Case Study: Harry
Prolonged settling time
Harry was a delightful, funny and very bright boy with a passion for cars. He was the only son of professional [and exhausted] parents.
Harry had been born after a long and difficult labour, and from day one had found it impossible to settle alone. His parents had made the decision when he was born to have him sleep with them, but since he was around two years old they felt that both Harry and themselves needed more space. Harry was a wriggly sleeper who would often wake up for a chat and a drink in the small hours of the morning. His parents had organized a bed and lovely bedroom for Harry and were desperately trying to help him to stay in it. Harry found it very difficult to go to sleep at the beginning of the night without a parent lying with him. Although the family followed an excellent bedtime routine, the whole process from start to sleep took about 2 hours. [His parents had only been out for the evening together twice since Harry was born.]
After his prolonged settling time, Harry would typically awake at around midnight, 2am and 4am. At the first two wakings, his parents could usually settle him in his own bed but by 4am a mixture of his own lighter sleep, his parents’ exhaustion and sheer habit meant that Harry joined his parents in their bed. To make matters worse, Harry had recently been having the occasional nightmare, and his parents were understandably reluctant to leave him in distress. He was also very tired at nursery school.
Unable to sleep alone
Harry’s parents needed to know that his expectation that at some point in the night, he was going to move from his own bed to theirs was actually hampering his ability to settle and to really sleep well alone. It was clear too that Harry’s dependence on his parents as sleep prompts at the beginning of the night was also preventing him from sleeping well. Almost every time he woke up [sleep cycles] he needed to find them in order that they could help him to go back to sleep. They also needed to know that Harry’s nightmares were a normal and transient sign of his developing young mind; and that there were strategies which they could use to help him.
Harry’s parents were advised to schedule a period of one week when they would be able to set time aside to really tackle his sleep problem. They would prepare themselves mentally and physically, by getting as much rest as they could in preparation, and choosing a time when there were no unusual work pressures. By addressing three issues, they would be able to help Harry to sleep really well. These were:
- Harry to learn how to settle happily and alone at the beginning of the night.
- Harry to overcome the expectation of being moved to his parents’ bed during the night.
- Harry’s parents to learn how to recognize and cope with his nightmares.
To this end, we developed a sleep strategy for the family to follow. This was based on developing an excellent bedtime routine, followed by a gradual withdrawal of his parents’ presence at bed time. This was to be done slowly and backed up with rewards. In addition to this, Harry was to be encouraged to discuss any worries or fears during tea time. When he reported having a nightmare, his parents were to guide him to change the ending of the dream into a funny or harmless one. On waking, he was to be taken calmly back to bed no matter how many times he got up. His parents were to respond to Harry’s protest and crying with calm, firm but loving demeanour.
Happy child and parents
On the first night, Harry responded very positively to the sleep plan. It took him about half an hour to settle alone. Although he still woke up three times, he went back to sleep with just a little assistance and encouragement. The second night was even better and he was delighted with his rewards on both mornings. On the third night, however, Harry began to miss going into his mummy and daddy’s bed. He was very upset at bedtime and cried for 45 minutes. Either parent went to him frequently to reassure him and he eventually fell asleep. That night, he slept through without needing any help. His parents found this very upsetting, as if they had broken his will. In the morning, however, he was still thrilled with his reward and did not seem to be upset in any way. That day, he was off to the car show room with daddy.
It took Harry just one week to alter the habit of his lifetime. Apart from a difficult night 3, the family felt that Harry’s sleep problem was a positive experience. Harry now goes to bed happily and does not wake during the night. His nightmares have become less frequent, and he is better tempered during the day. His parents are now enjoying their precious only child more than ever before as well as enjoying having time for their own relationship.