Stick around till the end to learn how the labels you use to describe your child’s sleep habits might be getting in the way of their sleep!
Do your kids have trouble sleeping? Do you have trouble settling down to sleep or staying asleep? Dr. Nanika Coor talks with Dr. Funke Afolabi-Brown to get some tips for common sleep problems with kids and making sure everyone in the family gets a good night’s sleep.
Follow Dr. Afolabi-Brown:
https://www.restfulsleepmd.com/
https://www.instagram.com/restfulsleepmd/
Project Parenthood is hosted by Dr. Nanika Coor.
Have a parenting question? Email Dr. Coor at parenthood@quickanddirtytips.com or leave a voicemail at 646-926-3243.
Find Project Parenthood on Facebook and Twitter, or subscribe to the Quick and Dirty Tips newsletter for more tips and advice.
Project Parenthood is a part of Quick and Dirty Tips.
Links:
https://www.quickanddirtytips.com/
https://www.quickanddirtytips.com/subscribe
https://www.facebook.com/QDTProjectParenthood
https://twitter.com/qdtparenthood
https://brooklynparenttherapy.com/
Hey parents! You're listening to the Project Parenthood podcast. I'm your host, Dr. Nanika Coor, clinical psychologist and respectful parenting therapist. Each week, I’ll introduce you to the same respectful parenting practices that I use to help parents repair and deepen connections with their children. You’ll get tips for cultivating more parental self-compassion, more cooperation from your kids, and more joy, peace, and resilience in your relationship with them.
In today’s episode, I’m talking to Dr. Funke Afolabi-Brown, a pediatric respiratory sleep medicine physician who helps parents and children prioritize sleep for optimal physical, emotional, and mental well-being. You’re going to hear about how to manage your own mental restlessness at bedtime, how to gauge how much sleep your kiddo needs, and how to build good sleep habits right from the start. Stick around till the end to learn how the labels you use to describe your child’s sleep habits might be getting in the way of their sleep!
Dr. Funke Afolabi-Brown is board-certified in pediatric pulmonary medicine and pediatric sleep disorders. As a double board-certified pediatric respiratory sleep medicine physician, Dr. Brown helps her patients breathe better and sleep better. By extension, she helps improve the sleep of their parents. Based in Pennsylvania, Dr. Brown is a speaker, an educator, a writer, and the founder of Restful Sleep MD where she helps busy professional women and their children prioritize sleep to not only achieve their optimal health but also thrive and live to their fullest potential. She does this through courses and programs focused on educating and empowering busy professional women to make sleep a priority as a critical pillar of their health. Dr. Brown does this work to help families learn how to create the best versions of themselves without sacrificing their health and losing sleep!
Here’s my chat with Dr. Afolabi-Brown:
The following is a rough transcript of the conversation.
Dr. Nanika Coor:
Hi everyone. I'm here now with pediatric pulmonologist and sleep medicine physician, restful sleep, MD Dr. Funke Afolabi-Brown.
Dr. Funke Afolabi-Brown:
Thanks For having me.
NC:
FA:
I love it. I'm all about that
NC:
Yes. So, before we jump into talking about the how-tos of restful sleep for children, can you tell us a bit about what sleep pulmonology is and what you do as a sleep medicine physician?
FA:
mm-hmm.
Because one of the things we know is if you have breathing issues, then your sleep is gonna be affected.If you have stress in your life, your sleep is gonna be affected. We have been in the middle of a pandemic for the last two years right now, so a lot of childrens’ sleep and their parents' sleep is affected. A lot of the work that I do is focused on helping children sleep better as well as their parents. One thing we know is when children are sleeping better, then
NC:
Absolutely. Absolutely. Thanks for that explanation. Speaking of parents, one more thing I wanna touch on before you start talking about the kiddos is, what are a couple of tips for us as adults to calm our racing minds so that we can get some sleep? Sometimes you just lie down and your mind starts going. What are some ways for us to get into that restful mode?
FA:
Yeah, that is such a common entity and that's the reason why I said many times we blame our sleep on our kids, like my kid doesn't sleep and comes into my room and wants to co-sleep with me and all that, and so I don't sleep. But then we now get to the point where, oh yeah, my kid is now sleeping well on their own, yet I'm still not sleeping. And for many parents, it's that racing mind, that endless to-do list of things you should have done, you could have done, you would've done, that keeps running this endless loop in your mind. And so a lot of times what I recommend doing is first stepping back to seeing why that is going on. Is this a one-off thing, something that's happening over maybe a period of a few days because you're undergoing a lot of stress, or is this something that's been going on over a very long time?
In which case, we do need to address it because it might be related to insomnia, which is when you have difficulties falling asleep or staying asleep or you're waking up super early. That being said, a couple of practical things that I would recommend doing to address that racing mind is journaling as a form of mindfulness. You could either journal or meditation before bed,
NC:
mm-hmm.
FA:
making sure you have that incorporated into your nighttime routine. And the reason why that is helpful, especially as busy professionals, or moms where we've been going all day, we usually, get our kids tucked into bed where they have this wonderful routine where they talk about their day, we read to them, we have this lovely song and things, and they are off to sleep and then we just hop into bed.
We don't have any time to transition. And so when you have some level of either journaling or mindfulness, or some space to kind of reflect over your day, it helps declutter your mind a little bit. It allows you to sort of process and let go of things that are really out of your control. I would recommend doing that before getting into bed.
NC:
Mm-hmm.
FA:
I've seen that really dramatically change the level of mind racing that parents experience. Another thing you could do when you are doing that journaling activity is write a list of things you're supposed to do tomorrow. So it's not something that's now running in your mind like, “oh, I need to check on this person or send an email or pay this bill.” Write them all down.
And so that way you've let it go, and you'll address it tomorrow and then you could go to sleep. If you find that despite doing that, your mind is still racing, then usually what I'll recommend, especially if you are in bed and you're tossing and turning for so long, is to just get out of bed and do something else. Especially when you're now in that zone where you start to feel very frustrated about your sleep and you are worried about how bad the next day is gonna be, there's just really no point anymore. Just get out of bed, maybe do something calm and relaxing out of bed, and then get back into bed once you start to feel more sleepy.
NC:
Mm-hmm.
FA:
mm-hmm.
NC:
Switching gears a bit to the practicalities of good sleep for kids. Just sort of as a rubric, how much sleep does each age group really need? Like preschoolers, and elementary age kids, and middle schoolers, and high schoolers, do they all need the same amount of sleep, different amounts of sleep? I know that teenagers need a lot of sleep. What's the story there?
FA:
Yeah, absolutely. The National Sleep Foundation has recommendations of the adequate or appropriate number of hours of sleep for people by age. For instance, our newborns are sleeping anywhere from about 14 to 17 hours, so they need a lot of sleep because they're going through a period of very rapid growth and development. And then as kids get older, say our preschoolers for instance, three to five year olds will need anywhere from about 11 to 13. And then our school-aged children usually need about nine to 11 hours of sleep, and then our teens need about eight to 10 hours of sleep. And then in adults we usually will talk about seven to nine hours. So over time, as we get older, the amount decreases a little bit.
But overall, I think more importantly, beyond the absolute number of hours of sleep, because there's such a wide range, is to really see how you feel or how your child feels. If they're having a hard time waking up, for instance, in the morning where they're groggy and they’re exhausted, that might be a sign regardless of what's going on, that maybe they need a little bit more. Maybe they're on the longer end of that range versus, they're ready to go and they're doing okay during the day. They're not sleepy or super duper cranky or having any behavioral issues. I think it's really important to look at the child, see how they are, and then you can make some adjustments to say, “you know what? I noticed every day that you have either a hard time falling asleep at night or that you're not getting adequate sleep. I see that you are just having such a difficult time with regulation, so let's try to get you a little bit more sleep.”
NC:
Mm-hmm.
FA:
I know. Let me breathe. I know.
NC:
Yes.
FA:
And it's true. You know what? You bring up a very good point. When we are sleep deprived, usually we are tired, we're exhausted, we feel sleepy. Most times, our kids are on the opposite end of the spectrum where they are very hyperactive. They may have frequent tantrums, they may be irritable, but usually they're not necessarily sleepy. Mm-hmm.
NC:
You missed your window or something.
FA:
Exactly. Exactly. So you may see their energy level is ridiculously high. That may be a sign that they're actually tired.
NC:
Yes,Yes.
FA:
Mm-hmm.
NC:
So what can parents do in those early years, those infant years, during those 14 to 17 hour sleeps? What can parents do to build healthy sleep habits in those early times, those early months? Are there things they shouldn't be doing or should be doing during that time to create some good habits?
FA:
Yes. I, they're absolutely, it's never too early to start incorporating healthy habits for the family.
NC:
Mm-hmm.
FA:
I usually would not recommend, say for instance, a baby or a newborn in the first four or five months of life, I don't recommend any type of sleep training or trying to put them on some kind of schedule or anything. They kind of make up their own schedule in that sense. But,at that earlier stage, their brains are not yet developed enough to the point where they even know the difference between night and day. And that's why. And then they're feeding so frequently because they're growing. So when they sleep in short bursts within those first few months, that's pretty normal and expected. But as they're getting older, even within that time, you could already start to put in some routines. Say,for instance, even though for your very, very small baby, they're sleeping for the majority of the day, but there's a time when night starts, right?
So you could have a really short routine where you clean them up, you change them into PJs, you sing to them, you could start to incorporate those routines in, and our brains are just incredible. Our brains start to anticipate sleep when you start to do that on a regular, consistent basis. And what I recommend is,don't make it complicated. Make it something sustainable. Make it something pleasurable. For some kids they like to have a bath, and then maybe we read a book and then some bonding time before we put them into bed. And so that's really something that I recommend. When people ask about what should be part of the routine, I think there are really three main areas. It should be around hygiene, around bonding and connection, and maybe some reading of some sort
or communication, I would say. If we talk about hygiene, that would be taking a bath, changing into their PJs, brushing their teeth or something of that sort. When it comes to bonding time, it could be sometimes just cuddling and rocking them a little bit, or singing to them, or just talking and connecting with them on that level. And then in terms of communication, it could be reading to them or having them read to you, whatever that looks like. So those three elements, if you can make sure that your routine includes that it's really, really, really helpful for your child.
NC:
Yeah, that's interesting. And as you say that, I'm remembering that, some of the things that we did when my child was an infant. We still continue to do those things now that she's seven years old. And even just when you start them, she'll just yawn right away.
FA:
That’s beautiful,
NC:
Really. I know that I'm in a good spot. I'm like waiting for the yawn. I'm like, “okay, we're in the spot. We're in the zone.”
FA:
That's exactly what happens. Cause her brain has been conditioned
NC:
mm-hmm.
FA:
to do that. Like it knows, “oh wow, when we start this, then sleep is next.”
NC:
Yes.
FA:
And you know, when you do that and you do it in such a way that's very predictable, especially for young children, they anticipate it and you get less of a pushback because they just know, this is what we do at home. It's not something random or like luck of the draw. And so I think that's really helpful.
NC:
It's true. As you say that I'm realizing, at seven there isn't as much pushback, but I do remember those three, the four, the fives there was, sometimes at bedtime, just so much resistance, so much stalling, so much, “one more book, one more song, one more,” and I don't see that as much anymore. Do you have any advice for parents who are in that more toddler stage when there is a little bit more pushback at that time?
FA:
Yeah, that is so real. The struggle is real. It's very common. And you know, in some cases it might be a little bit of a pushback and eventually they oblige, but in some cases it actually delays their sleep time significantly, and they're tired and they're not going to bed for hours. And it becomes what we call insomnia, behavioral insomnia in children. Because then it impacts the amount of sleep they can get. One of the main things we try to do, especially what that scenario you just described is, is related to limit setting. And sometimes it's present during the day, and it's also present at night. Sometimes it's only present at night. I think one thing is important to address, what the issues are. Is your child scared?
Is there some insecurities going on or something of that sort? Is there a medical condition that's pushing back? Are they uncomfortable or in pain? You wanna rule out anything serious after that. After that, I would say in most children it's neither of the first two, it's just resistance. They don't wanna miss out on all the fun, right?
And so for every request they have to trade in that pass. So we now don't have 10 or 20 requests, we have two or maybe most three, right? You wanna set them up for success. And the conversation you have before that is, “listen, you get two requests and once you're done with the requests, that's it. No more requests, it's done.” Like there are no more requests because they trade that pass in for the request, and then on the, on the other end, you tell them, “but you know what, if you keep those requests, guess who gets to trade the requests in for a treat in the morning?” So then it kind of teaches them. They'll be very careful about what they're requesting. They're not gonna wanna waste it. They'll be better stewards of their multiple requests. And then two, they now have sort of the motivation to hold on to those passes so that they could trade it in for something in the morning either, pick something simple, favorite cereal, you get to make breakfast, you get to pick a breakfast of your choice, you get to, maybe you get a small toy from the dollar store. Nothing huge at all. And if you can maintain that consistency, usually we're able to curb the bedtime resistance and get them sleeping on time.
NC:
Yes. You know, what worked for me at times was to slow down a little bit, and sort of turn up the connection a little bit. Sometimes I found that my child just wanted a little extra time with me. So if I could just sort of give a little bit more, a little more play time, or make it a little more fun, or something more connected, then sometimes that would fill her cup a little bit and she'd be able to settle.
FA:
Oh yeah.
NC:
But that was a challenging time. Those years were challenging. It's really nice that that is behind you. Yeah. Really nice.
FA:
And I love that. I love what you just said because again, it's like looking to see what's going,is there anxiety? Is there stress? Do they feel emotionally a little bit depleted? Do they need the love tank filled a bit?
NC:
Mm-hmm.
FA:
Is it that we've been so busy all day? There's sometimes when you are there, but not really there, you're just like, let's get this routine over with so that I can get back. And they can tell, and sometimes that's their own way of saying, “I need you to be present.” I love what you just said and I highly recommend that. Because at the end of the day, it may just be an extra two minutes and all of a sudden you get their buy-in. So definitely, definitely an option to use.
NC:
Mm-hmm.
FA:
Yeah.
NC:
And it's still for parents' night time, I'm not really ready yet. Do you have any good ideas for this early morning waking? It's not like the middle of the night where you are gonna go back to sleep. Technically it's close to morning, but it's not really morning.
FA:
Yeah. So I think that is something that also happens especially with the time change.When we spring forward and things like that where it seems like it's getting light out, earlier, in those situations, I think the first thing again is checking in, like, are we missing something? If it's a child that's not fully potty trained, they need to use the bathrooms, things like that. Is there anything else going on? And then in that situation, most times you really want to try to maintain that consistency in when they wake up. And so you don't wanna feed into it and say, “okay, you know what? You could go downstairs and watch some TV as long as you don't wake anybody else up”. And that's something that we tend to do because it's like, listen, everybody else is still sleeping.
The problem with that is you have to be careful because sometimes then their brains now get conditioned to saying, “oh, well guess what happens? Every time I wake up early, I get treated with time in front of the tv.” Right? And that may not necessarily be what we want. So what I usually would recommend for that particular situation, first of all, make sure the room is as dark as possible. Because any amount of light that's coming in, it may be light from outside that's streaking in through either the blinds or something like that, that's enough for them to wake up.Our brains are very sensitive to light. So if that's something that's going on, you wanna just check. You wanna make sure their room is really, really dark. You might need to get some blackout shades or blackout curtains or something of that sort.
And if that's not the case, then I usually will recommend getting what you call an Okay To Wake Clock. That's something that works very often where it changes color at a certain time. If,for instance, you would like their wake up time to be 6:30 or 7:00 AM and they're waking up at 5:00 AM, I wouldn't recommend setting the clock for 7:00 AM. I would recommend setting it for maybe 5:30 AM. So it's gonna change color from red to green at 5:30, so they're not allowed to come out of their room until that set time.And then over time, when they're consistently staying in their room at that desired time, you could then start to push it back a little bit and that tends to work very well. If they're in the room and you notice they're still waking up earlier, I would say focus on the light. I have kids who,sometimes the humidifier has like this tiny bright light
NC:
One other issue that we deal with too is,waking in the middle of the night, sometimes even in those early elementary school years, like the five, sixes, and just like waking up in the middle of the night a lot of times, and I'm wondering what you recommend for sort of settling kids back down and getting them back to sleep. Do you stay with them? Do I just stay in bed with them? Do they sometimes come into my room? What is a good way of getting everyone back to sleep again?
FA:
Yeah. That's also something that happens commonly. So one of the things I usually will say is, “whatever you need to fall asleep is what you need to stay asleep”, right? We all have the sleep associations we do, right? I have my pillow, it's cool on one side. Over the course of the night, if it gets warm or uncomfortable, I might wake up and then I switch it over to the cooler side. Or if the pillow falls to the ground for some reason and I wake up, I'm gonna need to pick that pillow up to continue sleeping. The reason why is because the last time I fell asleep, my brain associated my sleep with sleeping on a very cool pillow. So, it turns out we all wake up in the middle of the night, everybody wakes up, we wake up about five times or even more and it's normal, right?
We go through stages of sleep, we go through what we call sleep cycles. You go through light sleep, then you go to deep sleep, and then you go to the dream sleep or REM sleep, and then you cycle through and have a very brief awakening in between those cycles. Those awakenings are called arousals. We are not even aware of it. We don't know, and our kids technically don't know unless the last time they fell asleep there was something present for them to resume sleep. So if for instance, like I mentioned the pillow, if for instance a parent was there, like you as a parent, you lay with them to fall asleep and they fell asleep and then you left the room. When they're cycling through their sleep, they're gonna have that brief awakening. But then their brains
will look out for, “okay, am I safe right? Is my parent here? Because my parent was here when I fell asleep last time. My pillow, my blanket, all those things that I fell asleep in are still present,” and if it's not present then they wake up more fully and then they need that element, that parent or blanket, whatever it is, they need it to resume sleep. And so that's the principle. Funny enough, even though people come and are like, “well my child wakes up a lot, how do I settle that?” We go all the way back to the beginning of the night and I say, “what's your routine like and how is your child falling asleep?” I would say 7 times out of ten, parents are with their child when they're falling asleep and so the child is scared when they wake up cuz they need their parent.
If it's a baby, sometimes they may be given a bottle, and they fall asleep with the bottle,and then when they wake up, they need that bottle. When we're able to then notice that association, what I recommend doing is breaking that association gradually, as much as you can tolerate as fast or slow as you can. So if you are a parent that needs to be there, then we kind of have to walk you gradually out of the room. Only focus on the nighttime for that period. Because in the middle of the night, if you're trying to do all that, everybody's gonna be frustrated and nobody's gonna get sleep. So, in the middle of the night, if you have an awakening, I would say just do whatever it is you need to get back to sleep and we just focus on bedtime. Once we're able to address that independent sleep at bedtime, then as your child wakes up, typically they'll be like, “oh yeah, the last time I fell asleep I was here by myself with my blanket. No parent was here. I'll be able to resume sleep again.” Really that's the strategy. I wouldn't pay too much attention to the middle of the night if your child needs you, or needs a bottle, or needs some kind of crutch to fall asleep.
NC:
Mm-hmm.
FA:
Yeah.
NC:
Okay. That makes a lot of sense. And so as we're coming closer to the end of our time together, I'm wondering,in all of your travels in sleep hygiene,what's one of the things that is maybe a myth that you wanna clear up about things that parents might think about sleep or sleep hygiene?
FA:
Two things I would say. One is for the parent and then one is for the child. One thing I hear a lot of people say is, “my child is a bad sleeper.” It's very common, and it sounds very benign, but the thing is usually we say it within earshot of our child too, and I would say, your child is not a bad sleeper. Your child may need you to fall asleep and may have some sleep struggles, but every child can be taught to sleep well. They can have the skills to sleep independently and if not, if you need help, there's help out there. But, bad sleep is not who they are. They may not sleep well, but it doesn't really define them. So I think that that helps a lot because when people come in and say, “well my child is a bad sleeper. My first born sleeps well, the second bone is a bad sleeper. I was a bad sleeper.” It almost seems like, well there's really nothing we can do. This is how they’re genetically built
NC:
FA:
Yes we do. And then the other piece for the parents is the myth of, “I need seven to nine hours of sleep.” It becomes something we fret over and we feel like we’ve fallen short because we didn't get seven to nine hours because we brought our phones into our beds, or because our mind was racing, and then it becomes a guilt trip, right? That's not the goal. Like I mentioned, seven to nine hours is the recommendation, but there are people that sleep a little bit less than that. There's some people that sleep a little bit more than that. And so really finding who you are in terms of, how do you feel when you wake up? How do you feel during the day? Do you need caffeine? Are you taking naps nonstop all day? Then you kind of work your way back and say, “okay, I think I need a little bit extra.” But that seven to nine, it sometimes locks us in. It ends up creating a lot more anxiety.
NC:
Yeah. That's such a good thing to remind us of. Especially parents who can give themselves such a hard time about so many things that it really does make good sense to be self-compassionate. Right. And, and be easy on yourself and try to sort of tweak things little by little rather than just deciding that you're a failure at something.
FA:
The parenting journey is hard enough already, right,
NC:
I'm Telling you. I'm telling you. Thanks so much for being here with us. Thank you for giving us your expertise and sharing your knowledge with us. And I'm sure I'll have many, many more questions.
FA:
Oh, thank you. I really appreciate it and I've just had a great time chatting with you.
—----------------------
I hope that’s helpful!
You can learn more about Dr. Afolabi-Brown’s work at https://www.restfulsleepmd.com/ and follow her on Instagram @restfulsleepmd.
You can learn more about my work with parents at www.brooklynparenttherapy.com and follow me on Instagram at BKPARENTS.
If you have more questions about family sleep hygiene, or any other parenting questions or stories, leave me a message at (646) 926-3243 and be sure to let me know if it's okay to use your voice on the show. Or, send an email to parenthood@quickanddirtytips.com. And don’t forget to subscribe to Project Parenthood on Apple Podcasts, Spotify, or wherever you listen to podcasts.
Catch you next week!