Monthly Archives: January 2010

Infant Sleep Diary

The Infant Sleep Diary below is for one day of data.  Keep this diary for 3-4 days, then take the time to analyze it.  The primary thing to look for is consistency:

  • Are the times the same each day?
  • Is the location of bedtime or naps the same each day?
  • Is the order of activities the same?

The answer to each of these questions should be yes.  Research into infant sleep has shown that many sleep routines work well, so long as they are consistent.  For sleep deprived parents, this consistency can be hard, but it will pay off in the end with a child who falls asleep more quickly, and has fewer night-time wakenings.

Naps During the Day

  Nap 1 Nap 2 Nap 3
Start time      
How long to fall asleep      
Total sleep      
Who put baby down      
Location      
Activities 10 minutes before sleep, in order      

 Evening Bedtime

Bedtime:

How long to fall asleep:

Who put baby down:

Location:

Activities 20 minutes before:

Wake time:

Wakenings During the Night

  Wakening 1 Wakening 2 Wakening 3
Wake at time      
How long awake      
Who cared for baby      
Activities during waking      

Total sleep for last 24 hours:

Hotflashes Disrupting Your Sleep?

As women get older and go through the menopausal transition they might experience hotflashes during the day, and nightsweats during sleep.  It is not unusual for me to hear from women that they wake up burning hot, and dripping with sweat.  They report being so damp they even need to change their clothes and the sheets. 

These sleep interuptions can lead to overall insufficient sleep, which contributes to excessive daytime sleepiness, irritability and mood problems.  Here are a few tips to reduce the nightsweats:

–  Consider bio-identical hormone replacement therapy.  You can find a naturopathic physician who specializes in this at www.naturopathic.org.

–  Hesperidin is a bioflavinoid from citrus which stablizes the capillary walls and reduces hotflashes and nightsweats.  My patients have had good success with this.  Be sure to find out from a licensed physician if this is right for you and the correct dosage.

–  One company has been highly recommended to me that makes nightclothes that wick away the sweat, so you can feel comfortably dry.  Check it out at www.wildbleu.com

–  Another company OppoSheets makes sheet sets with half flannel, and half cotton.  This is perfect for those couples where one person tends to be hot and the other cold.  www.OppoSheets.com.

(The Institute of Naturopathic Sleep Medicine and Dr. Darley have no affiliation with the above mentioned corporations).

Baby’s Sleep Routine Helps Momma’s Mood

Baby’s are born sleeping all hours of the day, and being awake in the night. This just doesn’t fit well with adult sleep-wake patterns, and is one of the reasons that new parenthood can be so challenging.

A new research study just published this year helped establish a predictable nightly bedtime routine for babies (7-18 months old) and toddlers (18-36 months old). The children soon fell asleep more quickly, and had fewer night awakenings.  Then they looked at the mother’s mood after the baby had been on the routine for just 3 weeks.  Mothers had significant reduction in tension, anger, fatigue and confusion. The mothers of babies were also significantly less depressed.

All these positive effects came from having a nightly bedtime routine.  In the next few weeks we’ll talk more about how to establish a healthy sleep routine for your baby.  And for those in Seattle, I’ll be giving a presentation on this topic on January 26th.  More details at www.naturalsleepmedicine.net.

Why House Calls are a Pleasure

As a naturopathic physician, it’s been a pleasure to do house calls for patients. It works out well for the patients and well for me, too.

For patients, they have the ease of fitting the visit into their schedule, with no added driving and parking hassles. They are comfortable and can be more relaxed in their home environment.

For me as the physician, I get to know my patients better, and to really understand their lifestyle. Since I specialize in sleep, it’s also helpful to see the bedroom sleep environment. Although we routinely discuss light in the initial office visit, I’ve discovered two patients had a skylight over their bed that they had forgotten to mention.

Historically, house calls were the way medicine was practiced until late into the 19th century. In 1971 only 1% of doctors visits were house calls. In recent years house calls have become more popular, especially for the elderly.  My hope is that this type of visit can become more common for people of all ages, and helps deepen the physician-patient healing relationship.

The Infant and Family Sleep System

There’s no doubt about it, parenting can be hard.  For all those new parents, one of the biggest challenges is helping your infant get to sleep.  The other challenge is to get enough sleep yourself.

Whenever a family talks with me about their infant’s sleep, I also look at the parents sleep.  With all that data about sleep deprivation causing mood and performance impairments, it’s clear that when parents are sleep deprived, they are going to have more difficulty parenting. 

When working with these young families, I encourage them to write down a sleep plan for the family.  The first section is to establish a sleep routine for the child that is consistent, regardless of which caregiver they are with each day.  Parts of this plan should include:

1.  Pre-bed routine that happens before each nap and night-time sleep.  Components can include feeding, rocking, a song or book, a clean diaper.  Doing these activities in a predictable order before each sleep period will help your infant know when to sleep.

2.  An approximate time for each nap and bedtime.  These times will become more established as the infant gets older.

The second section of the sleep plan should be about the parents.  Start by thinking about how much sleep you need to feel good and function well each day.  Segments of this plan can include:

1.  A ‘rest’ or ‘stop’ time about an hour before bed that you will stop doing tasks and switch into relaxing activities. 

2. A bedtime and waketime for each adult which allows enough sleep time.  This should take into account any night-time care that disturbs sleep.  Frequently one of the parents will do most of the night-time care for the children.  If possible,  plan for that care-giver to be “off-duty” at least one or two nights a week so that they can have uninterrupted sleep.  In our household, when we had an infant my husband took care of the baby on Friday nights while I slept in the guest bed, and that solid sleep was so valuable!

Coming up on January 26th I’ll be speaking about infant sleep at the Good Sheperd Center for PEPS (program for early parenting support).  More information at www.naturalsleepmedicine.net under Events.

How to Handle Shiftwork Well

You can learn to handle shiftwork as well as possible.  Here’s a few beginning steps:

  1. Educate your family or roommates about what you’ll need to sleep well.  This includes quiet without interruptions during your sleep time, a dark and cool room, and as regular a schedule as possible.  Sometimes family members are eager to see you and share their news.  When setting a sleep schedule, also schedule a predictable time that you’ll be available to them.
  2. Make your sleep schedule as consistent as possible over the entire week.
  3. If possible, take a short nap during the middle of your shift.  Be cautious to become fully alert before performing your job duties.
  4. Use caffeine strategically.  Caffeine is more effective as a stimulant if you don’t use it much.  During the night shift, take a serving of caffeine at the time when your alertness starts to dip.  The caffeine will take effect in about 20 minutes, and does improve measures of performance.  Be cautious not to take it so close to bedtime that it interferes with falling asleep.
  5. Limit light exposure on the commute home by taking public transit and wearing blue light blocking sunglasses.

With these strategies, shiftwork should be easier.  A special thanks goes out to all those folks who work nights, keeping the rest of us safe.

The Institute of Naturopathic Sleep Medicine focuses on natural care for sleep problems, including shiftwork.  More information is at www.naturalsleepmedicine.net.

Sleep Well in 2010

So . . . ’tis the season for making New Year’s Resolutions. Here’s my healthy sleep resolutions that will help make this the best year ever!
1. Get enough sleep each night, enough so I am ready to get up and start the day with enthusiasm!
2. Stop work, TV and computer about an hour before bedtime so that I can unwind before lights out, and fall asleep easily.
3. Schedule my work day in accordance with my circadian rhythm – mentally hard work in the morning and late afternoon, with filing and less demanding tasks during the mid-day circadian dip (for me this is about 1:30-2:30pm)
4. Keep my bedroom a great sleep environment – cool, dark, quiet, and without all that clutter which makes me think of my ‘To Do’ list rather than sleep.

What sleep resolutions will you make this year?

Dr. Catherine Darley is director of The Institute of Naturopathic Sleep Medicine in Seattle. More at www.naturalsleepmedicine.net