Sleep deprivation – top tips for parents!
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Mandy Gurney
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Former Director of the Sleep Clinic at the NHS St Charles hospital in London and Director of Millpond Sleep clinic. She also works as an NHS Sleep educator to health professionals across the UK.
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Baby Sleeping

How to regulate your child’s sleep hormones

For thousands of years, we have lived on a planet with daylight and darkness. We have evolved sleep hormones called melatonin and cortisol that help us to sleep in the dark and wake in the morning. Sometimes these hormones get out of kilter, and our sleep might be disturbed. It can be useful to know how to regulate them.
Video Tutorial
In Short

Many things can lead to increased levels of cortisol:

Sleep deprivation or bad quality sleep.

Light from screens - TV, computer and phones.

Stress, light, noise.

Being left to cry.

High levels of cortisol will lead to a baby sleeping poorly and possibly waking very early in the morning.

Sleep hormones

Our planet has day and night and human beings are day living (diurnal) animals, that means we are awake in daylight and asleep in the dark (as opposed to nocturnal animals that hunt and are active during the night and sleep during the day). Our sleeping and waking cycles are set by daylight and dark.

We have two sleep hormones called melatonin and cortisol. Babies are born with a very free flowing sleep and wake rhythm as they have been living in relative darkness of the womb for nine months. However, their diurnal rhythm develops in the weeks after birth. There are vital things you can do to stimulate your baby’s melatonin production at night. This will help them be awake in the day and sleep at night.

Melatonin

Melatonin is known as the sleep hormone and it peaks in the bloodstream just before we go to sleep. It is known as the “sleep trigger”.

Cortisol

Cortisol is known as the stress hormone, but it is also the hormone that wakes us up. Cortisol levels are at their lowest level about 3-5 hours after we fall asleep. They then rise slowly through the night – to peak around 8am.

Sleep Hormone levels

At bedtime, we want melatonin to be high and cortisol to be low. During the night, melatonin will decrease, and cortisol will rise. At a certain point, the hormone levels cross – and the cortisol level is higher. This is the point at which we wake up. This applies to adults as much as it does to babies and children.

High cortisol levels can lead to sleep deprivation – which in turn leads to higher cortisol… and so on…

The level of cortisol rises naturally throughout the night – its job is to wake us up.

However cortisol levels can also be increased by other things – such as stress. This is the reason that when you are stressed as an adult, you may find yourself waking up on the dot of 4 or 5am every morning.

The reason this is happening, is that your cortisol levels were too high (from stress) when you went to bed – so the melatonin/ cortisol cross over point was much earlier than it should have been in the morning.

For babies and children – one of the main reasons cortisol levels can be too high, is from sleep deprivation. Sleep deprivation leads to stress – which leads to increased cortisol.

This means they will be going to sleep at night with high cortisol – and therefore waking too early in the morning.

When adults are tired, they wind down. When babies and children are tired, they get “wired” and don’t sleep.

So a cycle of sleep deprivation can start very easily in babies and children.

Putting them to bed later, to try to get them to sleep longer, will make the problem worse.

Counterintuitively, they need to go to sleep earlier, and have the proper amount of naps through the day, in order to sleep longer at night.

In summary – if your baby or child is regularly waking up early, and not napping through the day – it does not mean they have had enough sleep. It means their cortisol levels are too high when they go to bed and you need to look at ways of reducing this.

Other reasons cortisol levels may increase

Babies left to cry themselves to sleep have high levels of cortisol even when they were asleep and not crying.

Children left to cry uncomforted for prolonged periods during the day and night will produce elevated cortisol.

How to restore the hormone levels

Think like a cave man!

When our cave dwelling ancestors approached night-time, it became dark and cool. These two factors triggered melatonin production which, in turn, triggered sleep.

Replicate this at home. Lower the temperature – around 18 degrees is right for the nursery or your room – and darken the lights.

TV and computer screens decrease melatonin and increase cortisol so turn them off at least an hour before bedtime.

A bedtime routine for babies will help them know what’s coming. They will relax more quickly and be ready for sleep.

Sleep Training NHS staff since 2007

If you or your colleagues want to know more about children’s sleep and how you can help the families you are working with, Millpond Sleep Clinic run one-day Sleep Workshops aimed at health care professionals.

These highly engaging sessions are based on proven research and years of experience and are suitable for all staff working directly with the families of babies through to school aged children.

The workshop is fully certified and approved by The CPD Certification Service.

If you would like to find out more about the sleep workshops please contact Millpond direct on:

Tel: 020 8444 0040

Or website:http://millpondsleepclinic.com/accredited-sleep-workshops/

References and Further Reading

Teach Your Child To Sleep, Millpond / Hamlyn, Revised 2016.

Sleep Faring, Jim Horne / Oxford, 2006.

Take Charge of Your Child’s Sleep, Judy Owens and Jodi Mindell / Marlowe and Co, 2005.

Healthy Sleep Habits, Happy Children, Dr Marc Weissbluth / Vermilion, 2010.

Sleeping Better, A Guide to Improving Sleep for Children with Special Needs V Mark Durand / Brookes Revised Edition 2014.

Outcomes at six years of age for children with infant sleep problems:

Longitudinal community-based study Anna M.H. Price, Melissa Wake, Harriet Hiscock et al, Sleep Medicine 13 (2012) 991–998

Short Nighttime Sleep Duration and Hyperactivity Trajectories in Early Childhood,Tourchette et al. Pediatrics.2009.

Sleep and Depression in Postpartum Women: A Population-Based Study; Dorheim SK et al, Sleep 2009; 32(7): 847-855.

Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum. Goyal D, Gay C, Lee K, authors Arch Women’s Ment Health. 2009;12:229–37.

Sleep problems in young infants and maternal mental and physical health, Jordana K Bayer, Harriet Hiscock, Anne Hampton and Melissa Wake, Journal of Paediatrics and Child Health, vol 43, issue 1-2, January/February 2007.

Longitudinal analysis of sleep in relation to BMI and body fat in children: the FLAME study. BMJ 2011.

Short sleep duration is associated with increased markers in European adolescents.

International journal of Obesity (2011) 35, 1308-1317 M Garaulet et al.

Sleep and the epidemic of obesity in children and adults; E Van Cauter & K Knutson, 2008.

The use of Melatonin in children with Neurodevelopmental Disorders and impaired Sleep: a randomised, double-blind, placebo-controlled, parallel study (MENDS),Re Appleton, AP Jones, C Gamble, PR Williamson, L Wiggs, P Montgomery, A Sutcliffe, C Barker and P Gringras. Health Technology Assessment 2012; Vol. 16: No. 40 DOI: 10.3310/hta16400.

Kids’ behavior impacted by lack of sleep, Jase Donaldson, Insight Journal, Feb 13 2006.

What affects the age of first sleeping through the night? S M Adams, D R Jones, A Esmail and E A Mitchell, Journal of Paediatrics and Child Health, vol 40, issue 3, March 2004.

Behavioral Treatment of Bedtime Problems and Night Wakings in Infants and Young Children; An American Academy of Sleep Medicine Review, Jodi A. Mindell, et al SLEEP, Vol. 29, No. 10, 2006

References are reviewed on a regular basis and are updated when applicable.

Note
Do you need more help?

If you are a health professional or a parent, who needs more guidance on helping babies and children to sleep better, we suggest getting in touch with Mandy Gurney direct at www.millpondsleepclinic.com or 020 8444 0040. Mandy gives the NHS evidence-based, expert advice, and she is our recommendation for you too.
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DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.