Friday, July 04, 2008

Bedtime Routine

Seng Chor and I have been struggling with Jordan's sleeping habits for quite some time. I guess both of us have failed to establish a proper bedtime routine with Jordan. We find the article below from The Star useful. Seng Chor read it first and shared with me during lunch time yesterday. Coincidentally, my mum forwarded the article to me after lunch.

We have also heard positive comments from friends who have been practising regular routine with their children. Seng Chor and I have started to work on some of issues with Jordan. Last night was a good start.


A regular routine helps children to settle down for the night.

IF you are a parent with young children but physically resemble a character from Night of the Living Dead, read on. Parents tend to be more concerned about their child’s nutrition and learning abilities rather than sleep.

A recent international study involving 30,000 children aged zero to three has shown that many parents feel their children do not sleep well, especially Asian children.

Completed last year, the International Sleep Study on Infants and Toddlers was conducted in 17 countries. It involved 12 Asian countries (over 20,000 children) and five Western countries consisting of the United States, Canada, Britain, Australia and New Zealand. In Malaysia, 997 parents and caregivers responded to the survey, which was conducted online.

The survey, jointly conducted by Johnson & Johnson and the Asia Pacific Paediatric Sleep Alliance (APPSA), is believed to be the largest of its kind.

“Sleep may seem like a natural process but many mothers neglect the importance of good sleep in their children,” said Joyce Lee, Johnson & Johnson Malaysia’s managing director.

Led by prominent US-based paediatrician Dr Jodi Mindell, the study showed that 26% of parents in Caucasian countries believe their child has a sleep problem compared to 54% in Asian countries. (Overall, results in Malaysia and the other Asian countries were very similar.)

Among the questions in the survey was whether parents practised a consistent bedtime routine with their kids.

“Only 53% of Malaysians practise the same bedtime routine with their child compared to 71% of Caucasians,” said How Ti Hwei, director of professional marketing with Johnson & Johnson Asia Pacific.

“In addition, 84% of Malaysian children sleep in the same room as their parents compared to only 35% of Caucasians,” said How, who was involved in the survey.

However, consultant paediatrician and paediatric pulmonologist at Hospital Serdang, Dr Norrashidah Abdul Wahab, advocates co-sleeping, but in different beds.

“The main reason for sleeping in different beds is safety. I also find that mothers do not really want to be separated from their young child.

“It is also easier to breastfeed a child who is in the same room and mothers can also tend to the needs of the child immediately,” she said.

The sleep survey also found that the average time children go to bed in Asia is 9.30pm but in Caucasian countries, it is 8.30pm.

“Caucasians have a specific, earlier bedtime for their children. On the other hand, most Malaysians are not aware of the importance of good (sleep) habits,” said Dr Norrashidah, who is a member of APPSA.

Dr Norrashidah believes that the time children go to bed is important.

“Malaysian children tend to sleep later and wake up late, at nine or 10am. They should sleep by eight or 9pm for the proper cycles of rapid eye movement (REM) sleep and non-REM sleep to take place,” she explained.

REM sleep is important for brain development while during non-REM sleep, physical growth takes place.

She said that non-REM sleep occurs from 8pm onwards; towards the early morning, more REM sleep occurs.

“The age between zero and three is a crucial period for growth, which happens during sleep,” she said.

To get children to sleep earlier, their afternoon naps should only be about one to two hours, she added.

Proven routine

Prior to the International Sleep Study, Dr Mindell carried out a clinical sleep study in the United States involving 58 mothers and their babies aged seven to 18 months over three weeks.

The study, conducted in 2005, involved practising a three-step routine before bedtime, which comprised a bath, massage and quiet activities like story time.

Results showed that babies slept faster and woke up in the middle of the night less. The longest sleep period in the night also increased by 23% and mothers reported that they were less tired.

“This study shows that a simple three-step routine can help both children and mothers sleep better,” he said, adding that the routine should not take more than 30 minutes.

Added Lee, “Many mothers know intuitively that a routine works. Now, we are sharing with them a practical and proven routine to follow.”

Asian parents who might not be open to bathing their children at night have an alternative – wiping them down with warm water.

“The warmness calms and relaxes the child,” said Lee.

Dr Norrashidah said a regular bedtime routine is important to teach the baby to unwind and go to sleep to maximise the restorative benefits of sleep to aid the baby’s cognitive, social and physical development.

“The lack of a bedtime routine and healthy sleep in the long term can affect a baby’s memory, learning ability and even well-being,” said Dr Norrashidah.

She stressed that the key points are to put a baby to bed early from the start and to continue practising a routine.

“Bathe or wipe them down, change them into their pyjamas, dim the lights, and spend time with them. Read them a book or sing a song. It’s also good to massage them because it is relaxing.

“A routine should continue until the child is about five years old,” she said.

She added that many Malaysian parents do not practise a set routine with their children due to their busy lifestyle.

“Understandably, most mothers work these days and come back late but they still want to spend time and play with their children at night,” she said.

Dr Norrashidah added that although a bigger study is needed, the clinical sleep study shows that a routine is effective in helping children sleep better.

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