Is My Child Overtired?: The Sleep Solution for Raising Happier, Healthier Children by William G. Wilkoff

From Barnes & Noble

Our Review
Leg cramps, migraines, poor academic achievement -- even marital discord can be attributed to an affliction that many might consider prosaic: lack of adequate sleep.

So says author and pediatrician Will Wilkoff, who, during his 25 years of practicing medicine, has found sleep deprivation to be the culprit in numerous health problems. In his new book, Is My Child Overtired? The Sleep Solution for Raising Happier, Healthier Children, Wilkoff admonishes parents to take a critical look at their children's sleep patterns as well as their own.

"Although there is a wide variation in the stamina of children, most parents underestimate how much sleep their children need," he writes. "Before you consider a later bedtime you must be able to honestly say that your child is happy, successful, and healthy -- and that you are rested and have enough time for yourself."

The premise is intriguing -- think how often new parents worry that they are not meeting their infant's sleep needs properly or wish desperately for a couple of hours to themselves at night. Could it be that lack of adequate sleep for both you and your child could be detrimental to your child's overall health and happiness?

Wilkoff believes that getting an early start in helping your child form good sleep habits is essential. Within the first few weeks of life, he writes, you should place your baby in a separate room, or at least in a darkened corner, and pick him up only for changing and feeding. You must keep the lights low and activity limited between 7pm and 7am to begin the process of teaching him the difference between night and day, sleep time and play time. By consistently putting him in his crib to sleep, you will help foster an association between a cozy place and slumber. These rules for infancy establish the guidelines for childhood and beyond.

Although the author discusses the various obstacles parents may encounter in implementing his sleep schedule, his solutions invariably turn to behavior-modification techniques. He does not offer different tactics for different personalities, nor does he discuss the more complex psychological reasons for sleep difficulties.

Wilkoff's approach can seem coldhearted. He believes that in some instances parents should let a baby cry herself to sleep for up to an hour without visits -- and in the case of an older child who repeatedly leaves her room at night, they should lock her door. "Don't worry if you find your child asleep on the floor," he comments on the latter scenario. "If you have provided her with warm pajamas and enough blankets she will be able to keep herself warm." Such an unyielding approach will certainly repel some parents.

Still, to his credit, Wilkoff makes numerous creative suggestions for a wide range of sleep-related dilemmas. He recommends serving lunch mid-morning for an overtired or sick toddler who could use an extended after-meal nap, preserving an afternoon siesta, or quiet time, when your child has outgrown naps, and negotiating realistically with teenagers, who need more sleep as they approach adulthood, not less. He offers practical advice on choosing a sleep-friendly daycare, getting decent rest while traveling, and balancing children's visits between divorced parents.

Although the book's strongly behaviorist bent is surely not for everyone, Wilkoff's clearly stated thoughts on the vital importance of sleep will make you think twice about taking your one-month-old to a wedding or planning a busy overseas vacation. The book will inspire you to reassess your own and your children's sleep habits and perhaps make some real changes to get the rest you all badly need.

--Sara Kandler

From the Publisher

More and more often, bedtime is a battle that parents just don't have the energy to fight. With the demands of juggling work, running a household, and raising kids, it is easy for parents to be lax about their children's sleep habits. They may not realize that fatigue is the number-one cause of health and behavioral problems, and it is frequently overlooked. If you find that your kids are often cranky, hyperactive, or prone to headaches and growing pains, these are red flags that they may be overtired.

Describing the unique sleep requirements for every stage of a child's development from infancy through adolescence, Is My Child Overtired? is a proactive child-rearing plan that encourages parents to establish and stick to a sleep routine for the whole family. Pediatrician Will Wilkoff, M.D., explains how to recognize the signs of fatigue and gives you specific guidelines to determine how much sleep a child really needs (you'll be surprised -- they need a lot more than you think). Combining practical wisdom with a voice you can trust, Is My Child Overtired? discusses:

• Getting off on the right foot with your new baby
  
• Helping your child to sleep through the night
  
• Crafting a relaxing and reliable bedtime ritual
  
• Adding daytime siestas when nighttime sleep isn't enough
  
• Finding ways to maintain bedtimes on weekdays, on weekends, and even during school vacations and family trips
  

Simply put, when your kids sleep more, they'll feel better. And so will you.

Product Details

• Table of Contents
• Read a Sample Chapter

Table of Contents

Read a Sample Chapter

Chapter One: How Can I Tell If My Child Is Well Rested?

Step One: Suspect the Diagnosis

If your child is old enough to articulate her feelings, she may simply tell you that she is tired. However, most parents aren't this fortunate. Many five-year-olds with a thousand-word vocabulary will deny with their last waking breath that they need to go to bed, and then collapse into a deep sleep on the couch.

You may be able to tell when your child is tired by her behavior, but unfortunately many parents don't realize that their children are seriously fatigued. They may search for another explanation for a child's behavior when in reality sleep is the solution. Here are some ways to tell if your child is well-rested.

Let's Check the Numbers

Dr. Richard Ferber, clinical director of the Center for Pediatric Sleep Disorders at Children's Hospital in Boston, has kindly allowed me to reprint a chart from his classic book, Solve Your Child's Sleep Problems (Fireside Press). It clearly displays the relationship between age and sleep requirement.

FIGURE 1 Typical Sleep Requirements in Childhood

Like many other parents, you may be shocked to see how poorly your child's sleep patterns compare to Dr. Ferber's bar graph. You may be tempted to defend the situation by uttering the phrase I hear in my office on a daily basis: "My daughter [or son] just doesn't seem to need as much sleep as other children." You are probably wrong.

Yes, it is true that the sleep needs of individual children can vary widely, and Dr. Ferber's table should be used only as a rough guideline. However, in my experience most parents seriously underestimatetheir children's sleep needs. There are several reasons for this unfortunate miscalculation. One is the temptation to accept as normal certain fatigue-related phenomena such as falling asleep in the car or having to be awakened in the morning. Another is the failure of parents to recognize symptoms such as crankiness, temper tantrums, hyperactivity, headaches, and leg pains as manifestations of sleep deprivation. Instead these behaviors and complaints may be blamed on dietary deficiencies or some inherent personality flaw.

Carried by waves of technological change, our society has drifted from a lifestyle that was once dictated by sunrise and sunset. We have come to accept an abbreviated night's sleep as the norm. I continue to be troubled by how many parents believe that nine o'clock is an acceptable bedtime for a five-year-old who must be awake by seven to get ready for kindergarten. They wrongly assume that because their friends' children go to bed that late or later it must be normal.

There is a phenomenon scientists call "biologic variation." In simplest terms it means that we are all a little bit different. Your child may become tearful and clingy when she gets overtired. Mine may become belligerent and hyperactive. Your neighbor's six-year-old may appear to function perfectly well on ten hours of sleep each day, and your six-year-old may wake with fatigue-related leg pains if she gets anything less than twelve hours. It just happens.

I doubt that I will live long enough to see all of these differences and vulnerabilities explained, but I am sure that eventually scientists will be able to identify some of the minor variations in brain structure and chemistry that are to blame for these inequalities that at times seem terribly unfair. Don't wait for science to catch up with your own observations. Learn how your child's body and behavior respond to sleep deprivation and learn how much sleep your child needs. You can use Dr. Ferber's chart as a place to start, but your child's requirement may be slightly more than his table suggests is optimal. Don't compare your child's sleep patterns to her playmate's or her cousin's. You may be unaware of the problems their parents are experiencing. Each child has her own limits and peculiar ways of responding when those limits are exceeded. Yes, there are patterns, but treat your child as the special and unique individual that she is.

Here Are Some Clues That Your Child Is Sleep-Deprived:

Your Child May Not Be Getting Enough Sleep/Rest If...

• When compared to Dr. Ferber's table, her sleep deficit is more than an hour.
• She must be awakened in the morning.
• When allowed to sleep in the morning she sleeps more than a half hour longer.
• She falls asleep as soon as she begins an automobile ride.
• She is frequently cranky and whiny.
• She has numerous temper tantrums.
• It is hard to describe her as a happy child.
• She wants to carry a special stuffed toy or blanket all of the time.
• You frequently find her sucking her thumb.
• She often wakes at night with leg or foot pains.
• She frequently has what appear to be nightmares.
• She has severe afternoon or evening headaches that may be accompanied by vomiting.
• She seems distractible or hyperactive at times, usually in late morning or late afternoon.
• Despite doing well in grade school her grades begin to fall in middle or high school.
• She frequently says she is tired.

This is only a partial list. There are numerous other symptoms and behaviors that can be attributed to fatigue. If you can honestly describe your child as happy and content 95 percent of the time, your child is probably getting enough sleep and rest. However, if your child frequently seems unhappy or angry, and/or you aren't enjoying being a parent, it is time for the sleep solution.

Copyright © 2000 by William Wilkoff, M.D