Sleep survey says....

Ask any new mom to identify the perennial parenting hot topics — topics that tend to trigger the most debate amongst parents, both online and off — and you'll find that sleep ranks high on her list. Given how much moms value sleep, how difficult sleep is to get, and how much sleep-related advice she has to contend with (good, bad, dated and bizarre), it would be surprising if sleep didn't make her list.

Two years ago, I wrote my book Sleep Solutions for Your Baby, Toddler, and Preschooler with a single aim in mind: I wanted to help parents navigate the sleep information maze without feeling totally overwhelmed. (The first thing the parents on my advisory panel told me when I asked them for their input on the book I hoped to write was, "Don't make parents feel any guiltier than they already do about the subject of sleep." So I took that as my mantra right from the very first paragraph.)

Then the American Academy of Sleep Medicine decided that it should wade into the fray by providing parents with some guidance on interpreting the huge (and increasing) volume of sleep information and misinformation. A task force was asked to evaluate 52 studies  of behavioral interventions that parents typically use when dealing with bedtime struggles and night wakings in young children (Mindell JA, Kuhn B, Lewis DN, Meltzer LJ, Sadeh A. "Behavioral treatment of bedtime problems and night wakings in infants and young children: An American Academy of Sleep Medicine review." SLEEP 2006;29(10):1263-1276.). The aim was to help parents identify well-established treatments for sleep problems in young children so that they would be better able to make sense of the various sleep training methods and differentiate between those that are based on scientifically proven treatment methods and those that are based on (as yet) unproven theories of what might be helpful or effective.

The members of the task force came up with a list of five strategies which should be recommended to parents. They separated this list into two highly effective strategies and three less effective strategies.

They concluded that the two most effective methods for treating or preventing sleep problems are

1. Extinction (eliminating the sleep problem) with or without parental presence (the parents put the child to bed at a specific time and ignore the child's crying or calls unless they suspect that the child is ill and needs help)
2. Sleep education (when parents receive training on such issues as bedtime routines, developing a consistent sleep schedule, how to help a newborn learn to fall asleep on her own, how to respond to night wakings).

The three other strategies that are still successful, but not as successful as the other two, according to the task force, include

1. Gradual extinction (when parents ignore the child's crying, but respond to the child's crying at either pre-determined intervals determined by the child's age and temperament or how long the parents can stand the child's crying)
2. Bedtime fading (when the child's bedtime is gradually shifted earlier by 15 to 30 minute intervals until the child is falling asleep and waking up at age-appropriate times: this strategy requires a well-established bedtime routine)
3. Scheduled awakenings (the parents wake their child 15 to 30 minutes before the child typically awakes in the night and then rocks or nurses the child back to sleep; then the parents focus on increasing the time between awakenings until the night-time awakenings have been eliminated).

So where does this leave us parents?

Does this mean that there's no role for gentle sleep training methods or the method that never seems to get listed as an option: waiting and seeing if your child will grow out of this stage on his own?

Not at all. These are valid options, too, and options that many parents opt for. They simply don't make the list of the task force's most effective strategies because they aren't necessarily the most efficient methods of getting your child to sleep through the night, which is how scientists measure success.

During my time in the parenting and parenting author trenches, I've learned that every parent has his or her own criteria for measuring success; and the criteria that each parent uses to measure sleep-training success can vary from child to child and from stage to stage. Parents insist on factoring in other variables like family situation, child's needs, parenting style, and other variables that can't easily be factored into even the most complex sleep training study; let alone a review of 52 sleep training studies.

The art of parenting is, after all, far more complicated than the science; and it can't easily be captured by any formula or study.