Tuesday, January 13, 2009

the sleep train: part one

I'm not sure how many parts this series of blog posts will have. Hopefully not many. Either way, I thought it was about time I updated this blog on our efforts to help everyone get a little more sleep around here. It's a hard thing to write about without getting defensive, our sleep efforts the past week being one of the latest things we've done in the past seven (almost) months that I really never imagined I'd do. In short, we've resorted to letting Elias experience the dreaded "crying it out." As Neal tweeted the other day, "Crossed a parenting line last night. What do you do when the baby cries in your crib, in your arms, is clearly exhausted? Let him cry." That just about says it all.

Backing up a bit, however, you might remember that up until about three and a half months Elias, though he battled the daytime naps, was a pretty good night sleeper, going to bed pretty easily after his last feeding around 9 or 9:30 and waking up just once to eat again around 3 or 4 in the morning. On a really good night, he'd fall back asleep pretty easily until about 7 or so in the morning (his exact wake-up time is actually a bit fuzzy to me now). That was his usual pattern from about 6 or 7 weeks until we returned from our trip to San Diego in early October. Everything fell apart at that point. Elias started waking up several times a night for mysterious reasons. I bought the book The No-Cry Sleep Solution and read it cover to cover during a car trip to visit family in Connecticut. We never actually did the full-on logs, 10-day plan, or progress reports, but tried to implement some of Dr. Pantley's suggestions over the next couple of months, such as tweaking our bedtime ritual, introducing a "lovey", and, here's the deal-breaker, putting Elias in his crib while he was drowsy but not yet asleep. We tried, we really did, and I'm sure there was a window of opportunity for this kind of thing at some point that we missed, but it seemed virtually impossible to put Elias in his crib in any state other than deep sleep. Our "soothe to sleep" strategy mostly involved me swaddling and then bouncing and shushing him for about ten to fifteen minutes. I'd wait for this little exhaling thing he'd do after his eyes had been shut for a few minutes, bounce a couple minutes more, then very carefully transition him from my arms to the crib. For the most part, he'd stay asleep but more and more often lately, he'd wake up and I'd have to start all over again. I didn't mind helping him to sleep, but the starting all over again was getting a little frustrating, especially when he'd wake up as many as five or six times a night and require this little routine every time. I had to go to bed by 10 just so I could get about five or six hours of total, interrupted sleep by the time he was awake for the day around 6:30 or so.

But during the month of December it seemed like we were making some progress. Very, very slow progress but progress nonetheless. Elias had slept through the night, from about 7:30 in the evening until about 6:30 in the morning, no waking up, two or three times since the six-month mark. One of those nights he was even in the sleepsack! When he was swaddled, it was usually with one arm out or very lightly swaddled and he'd wake up in the morning with both arms free. But last week was downright brutal. Elias seemed to have taken a huge step backward, waking up every couple of hours, and it taking us two or three tries to get him back to sleep each time. Daytime naps disappeared completely. He didn't seem to be teething and ironically, while his sleep patterns had experienced a serious backslide, his spit-up decreased dramatically. So it didn't seem like we could blame it on his reflux, either. Finally, on Thursday night (or rather around 2 a.m. on Friday morning), I believe it was, after Neal and I both tried for almost two hours to get Elias, clearly exhausted but not hungry (mostly uninterested in the bottle I eventually offered him), recently diapered, temperature checked, back to sleep with no success, I felt helpless. We hit a wall. I didn't know what else to do, so I placed him in his crib, gave him his lovey, rubbed his belly, and told him I loved him, then I laid down in bed and listened to him cry for the next 30 minutes. He slept until about 8 the next morning and, fortunately, woke up his usual way - cooing and babbling to his lovey and a mirror that hangs in his crib and he greeted me with a smile when I got up and went to fetch him.

Now, I'm not going to sugar-coat this process nor am I claiming success just yet. But in the spirit of full disclosure that this blog seems to have, for the most part, maintained during pregnancy and beyond, I wanted to write a post while we're in full-on sleep training mode. Listening to Elias cry for 30 minutes sucks. There's no other way to put it. I feel physically ill. But I have to admit, so far at least, I thought it would be worse. I've heard horror stories about babies crying two or three hours before finally falling asleep. And we'll see what happens next time he's teething or following our next trip. But I felt desperate. We're employing Dr. Weissbluth's suggestions from this book (trying instead to "ferberize" Elias only lead to intensified crying each time we'd go in and check on him) and I have to agree with one of the "practical points" in the book that explains how "sleep problems in children may cause maternal depression." As always, there are far worse things we could be dealing with as parents, but after three months of this "sleep regression," "depressed" is the word I'd unfortunately use to describe how I've been feeling the past couple of weeks.

So where do we stand? Well, Elias has yet to cry for more than 30-40 minutes before falling asleep. On Sunday night I wasn't sure CIO was going to work. After about a half-hour of crying, we decided one of us should go in to check on him, make sure his head wasn't crammed into the top corner of the crib, that sort of thing. Neal checked on him and then his crying intensified with a vengeance after he left the room. A couple minutes later it sounded like he was gagging so I rushed in, picked him up, and he threw up at least the entire contents of his last bottle onto the floor. I stood there holding him in the middle of the room, both of us crying while Neal dried us off and then proceeded to rock Elias back to sleep. He woke up a few minutes later, fussed for a few minutes and then fell back asleep on his own. We'd decided that we should proceed with the plan but for that night at least, considering he'd pretty much emptied his stomach before falling asleep, err on the side of feeding him should he wake up in the middle of the night. Sure enough, he woke up around 1:30 and started to fuss a bit, but before I could even wake up enough to remember the plan he'd fallen back asleep. We had to wake him at 8 the next morning since we had morning plans. Last night was better in that, although he cried a few minutes longer, he never really got to the point of down and out wailing and as an added bonus, there was no vomiting. He was asleep by about 8 and slept until about 7:30 this morning. I might add that he's been unswaddled, in a sleepsack instead, and has managed to roll himself onto his tummy every night and during every nap since the sleep training began. Once again this morning I woke up to find him on all fours, a big smile on his face as soon as he saw me. Honestly, how this kid doesn't remember the trauma of the night before is beyond me, but I'm grateful for it.

As for naps, those have been a little hit or miss. Yesterday was a busy day so Elias napped mostly in his carseat. As for today, I put him down this morning, after he began to show tired signs, he cooed for a few minutes, fussed for a few minutes, and then slept for about an hour. This afternoon was a little less successful. He did the same thing he did in the morning, slept for about 20 minutes, then woke up crying. I'm still not sure what to do if we're successful at getting him to fall asleep on his own but he wakes up crying shortly after. Do we start all over or let him cry? I chose to go in and soothe him back to a sleepy state, then return him to his crib (he was clearly not rested yet). He of course cried pretty hard for a few minutes before falling back asleep and staying that way for a little over an hour.

We'll see how tonight pans out. Stay tuned...

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