtime stories. Sharing your bed. But your child still has problems falling asleep. Dr. Richard Ferber can help. Director of the Sleep Laboratory and Center for Pediatric Sleep Disorders at Children's Hospital in Boston, Dr. Ferber is widely recognized as the nation's leading authority on children's sleep problems. Based on six years of intensive research in a top medical facility, Solve Your Child's Sleep Problems is packed with tips, suggestions, sample problems and solutions, and a bibliography of children's "go-to-sleep" books.

Product Details

ISBN-13: 9781452660691
Publisher: Tantor Media, Inc.
Publication date: 12/11/2012
Edition description: MP3 - Unabridged CD
Product dimensions: 5.30(w) x 7.50(h) x 0.60(d)

About the Author

The author of Solve Your Child's Sleep Problems, Richard Ferber, M.D., is the director of the Center for Pediatric Sleep Disorders at Children's Hospital Boston.

George K. Wilson has narrated over one hundred fiction and nonfiction audiobook titles, from Thomas L. Friedman to Thomas Pynchon, and has won several AudioFile Earphones Awards.

Read an Excerpt

Chapter 1 At the End of Your Rope

The most frequent calls I receive at the Center for Pediatric Sleep Disorders at Children's Hospital in Boston are from a parent or parents whose children are sleeping poorly. When the parent on the phone begins by telling me "I am at the end of my rope" or "We are at our wits' end," I can almost predict what will be said next.

Typically, the couple or single parent has a young child (often their first), who is between five months and four years of age. Their child does not fall asleep readily at night and/or wakes repeatedly during the night. The parents are tired, frustrated, and often angry. Their own relationship has become tense and they are wondering whether there is something inherently wrong with their child, or if they are unfit patents.

In most cases the parents have had lots of advice on how to handle the situation from friends, relatives, even the pediatrician. "Let him cry; you're just spoiling him," they are told, or "That's just a phase; wait until she outgrows it." They don't want to wait but begin to wonder if they will have to, since despite all their efforts and strategies the sleep problem persists. Often the more the parents do to try and solve the problem, the worse it gets. Sooner or later they ask themselves, "How long do I let my child cry -- all night?" And if he or she gets up four, five, and six times at night, "Will this phase pass before we collapse from our own loss of sleep?"

Everything seems pretty hopeless at first. If your child isn't sleeping well or has other problems -- such as sleep terrors, bedwetting, nightmares, or loud snoring -- which are sources of worry and frustration, it won't take long for you to feel as if you're at the end of your rope too.

Let me assure you there is hope. With almost all of these children we are able to at least reduce the disturbance significantly, and often we can actually eliminate the sleep disorder entirely. The information in this book will help you to identify your child's particular disorder and will give you practical ways of solving the problem.

At the Sleep Center I meet with the family -- parents and child together -- and learn all I can about the child's problem. How frequent and long-lasting has it been? What are the episodes like? How do the parents handle the child at bedtime and during the nighttime wakings? Is there a family history of sleep problems, and are there social factors that might be contributing to the problem? With this detailed history, a physical examination, and, in certain cases, after laboratory study, I can usually identify the disorder and its causes. At that point I can begin to work with the family to help them solve their child's sleep problem.

Our methods of treatment for the "sleepless child" rarely include the use of medication. Instead, I work with the family to set up new schedules, routines, and ways of handling their child. Sometimes the child's biological rhythms may need normalizing or he may have to learn new conditions to associate with falling asleep. The family may have to learn how to set appropriate limits on the child's behavior, and the child may need an incentive to cooperate. I always negotiate the specifics of the plan with the family. It is important that they agree with the approach and feel confident that they will be able to follow through consistently. If the child is old enough, we include him in the negotiating. Thus we use a consistent, firm, but fair technique, tailored to the child, the family, and the particular sleep disorder. This works, time after time.

Usually the sleep problem has nothing to do with poor parenting. Nor are the episodes (with a few exceptions) part of a "normal phase" that must be waited (and waited and waited) out. And finally there is usually nothing physically or mentally wrong with the child himself. Most parents are immensely reassured to know that sleep disorders are common in all types of families and social environments, and that most children with such disorders respond well to treatment.

In certain cases, such as in sleep apnea, or less often in bedwetting, medical factors may be involved and our intervention may include medication or surgery. In other instances, such as the sleepiness of depression, recurrent nightmares, adolescent sleep terrors, and extreme nighttime fears, emotional factors may play a role. Here the source of these feelings must be identified and satisfactorily dealt with before the sleep problems will resolve. Sometimes professional counseling may be recommended.

The case studies in this book are based on my experience at the Sleep Center. The discussions of these cases, along with descriptions of the underlying sleep disorders and explanations of the methods of solving them, will help you to identify, understand, and deal with your own child's sleep problem.

Can a Child Just Be a "Poor Sleeper"?

If your child is a restless sleeper or can't seem to settle down at night, you should be very cautious about assuming that he is just a poor sleeper or doesn't need as much sleep as other children of the same age. Your own expectations can have a very strong influence on how your child's sleep pattern develops from the day you bring him home from the hospital. I have seen many families who were told by the nurse in the maternity ward, "Your baby hardly sleeps at all. You're in for trouble!" Because these parents were led to believe their child was just a poor sleeper and there wasn't anything they could do about it, they allowed their baby to develop poor sleep habits; they did not believe there was anything they could do to help him develop good ones. As a result the whole family suffered terribly. Yet I have found that almost all of these children are potentially fine sleepers and with just a little intervention can learn to sleep well.

It is true that children differ in their ability to sleep. Some children are excellent sleepers from birth. In the early weeks they may have to be waked for feedings. As they grow older, not only do they continue to sleep well, but it is difficult to wake them even when you want to. They sleep soundly at night in a variety of situations -- bright or dark, quiet or noisy, calm or chaotic -- they tolerate occasional disruption of their sleep schedules, and even sleep well during periods of emotional stress.

Other children seem inherently more susceptible to having their sleep patterns disrupted. Any change in bedtime routines, an illness, hospitalization, or guests in the house, may cause their sleep patterns to worsen. Even though these children may have always been considered "non-sleepers," we usually find that they too can sleep quite satisfactorily once we make appropriate changes in their routines, schedules, surroundings, or interactions with the family. Such children may still have occasional nights of poor sleep, hut if the new routines continue to be followed consistently, the more normal patterns will return quickly.

There are, of course, children who sleep very poorly for reasons we have, as yet, been unable to identify. For these few, our treatment may help very little, or not at all. If your child is up a great deal in the night it may be tempting to assume that he is one of these poor sleepers. But this almost certainly is not the case. Such instances of truly poor sleep ability are quite rare among young children, and in all probability your child's sleep problem can be solved.

Virtually all children without major medical or neurological disorders have the ability to sleep well. They can go to bed at an appropriate time, fall asleep within minutes, and stay asleep until a reasonable hour in the morning. And while it is normal for each child (and adult) to have brief wakings during the night, these arousals should last only a few seconds or minutes and the child should go back to sleep easily on his own.

It is very probable that your child, regardless of his present patterns, is just such a child, with a normal inherent ability to fall asleep and remain asleep. This is true even if he has a sleep disturbance such as sleepwalking or bedwetting. These events occur during sleep or partial waking, and children with these symptoms still have a basically normal ability to fall asleep and stay asleep. Sleepwalking and bedwetting are actually a bit more difficult to treat than sleeplessness, but nevertheless they too usually improve, and are often resolved, with the appropriate intervention.

How to Tell Whether Your Child Has a Sleep Problem

When your child's sleep patterns cause a definite problem for you or for him, then he has a sleep problem. This is true, for example, if he complains of inability to fall asleep, or if you find you must be up with him repeatedly during the night. Sleep problems such as sleep terrors, sleepwalking, or bedwetting are also readily apparent and quite easy to identify as sleep disorders. But others may be less obvious. You may not recognize that your child even has a problem, or you may not realize that the problem he does have should be considered a disorder that can and should be treated. You may not be aware that loud snoring every night, besides keeping you awake, may be a warning that your child is not breathing satisfactorily while asleep. Other symptoms of possible sleep abnormalities which should be identified and treated are: frequent difficulty falling asleep at bedtime, waking during the night with inability to go right back to sleep alone, waking too early or too late in the morning, falling asleep too early or too late in the evening, or being irritable or sleepy during the day.

One of the least obvious of sleep problems is that of insufficient sleep. There is no absolute way of measuring whether the amount of sleep your child gets per day is appropriate. Figure 1 on page 19 shows the average amount of sleep children get at various ages during the night and at naptime. But each child is different. We can watch each child's behavior during the day closely to see if he seems excessively sleepy or cranky. But the symptoms of insufficient sleep in a young child can be very subtle. If your two-year-old sleeps only eight hours at night but seems to be happy and functioning well during the day, it is tempting to assume he doesn't need more sleep. But eight hours is rarely enough sleep for a two-year-old, and with the proper intervention he can learn to increase his amount of sleep time considerably. You may begin to notice an improvement in his general behavior and only then will you be aware of the more subtle symptoms of inadequate sleep that actually were evident before you adjusted his sleep schedule. Now your child will probably be happier in the daytime, a bit less irritable, more able to concentrate at play, and less inclined to have tantrums, accidents, and arguments.

Adolescents often do not get enough sleep. Teenagers are not likely to wake spontaneously on school days and tend to sleep at least one hour longer on weekends. When adolescents have the opportunity to sleep as much as they like, they will average about nine hours per night, and this is probably closer to the optimal level for their age.

It is also difficult to decide when nighttime wakings are "abnormal." A young child from six months to three years may be getting adequate amounts of sleep at night, even though he wakes several times during the night and has to be helped back to sleep. Parents will say to me, "Tell me if this is normal. If it is, I will continue getting up; but if it is not, then we would like to do something about it!" I assure them that most healthy full-term infants are sleeping through the night by three or four months of age. Certainly by six months all healthy babies can do so.

If your baby does not start sleeping through the night on his own by six months at the latest, or if he begins waking again after weeks or months of sleeping well, then something is interfering with the continuity of his sleep. He should be able to sleep better, and in all likelihood his sleep disruption can be corrected. Chapters 5 through 9 will help you to identify his problem and show what you can do to remedy it.

How well your child sleeps from the early months affects not only his behavior during the day but also your feelings about him. I have often heard a parent say, "He is such a good baby. I even have to wake him for feedings." Although the parent is saying the baby is a good sleeper, the words imply that the baby is "good" in the moral sense. It is easy to see that this distinction will influence how you relate to your child.

If your child does not sleep well, he may well be making your life miserable. It isn't hard to think of such a bad sleeper as a "bad" baby. You will probably feel enormously frustrated, helpless, worried, and angry if you have to listen to crying every night, get up repeatedly, and lose a great deal of your own much-needed sleep. If your child's sleep disturbance is severe enough, your frustration and fatigue will carry over into your daytime activities and you are bound to feel increasingly tense with your child, your spouse, family, and friends. If this is the case in your home, you will be pleased to learn that your child is almost certainly capable of sleeping much better than he is now, and you should be able to get a good night's sleep yourself. To do this, you will need to learn how to identify exactly what your child's problem is, and then you can begin to solve it.

First, I want to explain briefly what we know about sleep itself. Although it is not necessary for you to be conversant with all the scientific research on sleep, it will be helpful for you to have some understanding of what sleep really is, how normal sleep patterns develop during childhood, and what can go wrong. Then you will be better able to recognize abnormal patterns as they begin to develop, to correct problems that have become established, and to prevent others from occurring.

Although the information on sleep in Chapter 2 is not overly technical, you may be eager to read the chapters that follow it to learn about the actual sleep disorders and their treatments. If that is the case, I suggest you scan the material on sleep in the next chapter and then come back to read it more closely when you have identified your own child's sleep problem. The information is very interesting to almost everyone, and especially important to parents who want to help a child sleep better at night.

Copyright © 1985 by Richard Ferber, M.D.

Table of Contents

IYour Child's Sleep13
1At the End of Your Rope15
2What We Know About Sleep22
3Helping Your Child Develop Good Sleep Patterns35
4Nighttime Fears46
IIThe Sleepless Child53
5What Your Child Associates with Falling Asleep-the Key Problem55
6Feedings During the Night-Another Major Cause of Trouble81
7Colic and Other Medical Causes of Poor Sleep90
IIISleep Rhythm Disturbances101
8Daily Schedules and Their Effect on Sleep-Biological Rhythms Revisited103
9Normal Sleep at the Wrong Time-Sleep Phase Shifts117
IVInterruptions During Sleep133
10Sleeptalking, Walking, Thrashing, and Terrors-a Spectrum of Sudden Partial Wakings135
VOther Problems191
13Headbanging, Body Rocking, and Head Rolling193
14Noisy Breathing, Snoring, and Sleep Apnea201
15Narcolepsy and Other Causes of Sleepiness214
AChildren's Books on Bedtime, Sleep, and Dreams235
BHelpful Organizations239

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"A practical, informative and sensitive guide." —-Booklist

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Solve Your Child's Sleep Problems 3.8 out of 5 based on 0 ratings. 19 reviews.
Guest More than 1 year ago
Everything does not work for everyone, but this worked for my child! As another reviewer has said, I did not want to like this book....but I must say, that for my child, it WORKED! I waited until she was 14 months and weaned, checked with her doctor and went for it. My approach was a mixture of Ferber and attachment parenting in that I didn't follow all of his suggestions to the letter. After all, at the end of the day, I'm the parent and no one knows your child like you. So take what you can from it, adapt it to your lifestyle and your child, and allow everyone in your home to finally GET SOME SLEEP!
Guest More than 1 year ago
A MUST READ for any sleep-deprived parent! I was intorduced to this book by my girlfriends, not by my medical colleagues. I have personally used Dr. Ferber's methods with my two children with great success. (My first child didn't sleep through the night for 15 months, but , after 3 nights of being 'Ferberized', he started sleeping all night. My second child slept through the night at 6 weeks! I now have a 4 year old and a 14 month old who fall asleep alone, in their own beds and sleep through the night (usually)). I have recommended this book to hundreds of parents in my practice and have received only positive feedback. If the methods seem extreme, you can modify them to suit your family's needs. It's normal to feel guilty when letting your child cry, but a well-rested family is a more functional family and you will all benefit when everyone gets enough sleep. I slept with this book on my bedside table for 2 yearsand would skim through it when a sleep problem arose at my house.
Guest More than 1 year ago
... for naps and at night on our bed. He slept with us at night. I had been continously on the phone to the parent helpline getting advice on controlled crying but could still not accept the idea. I was working from home and found it impossible to get any work done. My baby would also only sleep for 45 minutes at naptime because then he would realise I wasnt there. I read this book and after a week and at the 'end of my tether' I gave it a try. My baby quickly accepted the new method as though he was almost greatful to be able to sleep on his own. He is now much happier when he is awake and so am I. It made it easier for me when each time I went to my baby I would explain to him what I was doing and that I was doing this because I loved him. Us mothers have to remember that this method makes life a little easier for us and that in turn supports our child.
Guest More than 1 year ago
This book is EXACTLY what all parents need to do from the very beginning NOT what Sears says! It is what I have done with all 6 of my kids and they are trusting GREAT sleepers. Parents need to teach their children how to go to sleep. I have been doing daycare for 20 years and use this method with all my children and my daycare parents are amazed at how easily they go to sleep
Guest More than 1 year ago
This was a book recommended by our child's physician years ago when my husband and I disagreed on how to handle our non-sleeping child. It worked great for us and turns out in our situation that it was just as much of a behavior realization and adjustment for the parent as it is for the child. The procedure that the book outlines helps to teach the child that sleep time is just that and at the same time reassuring the child that he/she is not being left alone. Our first child was in the worst shape before we started this and thus the hardest - probably took a week. As other children came along and as each started to show the non-sleep behavior we would use this immediately. It only took a night or two on the other kids. I don't read many books and only when my husband and I disagree do we turn to books. Looking back now this one was a life saver!
Guest More than 1 year ago
this book really helped me to understand my babies sleep problems! Although we are still working on correcting them it has improved greatly in the past few months.
Guest More than 1 year ago
This book is the BEST thing that every happened to our family. I would recommend this to anyone & everyone that has children with sleep issues. After 3 nites, my 2 1/2 yr old was sleeping through the night! He hadn't done that in over a year! AND...after 1 month, he is STILL going right to bed when told and sleeping through the night. Never in a million years did I think this would work with him. I can't say enough about this book! Get it & stick with it!
Guest More than 1 year ago
This method was recommended to us by several people, and they were right! At 2 1/2 months my son was sleeping through! Four years later, he still falls right to sleep, he sees his bed/bedroom as a cozy, safe place, and he knows that Mom & Dad have not abandoned him, and that we will ALWAYS come for him. He has learned what we as adults know: SLEEP is GOOD! It only takes a few days, and a steady routine. Baby's thrive on routine, they are secure when they know what to expect next. And if you teach them to trust that you are not abandoning them, it's just time for sleep, they will learn to rest easy at bedtime.
Guest More than 1 year ago
As a psychology graduate I had some concerns about the impact of 'controlled crying', and I have heard the protestations of those who say it will impact on your child's ability to trust. All I can say is that like anything else, children need to be trained to sleep, and if they get into bad habits, it can be hard work to get them to change back. Don't forget that children need to sleep well in order to learn and develop. When they don't, they suffer as much as parents. Nevertheless, this book was consistent with my study of sleep therapy and explains simply why children fail to sleep. After following the advice and removing external stimuli such as bottles, dummies (pacifiers), rocking etc, in 4 days he slept through. He was 4 months old and waking up to 14 times a night. He is now 18 months and has only woken during the night on 2 or 3 occasions since, despite teething - he sleeps 12 hours per night minimum.
Guest More than 1 year ago
I am a former pediatric nurse who thought I was ready to be a great parent. Needless to say, I was a very TIRED parent, since my child awakened many times at night, and I had a great deal of difficulty soothing him. Since I was so tired, I found it difficult to have the energy to take care of my child. I read this book, and was very unsure of the technique. I decided to take a chance to see if it worked. Sure enough, within a few days, my child was sleeping well. There is nothing that has improved my relationship with my child more than reading this book. I now have more energy, and my child sleeps wonderfully. It is also a great resource throughout a child's life. I now rely on it when I am not sure how long the average child of a particular age sleeps at night and naps during the day. Iif my child has a night terror, I can calmly read this book to make sure I am doing the right thing. When I talk to the parents of my child's friends, they are amazed at how easily my child goes to bed, and how pleasant the sleep experience is for him (he even tells me sometimes when HE is tired and wants to go to bed).
Guest More than 1 year ago
I had heard about this method and thought it was cruel and harsh. After reading other books with little satisfaction, I finally ordered it. When I read the chapter about feedings during the night, I realized that it was describing my six-month-old daughter, exactly. I had to nurse her to sleep and if I didn't wait long enough to lay her in her crib, she would wake and I would have to start all over. Then, she would wake every hour to nurse all night long. Naps were just as bad; if she would take one, I couldn¿t get any work done for fear of waking her. It described us so precisely; I knew I had to try this method to solve our problem. I agonized over my decision and found reasons to put it off for a week. I felt like I would be making my baby pay for mistakes that I had made. Upon putting her to bed the first night, she cried for 70 minutes then slept for 3 1/2 hours. I fed her twice that night and she only fussed for a couple of minutes after the feeding and slept good in between. The second night she only fussed for about ten minutes. I now put her down at night and for naps with minimal protest and she is sleeping well. Looking back on the way things used to be, I only regret the guilt I placed on myself.
Guest More than 1 year ago
Our 15 month old suddenly started to cry for us 3 or 4 times each night. This was after several months of sleeping through the night. After 5 weeks of very little sleep for any of us, we knew something had to be done. Dr. Ferber pointed out to us that we actually trained our baby to behave the way he did. Now we had to retrain him to fall asleep without being in my arms with a bottle in his mouth. This program worked in six days and by the seventh night we could put our child into bed awake with no crying at all. He'd be asleep within ten minutes and except for two occurences, has slept through the night for the past 4 weeks. Thank you Dr. Ferber!
Guest More than 1 year ago
This book was recommended to me by a number of people. When I finally bought it and read it I thought surely it can't work as good as everyone said it did, and guess what, it did!!! My baby finally started taking naps during the day, going to be early and sleeping through the night and just after 1 day. This book is wonderful and I recommend anyone with children reading it!
Guest More than 1 year ago
I read this book cover to cover to solve my 4 month olds sleep problems. And needless to say, after 6 weeks of hearing her cry for every nap and everynight, I had to find another solution. It was cruel to listen to my child cry til she was blue in the face every night...never getting any better. Though I am sure it worked for some children, this was child cruelty to mine. If this system doesn't work for your child after two weeks, I suggest you find another solution.
Guest More than 1 year ago
If you want to let your baby cry himself to sleep save yourself the money and time of reading a book - just put him in the crib and let him cry every night until he falls asleep and check on him at 5 minutes, 10 minutes, 15 minutes.....60 minutes and so on. That's pretty much the "method". Most of this book is scientific sounding lectures that are supposed to help you feel better about letting your baby cry. If you want an alternative to crying check out The No Cry Sleep solution, a step by step plan to sleep without the crying.
Guest More than 1 year ago
As I attempted to sell my copy of 'Solve Your Child's Sleep Problems' at a recent yard sale, one customer summed up my feelings about this book exactly. She held it in the air and said, 'Don't sell it, burn it!' After many attempts at trying to 'Ferberize' my first born child, I felt like a failure since she still wouldn't sleep. It wasn't until she was 4 years old until she finally slept through the night by herself. No amount of allowing her to 'cry it out' helped. Her maturity and my understanding and sacrifice were the keys. There are no easy fixes which is why I say this book is perfect for today's quick fix society. My second child was a better sleeper by nature but I also put the time in to let him know that he was loved and his cries were being heard. No sleep problems and no guilt.
Guest More than 1 year ago
I gave this 2 stars because it does have valid information about sleep. But all sleep books seem to agree on the basic principles. I abhor the insensitive way that solutions are arrived at. Letting a baby cry alone for hours (even to the point of vomiting) to train him to sleep is simply wrong. Our children rely on us for comfort and security and we should accept that role. This also isn't a quick fix (my friend has been using it for about a year and her child still cries to sleep.) I much prefer the more kind and loving methods in The No Cry Sleep Solution which also covers the basics but lays out many ideas for getting sleep without the rigid let them cry ideas found here.
Guest More than 1 year ago
This book is 18 years old and the scientific data upon which it was based is now outdated. The recommendation to let your baby lay in his crib and cry to sleep because it's the only way to get him to sleep no longer applies. There are many other options to better sleep for babies and parents. Our generation has learned so much in the past 18 years and it's wise to take advantage of new research and information, and it's much easier on both parents and baby too.
Guest More than 1 year ago
So I thought I'd give this book a try. I'm giving it 3 stars just because it may work for your child (all the examples in the book seemed great) but it didn't for mine. He says let them cry and keep checking on them. Well checking on my child and calming her only made her more hysterical when I left the room again. Many times the crying led to throwing up - which he says is ok, it doesn't hurt them (but I'm the one that has to clean it up!) Going through all that, I gave it one last attempt at 3 in the morning. After 30 min. of crying, my daughter stopped. I thought 'My gosh, it worked.' But I had to peek in on her to make sure she was ok. She had thrown all her stuffed animals on the floor, except one, which she was hugging and sitting in the middle of her crib. She looked soooo sad. My heart sank - that was the end of Ferber. I went to her and she reached for me and she hugged my neck so tight like she never wanted to let me go. She's only 19 months old and I'm hoping with age and maturity comes the understanding of what I want her to do. I'm currently looking into a book that has a more gentle approach with William Sears. We'll see how that goes.