When your child's sleep patterns cause a definite problem for you or for him, then he has a sleep problem. This is true, for example, if he complains of inability to fall asleep, or if you find you must be up with him repeatedly during the night.
Sleep problems such as sleep terrors, sleepwalking, or bedwetting are also readily apparent and quite easy to identify as sleep disorders. But others may be less obvious. You may not recognize that your child even has a problem, or you may not realize that the problem he does have should be considered a disorder that can and should be treated. You may not be aware that loud snoring every night, besides keeping you awake, may be a warning that your child is not breathing satisfactorily while asleep.
Other symptoms of possible sleep abnormalities which should be identified and treated are: frequent difficulty falling asleep at bedtime, waking during the night with inability to go right back to sleep alone, waking too early or too late in the morning, falling asleep too early or too late in the evening, or being irritable or sleepy during the day.
One of the least obvious of sleep problems is that of insufficient sleep. There is no absolute way of measuring whether the amount of sleep your child gets per day is appropriate. We can watch each child's behavior during the day closely to see if he seems excessively sleepy or cranky. But the symptoms of insufficient sleep in a young child can be very subtle.
If your two-year-old sleeps only eight hours at night but seems to be happy and functioning well during the day, it is tempting to assume he doesn't need more sleep. But eight hours is rarely enough sleep for a two-year-old, and with the proper intervention he can learn to increase his amount of sleep time considerably. You may begin to notice an improvement in his general behavior and only then will you be aware of the more subtle symptoms of inadequate sleep that actually were evident before you adjusted his sleep schedule. Now your child will probably be happier in the daytime, a bit less irritable, more able to concentrate at play, and less inclined to have tantrums, accidents, and arguments.
It is also difficult to decide when nighttime wakings are "abnormal." A young child from six months to three years may be getting adequate amounts of sleep at night, even though he wakes several times during the night and has to be helped back to sleep. Parents will say to me, "Tell me if this is normal. If it is, I will continue getting up; but if it is not, then we would like to do something about it!" I assure them that most healthy full-term infants are sleeping through the night by three or four months of age. Certainly by six months all healthy babies can do so.
If your baby does not start sleeping through the night on his own by six months at the latest, or if he begins waking again after weeks or months of sleeping well, then something is interfering with the continuity of his sleep. He should be able to sleep better, and in all likelihood his sleep disruption can be corrected.
How well your child sleeps from the early months affects not only his behavior during the day but also your feelings about him. I have often heard a parent say, "He is such a good baby. I even have to wake him for feedings." Although the parent is saying the baby is a good sleeper, the words imply that the baby is "good" in the moral sense. It is easy to see that this distinction will influence how you relate to your child.
If your child does not sleep well, he may well be making your life miserable. It isn't hard to think of such a bad sleeper as a "bad" baby. You will probably feel enormously frustrated, helpless, worried, and angry if you have to listen to crying every night, get up repeatedly, and lose a great deal of your own much-needed sleep.
If your child's sleep disturbance is severe enough, your frustration and fatigue will carry over into your daytime activities and you are bound to feel increasingly tense with your child, your spouse, family, and friends. If this is the case in your home, you will be pleased to learn that your child is almost certainly capable of sleeping much better than he is now, and you should be able to get a good night's sleep yourself. To do this, you will need to learn how to identify exactly what your child's problem is, and then you can begin to solve it.
Copyright © 1985 by Richard Ferber, M.D.
Excerpted with permission from Solve Your Child's Sleep Problems, Fireside, 1986.