Newborn Sleep or Lack Thereof, and Solutions

There are two big surprises when you become a mom: 1) How much you love your kids, and 2) How little sleep you get. In fact, I remember thinking that the phrase “sleeping like a baby” was a huge joke and the joke was on me. It still is, in fact. It’s musical beds at my house most nights, so it’s pleasant when we have a night when only one kiddo wakes needing assistance.

Young babies are the trickiest to figure out though, particularly as a first-time parent. And it turns out you can even be a sleep expert and still get stumped, like Polly Moore, Ph.D. and director of Sleep Research at California Clinical Trials in San Diego. She, like most of us, was stumped when it came to understanding her first child’s sleep habits. Even though she was a professional sleep researcher, Moore was still surprised how difficult it was to manage her own newborn’s sleep and waking schedule. After consulting with pediatricians, expert parents, and infant-sleep books, with no clear answers, Moore noticed her daughter got sleepy at highly predictable times — almost exactly 90 minutes after waking up from her last nap. Moore quickly realized that this was no coincidence — that these 90-minute cycles, in fact, mirrored a well-known biological rhythm known as the basic rest and activity cycle (BRAC). Using this rhythm as a basic unit of time, Moore was able to figure out her daughter’s sleeping needs in no time.

 Thankfully for the rest of us, she’s put her knowledge in a book available this week, The Natural Baby Sleep Solution. Moore offers an easy, four-step program — NAPS — to help babies fall asleep, leaving them more well rested and sleeping for longer periods of time. And better yet, it’s foolproof to implement!

 The basics are this: 

N: Note the time of your baby’s last waking.

A: Add 90 minutes.

P: Play with your baby.

S: Soothe your baby back to sleep.

We got to shoot some questions over to the author to talk more about the elusive baby sleep and her program.

Q&A with a Baby Sleep Expert

How did you come up with the NAPS program?

By accident, actually. This is covered in Chapter 1. My first baby seemed not to have any sort of regular rhythm to her sleeping at all, and I had a hard time understanding why she would sometimes nap for 3 hours and sometimes just for 20 minutes. Or why she would sometimes fall asleep quickly, or sometimes needed to be soothed for a long time, sometimes she’d fall asleep nursing, or sometimes fall asleep in the car, etc. It seemed utterly and completely unpredictable. Because of my background in sleep disorders, I had been taught that humans have a specific NREM-REM cycle during their sleep that repeats across the course of a night with a 90-minute time frame, or cycle. (I use the terms cycle or rhythm or clock interchangeably.) By this I mean, during our sleep, in every 90 minutes we will have had some NREM sleep and some REM sleep and the REM sleep period ends with this precise timing of 90 minutes after the NREM part of the cycle had begun.

When I first noticed my daughter was yawning 90 minutes after she had awakened, my training had primed me to recognize the 90-minute rhythm not as a meaningless number, but as a meaningful and crucial clock time interval in the human brain. But at that point I hadn’t really thought it drove alertness rhythms, not yet. At the time I thought this was a little weird. A little unbelievable. Maybe just a coincidence. But as I tested it over the next few weeks and months, I realized that my baby’s alertness rhythms followed in 90-minute increments a lot like our NREM-REM cycles do.

Here is the most important thing about this rhythm. This rhythm helps a parent understand when a sleepy zone will take place, which means an optimum window of opportunity for sleep. There is a (brief) window of time every 90 minutes or so after waking in which the baby’s sleep mechanisms can be easily and quickly engaged. The window is not open indefinitely. If you wait too long to provide a nap opportunity, the clock keeps running and the baby’s alertness rhythm starts back up. Yes, you can still help your baby to sleep when he or she has moved into the alertness rhythm but what you find is that it takes a lot more effort on your part and in some cases it might be much easier just to wait for another 90 minutes and catch the next window of opportunity.

It’s important to understand this is a clock that is running in your child. It runs inside all of us. And similar clocks run in animals and plants and fish and insects, most living things on this planet have rhythmic clocks inside them. This is WHY sometimes your baby falls asleep nursing, and sometimes not. Why your baby sometimes falls asleep in the car seat, but not always. When you understand the clock, it clarifies a lot of your baby’s behavior.

How do you modify it for use for older babies who can stay awake for longer periods of time?

This is all covered in the book, but the short answer is, as your baby grows, the alertness/sleepiness rhythm is still driven by 90-minutes, but what happens is the alertness period extends to two full 90-minute cycles, or 3 hours. Later on in the first year, it extends to 3 cycles, or 4 and a half hours.

You should know that this book doesn’t have instructions on how to modify the rhythm, the book is intended to help parents understand and follow their child’s rhythms.

What is the biggest mistake parents make when it comes to their babies’ sleep?

I wouldn’t call it a mistake, first of all. We are all doing the best we can with what we have to work with. One of the most unfortunate misconceptions (I like this term better) parents have is the notion that if they try to keep the baby awake LONGER, then the baby will sleep longer and or deeper. Although this sort of works in adults, in babies it often backfires, where keeping up the baby later and later into the evening does not produce a baby that sleeps deeper or later. Instead of getting more tired they get more irritable. Keeping up a baby usually means the sleepy zone is missed and now you’re in the next alert zone. Sometimes this also produces a baby that wakes up even earlier than usual the next day, the opposite of what was intended.

Hopefully by now you get this idea that there is a window of time when sleep comes more easily to a baby. And it is not “random.” It is highly predictable and frankly to my mind almost scary how precise it is.

I have a friend who’s at her wit’s end with her 7-month-old. She’s breastfeeding. Her daughter wants to nurse for comfort a lot, and she has a hard time getting her to stay asleep at night. What are your best tips for moms who think their babies will never sleep more than an hour or two straight at night?

By the way, I hear this scenario all the time. There is an FAQ’s section at the back of the book, and this is one of them. The fussiness and comfort-seeking at night is actually a cardinal sign of the baby’s sleepiness.

Your friend may not like my advice, for many parents it is utterly counterintuitive, the opposite of what they think they should do. My advice for Mom is to focus her efforts on making sure the baby gets sufficient sleep during daytime. And this is my advice for several reasons. Partly because Mom’s got her wits about her better during the daytime than during the nighttime. Also, and weirdly, this is the counterintuitive part, the baby getting more sleep during the day will yield better and deeper sleep at night (this is only true for babies though). If you’ve ever been jetlagged or worked the night shift or have otherwise been overtired and exhausted but just couldn’t fall asleep, you know how unpleasant it is.

A 7-month-old should be getting at least two serious naps each day, and by that I mean 2- to 3-hour naps. The 90-minute cycle is observable at this age (it gets harder or more subtle after about 12 months). My book describes how to observe your baby’s signs of sleepiness which are often subtle or may seem innocuous or were something you didn’t even really notice before, or maybe you did notice but didn’t think it was important. Babies don’t all have the same sort of sign, I find. My book advises that as soon as you see your baby’s sign that you set about getting the baby ready for a nap. Consider a ride in the stroller, perhaps. Because as I said, the alertness rhythm stops for no one, and if you dilly-dally, the baby’s rhythm will run through the sleepy part of the cycle, and guess where it goes after that? Yup, right back into the next alertness rhythm, which means now you’ll have to wait for another 90 minutes for the next nap opportunity. This is covered in the book as well.

And you didn’t ask, but when this works, it is unbelievable, I do get feedback from parents about this method. When it works, parents tell me that they had assumed their child was overly needy or had a difficult or sensitive personality. Once they straightened out the baby’s sleep, they wondered if they had a different child, because the child’s demeanor and attention span was transformed, by changing how they helped the baby sleep.

Thanks so much to Dr. Moore for sharing these tips! Learning about the 90-minute cycle really blew my mind, but it makes so much sense. If you’ve ever battled an overly tired baby because you missed their sleepy window, you know what she’s talking about!

What are your baby’s sleepy signs? The eye rub was always my indication to get a baby down for a nap ASAP! —Erin