Sleep routines

Jennifer Marquis began to appreciate the importance of children’s bedtime routines when her oldest daughter, Maya, turned 2.

“We were having problems with her going to bed and staying in bed,” said the Spokane mother of two. “She’d get up and wander around. And we really needed a routine to help keep her focused. Otherwise, we found it was taking hours to get her ready for bed,” Marquis said.

Now a 4-year-old, Maya follows a bedtime ritual that suits everyone in her family of four, Marquis said.

Around 8 p.m., the blonde toddler gets a bath, plays in the tub, slips into her pajamas and then gets a choice of either first brushing her teeth or laying out the next day’s play clothes.

After that, she hops into bed and her parents read her a story. That’s followed by lights out and five minutes of snuggle time.

“Most of the time she doesn’t even snuggle anymore,” Marquis said with a laugh. It’s become the time when Maya says her final good nights to her mommy, daddy and family dog, Jasper, gets a kiss, a hug and high-five.

“After that, she’s ready for us to leave the room,” her mother said.

Start to finish, Maya’s bedtime routine takes about 30 minutes.

And it’s exactly what sleep experts advocate.

Without enough sleep, children become cranky, emotional, time bombs. They have trouble concentrating during the day and are even more difficult to toilet train, among other things, the experts agree.

Dr. John “Tad” Jaccard, a child psychiatrist at Sacred Heart Hospital, said: “This is a big issue, and if you look at the National Sleep Foundation study, they say: ‘Thirty percent of children less than 5 and as high as 60 percent of children under 10 have sleep problems.’ “

Establishing a set bedtime and a soothing routine are “paramount” in solving children’s ordinary sleep dilemmas, said Jaccard, who recently taught a dozen local pediatricians about kids and sleep.

Penny Pefley, a pediatric nurse consultant at Seattle Children’s Hospital, fields frequent phone calls from frenzied parents who don’t know how to consistently coax their little ones off to dreamland.

Her advice: “Have a pleasant, predictable bedtime routine. Try to keep the same sequence every night. Familiarity is important to children. It programs their little bodies and minds to fall into a drowsy state and fall asleep on their own,” said Pefley, whose professional training is supplemented by her own experiences raising three children, who’ve given her six grandchildren.

It also helps to tire toddlers out before bedtime, said Janina Flambouras, a mother and night supervisor at Round the Clock Childcare, a Spokane facility where up to 14 children between the ages of 1 and 12 spend most of the night. The center operates from 5 a.m. to 1 a.m. weekdays.

“We’ll do outside play if it’s a nice day about three or four hours before they have to lie down,” she said. At bedtime, staff members dim the lights, read to the children and use therapeutic touch such as back rubs and tummy rubs, to calm the fussiest children.

Once a routine is in place, follow it religiously, Pefley said. If children haven’t begun to settle down after two weeks and are still having problems, you may wish to consult a physician.

Jaccard is quick to suggest parents implement good sleeping habits before deciding their children may be suffering from attention deficit or hyper-activity disorders.

“Sleep deprivation can look the same,” he warned.

Here are some tried-and-true tips the experts recommend for lulling your little ones to bed:

“ Select an age-appropriate bedtime and create a pleasant, 15- to 30-minute bedtime routine. Jaccard said babies develop sleep-wake cycles between 6 and 8 weeks old. In the evening, dim the room lights, rock the baby, hum or play soft instrumental music and put the child into bed when she’s drowsy but still awake. She’s more likely to become a self-soother who drifts off to sleep and easily falls back to sleep if she wakes up during the night.

“ Do not let children fall asleep while nursing from the bottle or breast or the child will expect the circumstances to be carried out every night, said Pefley. So don’t coax a child to sleep in one place and then carry him to bed and expect he’ll remain asleep. Rather, slip the baby in bed and then coax him to sleep. Otherwise, he’ll get confused when if he falls asleep in one spot and wakes up in another.

“ Remove TVs, video games and computers from childrens’ bedrooms, said Jaccard. Screens emit bright lights that stimulate kids, inhibiting the release of melatonin, a naturally-occurring hormone discharged when darkness falls and preparing the body for sleep. A 2004 National Sleep Foundation poll found TVs in 20 percent of infants’ rooms, 18 percent of toddlers’ bedrooms, 30 percent of preschoolers and 43 percent of school-aged children.

“ Allow children to take a favorite stuffed animal, blanket or a piece of your clothing to bed, Flambouras said, adding that it works really well, it smells like home and helps children go to sleep.

Bedtime is a prime bonding opportunity, Jaccard said. Even if you’ve spent a long day at work, put your child to bed at the designated time. Don’t let them stay up because you feel guilty for not having spent enough time with them. Use the bedtime ritual as a time to talk with your child about her thoughts, feelings and activities. It may be the best time of the day if it draws you closer.

“Don’t let kids drag out the ritual, and keep your temper, Pefley said Before you leave the bedroom, make sure your child has a drink of water, has used the potty and has everything necessary for sleep. Then it’s easier not be repeatedly called into the child’s room for one last thing. Remain calm or by the time they’re toddlers, children will push all your emotional buttons, Pefley said. “Toddlers love to see parents react emotionally to them, it’s like a new weapon,” she said.

As children get older, their imaginations blossom, said Jaccard. Help them figure out what they need to feel safe. It could be a nightlight or a bottle of make-believe monster repellant. If after a nightmare your child tries to crawl in bed with you, gently take her back to her own bed, soothe her and let her fall back to sleep on her own. If you stay in the room until she drifts off, you’re developing an unhealthy dependency, Jaccard said.