PR-P003: 5 Research-based Sleep Training Methods

Cry it out and controlled crying are commonly recommended for addressing sleep problems. There are alternative sleep training methods. Mindell and colleagues (2006) reviewed research on 5 approaches (including cry it out and controlled crying). They concluded that each approach was much more effective than no intervention at reducing bedtime problems and night wakings. In summary, any approach that improves sleep for babies and mothers has benefits for the family. I would recommend prevention education for babies under 6 months old. For babies and toddlers 6 months and up I would try positive routines before scheduled awakenings, controlled crying, or cry it out. The review found all methods to be beneficial. Here are quick links to the 5 methods reviewed: 1. Prevention education 2. Positive Routines/ Faded Bedtime 3. Scheduled Awakenings 4 & 5. Cry it out and controlled crying If none of these sound quite right for you, or you just want more options check out: The Sensible Sleep Solution by Sarah Blunden The Possums Sleep Intervention from Possums Online The Dream Baby Guide by Sheyne Rowley The Sleep Options Wizard for 0-5 Year Olds for the entire range of suggestions tailored to your child Sleep training approach 1: Prevention education Prevention education involves teaching parents sleep strategies. The following advice was provided in five large evaluation studies. Advice common to all studies is stated first. Advice unique to a single study is stated last. Settling methods Lie baby in the cot sleepy but awake. If baby won't settle, try again after one of these (Give each action 10 minutes to work before trying another; James‐Roberts &Gillham, 2001): Check nappy. Check and adjust temperature. Try burping. Stroke and talk softly. Cuddle if necessary. Importance of routine. "Dream feed" between 10pm and midnight*. Bath at the same time each day. Maximise day and night differences (noise, light, activity levels). Respond to physical needs at night, but keep lights dim and avoid playing and socialising. If weight gain is sufficient at 3 weeks of age, stretch intervals between night feeds by using alternative settling methods*. Respond to crying, not fretting. Babies often fret before falling back to sleep. Don't allow lengthy daytime sleep. Change the nappy every night feed if 3 or 4 hours apart, or as required for night feeds less than 3 or 4 hours apart. *Steps marked with an * were recommended, but were not followed by parents. They may still be effective, but cannot explain the observed results. Does this advice work? Yes. The studies reviewed found that babies of parents given advice like this: Were more likely to sleep for 5+ continuous hours at night at 6-9 weeks (Pinilla & Birch, 1993; Wolfson, Lacks, & Futterman, 1992) and 12 weeks of age (2.5 times more likely than a control group; James‐Roberts & Gillham, 2001). Woke and fed less frequently at night at 6-9 weeks of age (but still consumed the same amount of milk per 24 hour period as babies in a control group; Pinilla & Birch, 1993; Wolfson et al., 1992). Slept for longer at night (total sleep compared to a control group; Pinilla & Birch, 1993). Had fewer night wakings, and woke on fewer nights at 9 months of age (than babies in a control group; Adair, Zuckerman, Bauchner, Philipp, & Levenson, 1992; Kerr, Jowett, & Smith, 1996). Had fewer difficulties settling to sleep at 9 months of age (than babies in a control group; Adair et al.,