Podcast #6
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[00:00:00] I wanna talk about babies and children and sleep today. Sleep is something I talk about all the time in my practice with both my adult patients and the parents of the children who see me. It is such an important topic and it really is something that. Can make life as a parent of babies and young children.
Incredibly challenging. Sleep has critical functions relevant to developing brains. Sleep in general supports memory consolidation, emotional regulation, immune function, and overall health of the brain and nervous system across the entire lifespan, not only in childhood. There's a really fascinating book on sleep that was written by Matthew Walker.
The name of the book is Why We Sleep, and in it [00:01:00] he talks about sleep and learning. You wanna remember that for babies and for children, learning is their full-time job, right? It's pretty much all that they do, and being able to do it well is dependent on sleep. According to Walker's, sleep is necessary before learning something new in order to be able to learn and absorb the new experience and sleep after learning stabilizes new neural connections so that you can remember what you learned after the fact.
So what he's saying is that you have to sleep in order to learn something new. And you have to sleep after learning something new in order to remember what you learned. That describes sleep in quantity, and it's really important that our kids are getting enough. Sleep. The quality of the sleep we get helps us to shape emotional [00:02:00] regulation and cognitive function.
And that's also not only for our kids, I think any of us can attest to the fact that when we get tired, cognitive function and emotional regulation decline for all of us. And we have definitely all seen what a 3-year-old who has. Hit the wall looks like right. The dreaded overtired has caught all of us off guard more than a few times.
I have no doubt. The hard part is that babies are born with an immature brain and an immature nervous system that isn't automatically wired to sleep like adults do. And in addition to this, newborns have. No strong circadian rhythm, which is sort of the signs that help all of us to know when it's daytime and when it's nighttime.
And early signs of circadian circadian rhythm can be [00:03:00] seen around about three to four months of age, but it really isn't fully established until we're about four years old. And that makes it really hard for babies to know when it's daytime, when it's nighttime, when they're supposed to be awake, when they're supposed to sleep, and that complicates things.
In addition to this, there's something really important that we need to take into consideration, and that is that. Babies are born with a brain and a nervous system that isn't mature. They have to learn how to do things that we as adults take for granted that we ever had to learn because we can't remember doing it.
And. According to Steven Porges, who wrote a very well-known book on the nervous system called the Polyvagal Theory, the autonomic nervous system has three states. The first state is [00:04:00] called the ventral vagal state, and this state of the nervous system is all about safety and connection. When we're in the ventral vagal state, we feel calm, we feel connected, we feel flexible.
Our body feels regulated. When you're in a ventral vagal state, you can think you can relate, and you can respond. The second state of the autonomic nervous system is the sympathetic state. A lot of us have heard the sympathetic state described as the fight or flight system. It mobilizes us to act. This state brings with it typically anxiety, anger, panic, a sense of urgency.
We have a high level of energy. We have a fast heart rate, we feel ready to act. Sympathetic, overwhelm can send some people into a freeze response, which means they're in sympathetic. [00:05:00] Uh, fight or flight mode. They're in the sympathetic overwhelm, but they're immobilized. They're not in a state of being ready to react.
They're in a freeze state. And the third state of the autonomic nervous system is called the dorsal vagal. And that's the opposite of the sympathetic response. That's a, that's a state of our nervous system that's all about shutdown or collapse. We're in a state of being immobilized. We have low energy, numbness, dissociation, hopelessness.
We get a slowed heart rate, we have reduced metabolism. It's a feeling of not being able to. To make a change in this, in whatever situation it is that we're in. So why am I telling you about the three states of the autonomic nervous system? Because sleep is only accessible [00:06:00] from the first state that we talked about, the ventral vagal state, and.
What makes this challenging is that babies and children cannot self-regulate into the ventral vagal state. They rely entirely on co-regulation with a caregiver. They need a calm, present adult to support sleep for the child. Separation, distress, or overwhelm in the nervous system can block. Babies and children's ability to sleep, ability to initiate sleep or to maintain sleep, to stay asleep once they've fallen asleep.
So let's break this down a little bit more. From infancy to early childhood regulation into this ventral vagal state, this feeling of calm, connected, and relaxed [00:07:00] energy is a state. That supports sleep. And as we talked about before, it's, it's almost entirely co-regulatory. A calm, adult nervous system literally assists the baby or the young child's nervous system to get to a state where they can sleep.
From early childhood, up to about five or six years of age, children begin to practice self-regulation. But when they're under stress, they will still strongly depend on adults to return to this state of ventral vagal safety, calm connection. And then from about. Six to seven years of age, and sometimes older children may begin to reliably access this ventral vagal regulation on their own.
Why at this age? Well, it coincides with more maturity in the other [00:08:00] autonomic pathways and an increased integration of the brain's ability to regulate the autonomic system because it's matured somewhat and children at this age are also. More mature when it comes to sort of understanding social cues and engagement.
They're understanding that it's bedtime. They're understanding that this is something that we do every single night. They're understanding the routines in a different way. I. I'm sure that right now a lot of you are irritated that I'm being wishy-washy on exact ages, and I'm using terms like early childhood instead of giving you an age and they're beginning to practice and they may begin to access instead of saying that from these ages, children can so.
Why am I being wishy-washy? Because it's not that simple. There is no age where co-regulation stops being necessary. Even [00:09:00] adults still depend on it. We just hide it better sometimes. So if you see claims that kids should be able to self-regulate by whatever age, that's not accurate. The capacity to regulate, the ability to be able to do it does not mean that children can do it consistently.
A child may be able to self-regulate sometimes, but still lose access to the ability if they're under threat or if they feel overwhelmed if, and we have all been there. Who hasn't found themselves awake at night, unable to sleep because they are upset or worried about something and have, you know, been unable to find the calm state in the nervous system that allows for us to sleep.
It happens all the time. It happens to adults, it happens to [00:10:00] children, so. If we wanna sum up self-regulation or the ability to find the ventral vagal state of the autonomic nervous system, we can summarize it like this. Co-regulation comes first. Self-regulation emerges from this co-regulation and the feeling of safety, not the age is the determining factor.
Being stressed out or feeling unsafe, sends children right back into an inability to find the ventral vagal state on their own, regardless of their age. Reliable self-regulation into a ventral vagal state happens after years of co-regulation or practice with an adult, and it really does remain context dependent throughout life.
So [00:11:00] let's tie all of this information about the autonomic nervous system back into the point of the podcast, which was sleep. The ventral vagal system is immature at birth and it develops through years of repeated experiences of safe connection. Babies and children from at least birth through five years of age, and in many cases older than this, co-regulate with adults and sleep then becomes an extension of this co-regulatory process.
It's very normal for babies and for young children to wake frequently. This reflects an immature nervous system that's scanning for safety in their environment. A caregiver's presence restores ventral vagal tone, and then sleep can resume. And this process strengthens the autonomic [00:12:00] flexibility and the learning that comes with continual practice of learning to regulate into ventral vagal, and it builds for our children long-term emotional regulation capacity.
And within that. It builds the familiar and the well-known feeling of safety in their nervous systems that they need in order to find sleep and to maintain sleep on their own. And let me be really clear, this is a lifelong process. Nobody has it all the way down. And a healthy nervous system means that there is flexibility to move from dysregulated back to regulated.
Not that one never finds themselves dysregulated ever again. That is unhealthy and it's unrealistic for both children and for adults. So how can we use this [00:13:00] information with regards to facilitating good, healthy sleep patterns for our babies and our children? We've talked about co-regulation or our children borrowing the ventral vagal or the safety and connection state of our nervous systems.
How do we do this? First of all, we as parents need to have realistic expectations to this phase of life ourselves, and we need to try as much as we can. To set up our lives around the time of having really young children to allow for some space and some breathing room so that everything in our lives doesn't fall apart for us as adults if we aren't getting 10 straight hours of sleep, right.
And that's not to say that we won't, both of my kids were really great sleepers from pretty much the very beginning, but I was also very [00:14:00] intentional in the ways I facilitated this. And so many things come up along the way. Different stages of development when they're teething, if they're sick, you know, things that have happened during the day when you've moved into a new phase of something happening in their lives that can, can affect their sleep and will send you into periods of time where, you know, sleep is more challenging or something that you have to, you know, to work back into getting into good routines.
And that's true for all of us. So first of all, we as adults who are in charge of bedtime need to work to not have a stressed out nervous system ourselves. When we get to this time of day, we all need time to wind down and to understand that we're preparing for sleep. You wanna really think about how much sensory stimulation you have going on in your house in the last couple of hours before bedtime.
Dimming the [00:15:00] lights. Not having the TV blaring, not using screens in general for kids in the time before bed is really important. Considering that the type of light from these screens mimics daylight and it makes their brains think it's time to do anything but sleep. And we definitely don't need to make life even harder for ourselves by having things like screens influencing sleep patterns.
It's really good to establish a routine that babies and kids can recognize and have it be as close to the same every night as you can. That is going to look different for everybody, but it could be. That an hour before you want them to be in bed. It's bath time with dimmed lights in the bathroom, and after that you sing the same four songs in the same order while putting on pajamas and brushing teeth.
And after that it's dimmed lights in the [00:16:00] bedroom and you read the same two books. And the point of this is not for you as the parent to die of boredom from the same songs and the same books, although it can definitely feel like you are going to. I still have the same four bedtime songs on repeat in my head, and my youngest is now eight.
And I haven't sung those songs for years, but I think they're permanently burned into my brain. But the point is, again, not for you to die of boredom, but for the baby or the child to start to recognize, ah. This is what's happening. We're winding down soon. It's time to sleep. We did this yesterday. We did this the day before and all the other days, and it went just fine.
You're priming their nervous system with your calm, steady, predictable behavior for what's to come. Your tone of voice is important. Your facial cues, the rhythm of your movements, the way it feels to be in the room with you. All of [00:17:00] those things are really important. Because you're creating a sense of safety that you're sharing with your child.
You are helping them to feel their way through you, into that part of the nervous system that allows for them to feel calm and allows for them to feel safe and connected. Is every night going to be an easy dance? No. Is every night, uh, easy for you to find peace and sleep soundly? If you've answered yes to that question, I'm very jealous of that.
But most of us experience sleep differently from night to night, and some nights are easier than others, and it will be that way with your kids as well. But the work that you put in early to establish safe, predictable routines and create a space for closeness and connection [00:18:00] that allows your kids to build the muscle of finding that feeling in their own nervous system is priming the foundation for how that child's stress response is going to function later on in life for babies.
I know that. Most people have an opinion on where babies should sleep, and it varies for each family whether kids should sleep in the same bed as their parents in a side sleeper or a crib right next to the parents or in their own room. The point is that all of us wake up at night and we as adults have trained our brains to understand that we're safe to fall back asleep.
But. Babies and kids haven't yet. Most babies and children are going to need that reassurance during the night from a safe adult that they are also safe to fall back asleep. [00:19:00] That's completely healthy. It's completely normal, and it's a part of learning how to regulate the nervous system for sleep. So however, that needs to look in your family for everybody to get the most sleep possible.
That's the way you should do it, in my opinion. There's a lot of discussion on sleep training, and for the most part, that refers to training babies to sleep through the night by letting them cry for periods of time to teach them to fall asleep on their own. When we look at this method through the lens of developing neurology.
We can understand that kids will eventually fall back asleep after crying, but we did not help their nervous system to grow and practice finding the ventral vagal state with an adult. [00:20:00] And we did not create a feeling of safety in their nervous systems by leaving them alone and not meeting the need for safety that they were signaling that they needed.
So it may work in quotations, but is that method helping develop children, teenagers, and adults who are able to regulate their nervous systems out of a stress response in a healthy way? I would argue that it's not, there are. So many young kids these days who struggle with anxiety and emotional regulation, and these things are a sign of dysregulation in the nervous system.
We need to be educated and we need to be aware of the ways that we can help our kids to find their way to feeling safe inside themselves, not just so they can sleep, but so that they aren't. [00:21:00] Finding themselves in a situation as adults where they have to try to figure out how to create a feeling of safety in their bodies and regulate their nervous systems in a way they never learned how to do as kids.
This is a huge gift to be able to give our kids, and it really does start with being a regulated adult for the most part, and being sensitive to our kids' needs and being alert to the situations that they're in and looking at what's happening through the lens of neurology and development. So I look forward to having more conversations about.
Sleep and routines and the neurology behind it. And this was just a start to the whole conversation. But I'm really excited to continue with this and I wanna say thank you again for being here with me today and [00:22:00] spending this time, and I really look forward to the continuation. Until next time, be well.
