Art imitates life. Again.

Denise worked with another patient last week: an adolescent male with ADHD and difficulty initiating and maintaining sleep.  As she always does, since she is perfect, Denise reminded the patient and parent that there should be no chocolate or caffeine consumption prior to lights out and that lights out would be at 10PM.  The patient's father was aghast, since the patient would not, could not, will not go to bed before 1AM.  Sleep Lab rules, Denise said, in the nicest way imaginable.  Let's try it this way for tonight.

A little later, Denise returns to the patient's room only to find crumbs that look suspiciously like CHOCOLATE littering the bed.  Oh, says the patient, I had my nightly CHOCOLATE POP TART.  Um, what was it about "no chocolate" that you didn't understand?  And, Trixie would like to point out, Pop Tarts are the work of the devil and contain nothing but chemicals and high fructose corn syrup, which are bad for you.

Anyhoo, after applying the usual 1000 electrodes and sensors to the patient, Denise prepares the patient for lights out.  And this boy, with his chocolate Pop Tarts and ADHD and inability to fall asleep before 1AM, gets out his cell phone and his iTouch and his Nintendo DS and prepares to fall asleep as he usually does: that is, by NOT sleeping and by STIMULATING his brain with all of this electronic paraphernalia.  So, Denise, bless her heart, turns all of the stuff to the OFF position and leaves the patient and his father sulking.

Lo and behold, the patient was asleep within FIFTEEN MINUTES.  Yet another cure for the Sleep Tech Moms.

Free Advice that is actually valuable

If you haven't subscribed to Baby Center, they have some good and practical advice on kids and sleep.  This link is on babies and includes tried and true Trixie and Denise methods like: if the diaper isn't leaking onto your hands, don't change it; turn off the lights; and Denise's fave, lose the baby monitor.

It really is just common sense!

babycenter

Hate to say we told you so

but we did.
Sleep Review Mag on kids and electronic media


Use the "off" button and remember that you, the parent, are indeed the boss of them.

Perfect Example

In yet another instance of life imitating art (or something like that), Denise had a wonderful example of sleep environment meets medical condition at work the other night.  A set of adorable male twins, age 2 (every sleep tech's nightmare: two is the very very very hardest) came in for a sleep study.  Denise, since she is perfect in every way, had read the patient charts ahead of time and knew that the instructions were that the little lads needed to be in bed NO LATER THAN 7PM!

Denise rolled her eyes and got to work early to accommodate these little darlings, even though she had already diagnosed them as "GOING TO BED TOO EARLY".  Chief complaints of the parents of these sweet boys were "restless sleep, awakening before 6AM."  Additionally, seasonal allergies were noted and snoring was reported.

Denise noted that Twin 1 had an essentially quiet night and that Twin 2 exhibited snoring and position changes.  Denise's diagnosis: Twin 2 is waking Twin 1 with his snoring.  Mom corroborates this theory by telling Denise that the twins do yell and talk at night.  Denise thinks to herself and refrains from saying out loud "Twin 1 is yelling at Twin 2 to stop making noise!"  Parents also note that maybe they should put the kids to bed a bit later, but that they (the parents) NEED TIME TO THEMSELVES.

So here, it is important to reiterate, if you have children, you will get time to yourself when your children are 60 years old and not a moment before.  Unless you have a full time nanny and housekeeper, in which case we probably don't want to know you.

Also, it is important to point out, that Twin 2 has a crowded airway and will likely have his tonsils removed.  Which will make Twin 1 very happy.

Just a little more on Newbies...

Lest we forget, those of you who give birth prior to your due date (especially those of you who insist on giving birth to preemies) and those of you who have little ones who come into the world a little unwell (whether it's jaundice, reflux or something more serious) can expect the calendar for sleeping to be pushed back even a bit more.

If your bun came out of the oven too soon, remember to count developmental age from his or her due date, not from the birth date.  And don't expect consistent sleep if your Muffin is battling a medical condition, whether the condition is short-term or long-term.

Sorry for the tough love: no one understands sleep deprivation like a sleep technologist, since it is a job hazard for us.  Sometimes, though, knowing what to expect is half the battle.

Newbies

Trixie has four friends who are newbie parents.  So, that got us thinking about infants and how much they sleep and how we will frequently hear newbie parents tell us that they are going to put their infant on a schedule.  And how we then nod politely before leaving the room and doubling over with maniacal laughter.

If you try to put your newborn infant on a sleep schedule, it will fail miserably, UNLESS the schedule that you decide on is the one that came with the infant.  Remember that your little bundle has been developing sleep habits during fetal development and that is not going to change just because the bundle no longer resides in utero.

When baby arrives, he or she will sleep as much as 18 hours per day, usually in 4-6 hour increments.  If your friend's mother's cousin's sister-in-law's baby slept through the night from birth, please note that she was LUCKY and that that is extremely uncommon behavior.  Or, perhaps this baby's parents are putting whiskey on the binky, like Trixie's parents did so long ago, but that, of course, is another story.  For the first month, baby will sleep when he or she feels like it and you should sleep then too.

Waah.  Waah.  We know you have jobs and responsibilities and need time to do 100 loads of laundry stunk up with milk puke.  Trust us: learn to nap and learn to go to bed early.  That's why God invented TiVo.

REM sleep, or dream sleep, starts at about six weeks of age.  Coincidentally, that is also around the time that a baby learns to smile.  So now, if  you are ever on Jeopardy and there is an "Arcane Sleep Factoids" category, you can use that.  Also around this time, babies shorten the amount of time they sleep each day and may even stay asleep for longer periods of time.

Three months of age is the earliest that you should expect to have success with a sleep schedule, since that is the earliest that a baby is likely to sleep for six hours or so at night.  And if you think that the NKOTB is going to stay asleep longer than that, well, I have news for you: that's what his teenage years are for.  It's not gonna happen.

So, instead of setting up unachievable expectations, just settle in, learn to take naps and adapt your schedule to baby's instead of expecting it to work the other way around.

A few thoughts about the wickedly funny new book out there

http://articles.boston.com/2011-06-11/ae/29647783_1_parents-hostage-small-publisher-akashic-books

Since Denise and I are perfect in every way and, as Real Actual Profession Sleep People, have never ever had a night in which we even thought of shrieking "GO THE FUCK TO SLEEP!" (oops, pardon me), we understand that parents less perfect that we are may have considered, or even actually stated, those very words.

We think that the book is AWESOME in that it allows parents to admit that they have an issue.  But people, really, the way to address the issue is not by adding more and more complicated routines.  For example, we would recommend that the little lad featured in the article not be put to sleep in a Superhero costume, since a Superhero costume would, perhaps, send a message to the child that he or she can Leap Tall Buildings or Fly Faster than a Locomotive.  We might also suggest that, since this child routinely fights going to bed at his current bedtime and then awakens early in the morning, that the parents consider moving his bedtime back by 30-60 minutes.  Of course, I know that this darling child's dad is itching to grab the remote to watch the Sox and that his mom has had her hand on that bottle of wine since 6:30PM just waiting to pour, but maybe, just maybe, and extra half hour of specified wake time will make Superman more tired and ready to actually go to sleep.

Just saying.

We are also so happy that our Mentor and Hero, Dr. Dennis Rosen, weighed in with some common sense advice.  Thanks Dr. Dennis!

A new post, in which Trixie is aghast

One of Trixie's little darlings had a play date the other day with a pair of twins at his pre-school.  The twins are awesome: really great little guys.  When Trixie arrived to pick up her own LD, she saw that in the twins' bedroom, lining both adorable little beds, were rows and rows of STUFFED ANIMALS!  Trixie believes (and has scientific data behind her on this) that stuffed animals harbor DUST MITES and bacteria and dirt and lots of other yucky things.  Trixie remembered the twins' mom telling tales of upper respiratory woes and could barely restrain herself from grabbing all of the stuffed animals and shoving them into a plastic bag and taking them to the nearest Dumpster.  Harsh?  Perhaps.  However, while a stuffed animal or two can be a nice transition item for a child, three or more is a crowd of really icky and truly hazardous GERMS that get into the respiratory tract and cause all of those sniffles and coughs and repeated bouts of upper respiratory infection that, in turn, lead to disrupted sleep.

So, sorry to come back after a few months and get all snarly on you, but if your child has allergies or coughs at night and awakens from coughing, LOSE THE LOVIES.