Sleep Clinic – your questions answered

Supernanny is giving you the opportunity to put your sleep dilemmas to Mandy Gurney from the Millpond Children’s Sleep Clinic. Read on for some much-needed advice on common sleep problems, and check out our other sleep clinics!

Q "My 20 month old son slept through the night from nine weeks and has since been wonderful at going to bed. Just before he turned 18 months, he was put into his own bed and even that went surprisingly well. When I said it was bedtime at 7pm he would kiss Daddy goodnight, take his bottle and head for the stairs to go to his bedroom. I would put him in bed, kiss him goodnight, turn off the light, shut the door and we wouldn't hear from him until 6-6.30am the next morning.

Three nights ago he woke up screaming (quite hysterically), got out of his bed and started banging on the door. We thought maybe something wasn't right - it was so out of character - and after my husband tried to settle him and that still didn't work he bought him into our bed. He settled but it still took him a while to go to sleep.

The next night I put him to bed as usual and he was fine until I walked out of the door and shut it. I went in to put him back into his bed 28 times before he stayed there and went to sleep.

We didn't hear from him until the next morning. On the third night I suspected I would be in for much the same thing although hoped for less than 28 times. It was 25 times before he stayed in bed.

I thought I was onto a winner and over a few more nights he would get the message, but he awoke at 11.30pm and just banged on the door and screamed. I got up, opened his door and he ran back to his bed. I stayed with him for about ten minutes, standing beside his bed, not looking or talking to him. As soon as I walked out, the same thing happened, with screaming and banging on the door. Eventually I gave in, went downstairs with him and slept in another bed. He was fine in bed with me. Please help."

Mandy says:

“My first thought is that your child may be starting to have nightmares, which could have triggered this problem in the first place. This means that he has to be given reassurance.

However, children don’t have nightmares every night, or frequently throughout the night unless there are some underlying anxiety issues. If he is upset that often, then it’s more likely to be a behavioural issue.

If this is an anxiety-related sleep problem, as I think it might be, then you need to take it slowly. You don’t want to increase the anxiety levels.

I would suggest introducing a Gradual Retreat Programme, that gives your child time to adjust as you distance back from him until he has the confidence to sleep in the room alone.

The Gradual Retreat Programme

• Identify a cushion (one you already have at home) to become the ‘sleepy cushion’. Explain to your son that you will sit on the ‘sleepy cushion’ while he goes to sleep. For the first three nights, place the cushion next to his bed (wait five minutes once asleep to make sure he has gone into deep sleep).
• After three nights in this position move the cushion away from the bedside by one to two feet.
• Repeat this process, moving the cushion further towards the door in small steps every fourth night, until the cushion is outside the door and then along the landing in your room.
• The cushion is a symbol of where you sit and becomes more significant once you are out of sight. Make sure your son knows where you are sitting each night.
• Aim to be in the doorway by night 12.
• The whole programme should be completed by the end of three weeks.

If your child wakes in the night, then replicate exactly the same process as you did earlier.

Top tips

  • You mustn’t reward behaviour by communicating too much – maintain minimal eye contact
  • All communication should be simple.
  • Above all, don’t let the little one sleep in your bed, even if it’s five o’clock in the morning. Your child doesn’t know the time, so you might as well have had him in there all night! You must remember any behaviour that gets a ‘reward’ will not necessarily stop.

As a matter of interest, the Gradual Retreat Programme is also a very good technique to use for older children who have sleep problems. I have recently used it on a 13-year-old with great success.

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Sleep clinic 2 - Mandy answers more of your sleep dilemmas.

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Find out more

Millpond Sleep Clinic was the first private clinic to specialise in babies' and children's sleep problems. It now has a reputation as the UK's leading children's sleep clinic

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