My son can't fall asleep alone

ASK THE EXPERT A child needs a comforting routine to fall asleep at night, writes David Coleman

ASK THE EXPERT A child needs a comforting routine to fall asleep at night, writes David Coleman

WE HAVE A 19-month-old boy who has been sleeping in his own room, in (or should that be 'on'?) his own double bed for some time now. He has a solid bedtime routine which he enjoys, and he tends to go to sleep pretty easily.

However, I have always had to stay with him until he falls asleep. He routinely sleeps for a number of hours and then, on cue, awakens and one of us must go into his room to settle him. The problem is that as soon as you think he is settled and you begin to leave the room he freaks out and you end up having to stay in the room until he is sound asleep, which can take up to 45 minutes.

We have tried to avoid getting into his bed, as we know that this is sending him the wrong message, but sometimes it is just easier. His bed has safety rails but he can climb between them if he really needs to. We are exhausted and at our wits' end, so any assistance would be so greatly appreciated.

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We all need security and comfort to sleep easily. Have you ever noticed how hard it can be to fall asleep if you are worried about something going on in your life, if you hear a strange sound in the house, or if the room is too warm or too cold?

Similarly, children like the environment to be not just comfortable but consistently comfortable. That means trying to keep everything the same during the night as it is at the start of the night while they fall asleep.

Sleep disturbance is very common among all children, but especially young children. In your case, your son's disturbed sleep is not unusual, but your difficulty, it seems, is that he is used to either of you being there to help him fall asleep by offering the comfort and security of your physical presence. Because he relies on you to assist him when he awakes in the night, he can't get back to sleep without you and this is the bit that is disruptive and exhausting for you.

The key to teaching your son how to self-soothe to sleep is to let him learn this at the start of the night as part of his routine for falling asleep in the first instance. Once a child has a routine in place that includes falling asleep on their own, they usually will not need to signal for their parent even if they wake in the night.

So it seems to me that your task is to help your son become accustomed to falling asleep on his own at the start of the night. Once he can do that, it won't matter that he wakes up a few hours later as he will be better able to get back to sleep without calling you.

I suggest that you apply a gradual and phased withdrawal of your presence in the bed and/or in the room as he falls asleep initially. I'll assume that you are lying in the bed with him currently to get him asleep.

Begin the process by putting a pillow between you and him as you lie there but still hold his hand or stroke his head as reassurance. After a few days, when he seems comfortable with this, sit in the bed still separated by a pillow and still touching him with just a hand.

A few days or a week later sit beside, but out of, the bed and still touch him with a hand. After he gets used to this, continue sitting by the bed but don't touch him, just leave your hand near him so he can see it.

Then move on to sitting beside the bed but with your hands in your lap. Then after time, move the chair away from the bed but still in his eye line.

Once he gets accustomed to this you can move the chair out of the room with the door opened and eventually you will reach a point where you can close the door, but visit regularly. The final stage is increasing the time between "checking" visits.

If he panics at any stage then revert to the stage before for a few more days or until he gets comfortable, then move things on again. When he wakes in the middle of the night, offer him the reassurance that fits with whatever stage you are at in the initial sleep routine, ie just sit with him or sit outside the room as you do earlier in the night.

As you can see the process is slow but it has an end point. Most importantly, at no time will your baby get overly distressed or feel abandoned by you. In time you will have your nights back to yourselves!

• David Coleman is a clinical psychologist and author of Parenting is Child's Play. He recently presented 21st Century Child on RTÉ 1 television.

• Readers' queries are welcome but David Coleman regrets he cannot enter into individual correspondence.

E-mail questions to healthsupplement@irish-times.ie