I have been captivated by the open and honest conversation that the CNN Sleep Study post on our Facebook page has sparked and I want to take the opportunity to chime in.
Parents should consider their own preferences, and their infant’s temperament, developmental status and health, when deciding how to manage wake to sleep transitions and their own need for sleep. The article in Pediatrics is based on sound science and is one of dozens of articles evaluating the safety and effectiveness of interventions to help manage sleep problems in infants. Many of these techniques are also fully appropriate for parents who do not view their child as having a “sleep problem.”
The recent Pediatrics study, led by Michael Gradisar, PhD, tests two commonly used approaches to address sleep problems in healthy infants with normal development. The first is “graduated extinction,” which involves multiple visits to the child’s room to check-in and soothe them if they are crying. The second, “bedtime fading,” involves initially setting the bedtime close to the time the child falls asleep and then moving the bedtime earlier and earlier as the child learns to fall asleep. A third condition is a non-intervention comparison condition.
The article does not, in fact, test the “cry-it-out” method, which refers to the complete withdrawal of the parent’s presence at bedtime. While there are strong opinions about all of these approaches to putting a child to bed, it is my practice to respect and support parents’ individual preferences.
Dr. Gradisar’s well-controlled trial is unique because it evaluates changes in sleep, mood, and cortisol using bedtime fading and graduated extinction. While there are limitations and the sample size is small, it is excellent science that is consistent with findings of other studies and informs clinical practice.
When wake-to-sleep transitions become a problem, or if parents are unsure about how to manage bedtimes, parents sometimes need help to navigate the broad spectrum of options to decide what is best for both the infant and themselves.
Visit our Sleep Medicine division for more information and resources we provide at Children’s National.