Fallon Cook (00:02)
Night terrors, sleep talking, confusional arousals, sleepwalking and nightmares. They're all common types of parasomnias that can occur during toddlerhood. Parasomnias are undesirable experiences that occur during sleep. They usually aren't harmful, but they can be disturbing and frustrating for parents. So let's explore what causes parasomnias and how you can best manage these in your toddler.
Welcome back to Brand New Little People, the podcast companion to this Sombelle pediatric sleep clinic programs created by us. I'm Dr. Fallon Cook and I'm here with Dr. Laura Conway and we're the directors of Infant Sleep Australia. Laura, did you ever have any parasomnias as a child?
Dr Laura (00:48)
Oh no, I'm giggling to myself here. I didn't, but my sister used to have sleep terrors and she had them well into, well, she probably still has some now every now and again. They were legendary in our family. And my funniest memory of
Fallon Cook (00:51)
you
Uh-huh.
Let's phone her and find out. New segment. β
Dr Laura (01:16)
of my sister and her sleep terrors was when we were traveling together in Africa and we were staying in a youth hostel β somewhere like β Zambia, I think it might have been, and there was a terrific thunderstorm going on and we were staying in the youth hostel in a dormitory with, I don't know, about other people, we're like packed in sardines traveling on a shoestring and β
It was a pretty scary night anyway because there were no curtains on the window and there was thunder and lightning flashing out the window. Yeah, and everyone in the dormitory had just settled down to to sleep. Sorry, I was just so funny. β my sister, my sister just was sound asleep. Everyone was quiet and... β
Fallon Cook (01:54)
Oh my god, it's a horror movie style.
I can't wait to hear.
Dr Laura (02:13)
We've probably all been asleep for maybe an hour or two and then my sister had this insane sleep terror where she sat up in this bunk bed screaming at the top of her lungs like really really high pitched and so the whole dormitory erupted. β
Fallon Cook (02:32)
my.
Dr Laura (02:37)
And my sister slept. She just went back to sleep. Meanwhile, the entire dormitory was like traumatized and I was like, I'm so sorry. I'm so sorry about my sister. β God. It was so funny. She was very embarrassed the next day. She freaked everyone out. Yeah. And it was just, it was so frightening because of the just environment anyway. And then her doing this.
Fallon Cook (02:53)
That is so funny. β my God. I have freaked everybody out.
Yes!
Dr Laura (03:07)
So anyhow, yeah, she was none the wiser,
Fallon Cook (03:08)
That is so funny.
Dr Laura (03:11)
but we certainly had a few gray hairs. So there may be some parents listening to this who have children who have night terrors or sleep terrors who would probably β think, yeah, that rings some bells, that kind of middle of the night or not even middle of the night, start of the night, bone chilling screams. What about you Fallon?
Fallon Cook (03:14)
You
Yeah, it can be so
intense. β I know that I was a sleep talker and a sleepwalker when I was a child. I don't know that I had night terrors. β no one's told me that I did. β but my kids have at various times had night terrors and one of mine, I was just saying before, sleep talks all night, multiple times per night. I'll hear him call out and sometimes it sounds like he's just gaming with his friends on the PC or something.
Dr Laura (03:42)
Mmm.
Mm. Yeah.
Yeah.
Yeah. β
Fallon Cook (04:00)
They're like, no,
it's my turn. I'm going now. Yeah. It can be like these big, you know, one-sided conversations. β when he sleeps talking about night terrors, β my goodness. With my kids, they, they can be so intense. So that's why it makes me laugh so much about your sister because I know how it's like, yeah, it's like, they are absolutely terrified and to witness it is really, really intense. with thunder and lightning and everything. my God, that is hilarious.
Dr Laura (04:14)
Yeah.
Yeah.
Fallon Cook (04:30)
but yes, I have, have gone through it with my kids and generally as, know, they often start in toddlerhood and then as they get older, they start to decrease, β for most people, but adults can still get them as you very well know and half of Africa knows. Actually, I have a funny story about a parasomnia. My mom told me when this is a very long time ago when she was very young.
Dr Laura (04:34)
Mm-hmm.
Mm-hmm.
I guess.
Yeah.
Fallon Cook (04:56)
and she, she had a partner and they were traveling. I think they were in Papua New Guinea and he was a terrible sleepwalker. Like he would get up and do all sorts of things. And they, β had like an apartment in like a compound that had like a, β a car park sort of in the middle. And there were always lots of security cameras, looking at this car park. And one night he woke up with the keys to his car in the door, like unlocking it with his briefcase in one hand, completely naked.
Dr Laura (05:14)
Yeah.
β
Fallon Cook (05:25)
in the middle of this car park. He just suddenly woke up and was like, oh my God, what am I doing here? That would be so embarrassing. Oh, gosh.
Dr Laura (05:28)
β
That would be... Geez,
yeah, so you can really get into some pickles if you are a person who experiences some of these parasomnias. Mmm.
Fallon Cook (05:40)
Mmm.
Yeah, hopefully we
won't have any toddlers trying to escape their houses and drive off in the family car. It's a good case there for using a safety gate if they do sleepwalk. Well, let's yeah.
Dr Laura (05:50)
No, at least I won't reach the pedals. β dear, should say, sorry, can I just say, Fallon,
that we're just to our listeners, we are recording this at night β on a Monday night. β And for any listeners who have been following us from the start, you will know that we are always slightly more hysterical when we are recording a podcast at night. So I'm sorry for our hilarity. β
Fallon Cook (06:14)
Why is that though? Like I find that if
I start watching like really funny TikToks and it's nighttime, I'm killing myself laughing. Like something about at nighttime that I just, get the giggles and then I'm, I'm done. But anyway, okay, now we're to be serious. We're going to get back into work mode. β and let's, let's talk through some things that might actually be helpful to the parents who are tuned in.
Dr Laura (06:27)
Yes.
Yes.
Okay, let's be serious. Okay.
Yes.
Fallon Cook (06:42)
So starting, let's start with nightmares and night terrors because so often parents don't quite know what the difference is, but knowing the difference, recognizing the signs is really, really important. Laura, do you want to start by talking maybe about nightmares? Because they're pretty common. Like we all have nightmares at some point.
Dr Laura (06:45)
Mm-hmm.
Yeah.
Yeah, so nightmares normally happen during REM sleep, so rapid eye movement sleep, which is mostly in the latter half of the night when we're dreaming. That's where a lot of our emotion dreaming happens in REM sleep and therefore that's when we have bad dreams and nightmares. And nightmares can usually be remembered. So if you wake up, you sometimes can wake up straight out of a nightmare or you can
you can go through the nightmare and then wake up as you come out of REM sleep and you may recall it and you might say over breakfast, β this is what β happened during my dream. It was really scary. So they happen to everyone at some point, like you're saying, Fallon, and they can start to happen during the toddler years for children. And what parents will usually see is their child wakes up in the...
second half of the night, calls out frightened. They might even get out of bed and come and find you. They might be really upset. But they're fully awake and they can be describing to you as best as their language abilities allow what might have just happened. And they usually need reassurance from their parent at that point. So that's what a nightmare looks like. Do you want to describe what a night terror looks like, Fallon?
Fallon Cook (08:15)
Hmm... Hmm...
Yeah. Yeah.
So night terrors are a lot more intense. They happen during non-rem sleep or the deepest stages of sleep, which is why they typically happen in the first half of the night when we usually have quite a lot of our deep sleep. β But really importantly, your child won't remember them. So there's no, they might seem absolutely terrified when they wake up, but they won't have any memory of why they're frightened. You can ask them and they'll just look at you like,
Dr Laura (08:42)
Hmm.
Fallon Cook (08:51)
No idea what you're talking about. Around about 40 % of kids aged two to six years have night terrors, so reasonably common. And how you're going to know it's a night terror is often it's very sudden. So suddenly, you know, it's early in the night, your child might sit up in their bed or stand up and they'll be screaming, shouting, often they're shaking. They're full on horror mode is what I call it. They look absolutely
Dr Laura (08:52)
Mmm.
Hmm.
Mm-hmm.
Fallon Cook (09:18)
horrified about as frightened as you can imagine a child looking. β They won't make any sense. So if you say to them, what's the matter? What's wrong? They typically won't respond to you. They often describe it as they're kind of unreachable. It doesn't matter what you do. They're just somewhere else. They're not really noticing that you're there. β If they do respond to you, it won't entirely make sense with what they're saying. And so very, very, very intense. And what will typically happen is that that kind of horror
Dr Laura (09:22)
Mm.
Mmm.
Mm.
Fallon Cook (09:48)
goes on for a little while. And then suddenly it's like somebody switches a, flicks a switch and they just snap out of it. And they might just go from screaming to looking at you like, β what are you, what are you doing in my room? And they're, and you'll say, what's wrong? Why were you screaming? And they'll be like, was I screaming? They've got no recollection whatsoever. So they really quickly snap out of it. They'll be perfectly fine. And they won't be scared to go back to sleep because they have no recollection of whatever it was, β that was causing that night terror.
Dr Laura (09:55)
Mmm.
Mmm.
Mm.
Fallon Cook (10:19)
So
it's a different presentation. β Easy to confuse the two, I suppose, but I would say you're looking for that feeling like you can't quite reach them. You can't quite get through to them. That is the real key, key sign. β
Dr Laura (10:29)
Mmm.
Yeah. And some people
describe it a little bit like a glitch β when children are moving from the deeper stage of sleep up into the lighter stage. So going from stage three to stage two, it's like part of the brain is in one stage of sleep still and the other part is still in a deep sleep. And there's just a moment of catching and usually
Fallon Cook (10:48)
Hmm.
Dr Laura (11:01)
need to ride it out until the glitch passes. And because it's moving between the deeper stages to the light stages of sleep, some children can might not even wake fully at all. It just ends like you were describing, then they go back to sleep and they β seem perfectly calm. Meanwhile, as the parent, you're a quivering wreck beside their beds going, what just happened? Yeah.
Fallon Cook (11:07)
Hmm.
Hmm.
Yeah. Your heart's racing. The adrenaline's up. Yeah.
Yeah. It's much more frightening for parents than for the toddlers.
Dr Laura (11:31)
And that.
Yeah, whereas a nightmare, it's much more likely that they will actually be upset and seeking comfort from you. So it is quite a different presentation.
Fallon Cook (11:44)
Mmm.
Yeah,
I think that's a really good point. Also, you know, if you, if your toddler has an occasional night terror, maybe it's once or twice a month, you're probably not too worried. We do see families whose children have night terrors every night. It might be one to two every single night. And that's when it can really start to become just difficult for families. Right when you're trying to go to sleep, your child's then having a night terror and waking the house can be really tricky. So let's talk about what parents can do.
Dr Laura (12:02)
Mm.
Mmm.
Mmm.
Fallon Cook (12:15)
if they have children who have a lot of night terrors. One of my favorite hacks, this works for my own children every time, but is to keep them cool. So for some reason it's like, we don't understand night terrors very well. I should add that as well. They're very hard to study because, you know, most things you go to study it and it doesn't happen. So there isn't a lot of data, not a lot of EEG data, you know, from kids in the process of having a night terror. They're not well understood.
Dr Laura (12:35)
Yeah.
Fallon Cook (12:42)
But often people sort of theorize that these kids run a little bit hotter. So most humans cool down during sleep, but it might be that the kids who have night terrors have a tendency to run a bit hotter. So definitely I've had families where their kid will have, you know, nine or 10 night terrors a week. They remove a layer. It might be moving from a doona to just a top sheet or taking off a sleeping suit and just taking down a layer. And then those night terrors completely disappear. It's amazing.
Dr Laura (12:52)
Hmm.
Wow.
Mm-hmm.
Fallon Cook (13:11)
So you definitely want to cool them down a bit. Yeah. Yeah. It can be just
Dr Laura (13:11)
Wow, such a quick fix. Yeah.
Fallon Cook (13:14)
that instant. β and often these parents are like, β they would be so cold. I'd be so cold sleeping like that, but their child's sleeping perfectly happily and content. So yeah, it's really about thinking about what your child is actually needing. If they're running a bit hot, cooling them down can definitely help.
Dr Laura (13:24)
Yes.
Yeah, and potentially they could go to sleep with β a heavier doona on and you could go in and switch over the doona to a lighter one before you go to bed, for example. Yeah, I think β a really helpful β piece of advice for parents who often look at me aghast when I suggest this is
Fallon Cook (13:41)
Hmm.
Dr Laura (13:55)
that when your child is having a night terror as opposed to a nightmare is to avoid intervening, avoid touching your toddler or child and avoid trying to talk to them or snap them out of it. What we know is that actually that can lead to an escalation in the night terror and it can lead to the night terror lasting for even longer. So the best thing to do
Fallon Cook (14:04)
Mmm.
Mmm.
Dr Laura (14:23)
is just make sure that they're safe, that they're not hurting themselves, because some children having night terrors might flail around. So you want to make sure that they're not going to fall out of a bed if they're in a bed, and that there's nothing, there's no shelf or whatever that they're going to bang themselves on. So if you're sure that they are safe, then simply stay with them to ensure that they stay safe and that you can keep an eye on them, but just avoid trying to cuddle them or talk to them.
And it generally then passes a little bit more quickly.
Fallon Cook (14:51)
Hmm.
Yeah, it took me a while to learn that as a new parent. I just wasn't so switched on with night terrors. And yeah, if I tried to comfort my children when they're having a night terror with just like some touch or it's okay, you know, everything's okay. That night terror could go on for 45 minutes. β But if I just sat there as hard as it is, all you want to do is just give them a cuddle and tell them it's okay. But if you sit nearby and just wait two or three minutes, they just lie down and go back to sleep. So β
Dr Laura (15:01)
Hmm.
β Wow.
Yes.
Mm.
Fallon Cook (15:23)
Something
about that sensory input doesn't help, it just protracts it. yeah, such a good tip for families who are struggling with night terrors. Other things to think about are just checking in with your GP because especially if your child snores or breathes through their mouth a lot during sleep, if they seem really, really restless, there could be anything like that can, especially snoring or interrupted breathing can trigger a higher occurrence of night terrors.
Dr Laura (15:26)
Hmm.
Mmm.
Hmm.
Mmm.
Fallon Cook (15:52)
β Low
iron as well can really interrupt the quality of sleep and could be contributing. So definitely check in with your GP if they are really persistent. And Laura, I know you have a bit of a trick that you sometimes use with families when they report that they have night, you know, if they've got a toddler with night terrors at a very particular time every night, talk us through that one.
Dr Laura (16:12)
Yes. β
You know, we read about this in the training that you and I have had when we're learning about things like night terrors. One of the things that comes up is that they often happen at the same time each night. But actually, it's quite rare that you and I see toddlers who are having night terrors at the same time each night. And so this piece of advice only works in this situation where the night terrors are usually happening at the same time every night. And I was
Fallon Cook (16:29)
Hmm
Dr Laura (16:41)
absolutely over the moon one time when a family came in and a child was having a night terror every night at something like 9.50. It was like off by the clock. Because what this β approach does is it kind of stops that night terror in its track. So if you do have a child who has a night terror every night at roughly the same time, then what I would want you to do is to go into the room.
Fallon Cook (16:50)
Yeah
Dr Laura (17:09)
maybe 10 minutes or so before the night terror usually happens, and just gently rouse your child, not fully waking them. You might just go into the room and be a little bit noisy in the room, just put some toys into a cupboard or some β clothes into a chest of drawers, and just go over and maybe give your toddler a kiss on the cheek, just to rouse them ever so slightly, and then walk out of the room again.
And what that does is it seems to stop the night terror in its tracks and then your child simply doesn't go on to have the night terror that night. So give it a whirl if you fall into that, your child falls into that category. It can be like magic.
Fallon Cook (17:49)
Mmm.
Yeah, it's a great tip that one. And another thing that parents have often heard about is that night terrors can be more frequent if their child is sleep deprived. And a lot of parents are really frightened like, I've got to make them sleep more. But try not to get too panicked about that. If you're meeting your child's sleep needs and they're happy during the daytime, they're not sleep deprived in all likelihood to the point that it's going to cause an increase in night terrors.
Dr Laura (18:08)
Hmm
Mmm.
Yeah, absolutely. And the last thing we want to do is to be offering a child who has a 12 or 13 hour sleep need, 15 hours of sleep every day in an attempt to try to stop night terrors. If they are β meeting their sleep needs, then what we're really thinking about is improving the quality of your child's sleep. always looking at giving them the opportunity for the sleep that they need and as high quality as possible.
Fallon Cook (18:35)
Hmm.
Hmm.
Dr Laura (18:52)
So just ensuring that they have the right number and duration of naps during the day to meet their needs and an appropriate bedtime and wake up time in the morning. And that can help them consolidate their sleep into longer stretches. And then your child will feel better rested during the day and they're not going to be sleep deprived. And then they're less likely to have night terrors.
Fallon Cook (19:17)
Hmm.
Dr Laura (19:21)
And also know that if your child does have night terrors, they do tend to reduce as your child grows. Not in the case of my sister, but there's always an outlier.
Fallon Cook (19:22)
Yeah.
Hmm.
In next week's episode,
we're going to report back on whether she still has night terrors. I want to know now. That's funny. All right. Well, what about nightmares though? Cause these are really, really common. And I know that one of the first things parents often want to do is say, what was it about? What was the nightmare about? What frightened you?
Dr Laura (19:35)
Ring. Yeah, I'll be ringing her husband.
Mmm. Yes.
Hmm.
Fallon Cook (19:57)
And we don't do that. We don't want them to replay what frightened them in their mind. What do we do instead?
Dr Laura (19:58)
No.
Yeah, so when they have had a nightmare, go in, reassure them, cuddle them. You might need to give them a sip of water. If they're really upset, you might want to take them out of their sleep space and give them a cuddle on the rocking chair or out in the living room. Get them entirely calm. You can tell them that it's just a dream. It's just make believe and don't go any more into it at that point. Get them calm. Take them back to bed.
Fallon Cook (20:30)
Hmm.
Dr Laura (20:32)
What you can do outside of the bedtime and sleep time is during the day away from the bedroom is, and again, depending on the age, talk to them about what dreams are. And it can be really useful to tell a child that a dream is like a movie or their favorite TV show playing behind their eyes. And it's not real, just like the TV show isn't real.
and you can reassure them that they are safe when they're having one of those dreams and it's not going to do any harm and that can really just help them gain a little bit of understanding about what is happening because it can be as we know as adults that can be very frightening let alone a child when you don't understand what a dream is. What else would you suggest?
Fallon Cook (20:59)
Mmm.
Hmm.
Yeah, exactly. Yeah, I think it's,
well, I think sometimes with nightmares, especially as children get older, they can feel so frightened when they wake and it can be such an intense experience for them that sometimes we just need a circuit breaker. So sometimes just giving a lot of cuddles isn't quite enough. Their heart is pounding. It takes them a long time to calm down. And whilst of course we don't want to introduce
all these exciting things that happen in the middle of the night, because we don't want them to start to think, great, I'm going to keep waking up overnight and calling out because all these wonderful things happen. But there might be times where the nightmare is so severe that you need a circuit breaker. And by that, I mean, you might walk out to the kitchen with your toddler and let them have a little tiny little cup of orange juice or something they wouldn't normally have, just something that makes them go, β well, that's different. I don't normally have this.
Dr Laura (21:52)
Mm-hmm.
Yeah.
Fallon Cook (22:15)
β
And when you're doing that, you could say to them, and it depends on their age, of course, really little toddlers can't understand this, but older toddlers, certainly two and three year olds, you can say, do you remember when we went to your cousin's birthday party last weekend? Gosh, that was lovely. I think my favorite thing I ate was probably the cake. What was your favorite thing you ate? So you're just getting them to start to think about something exciting that didn't happen too long ago, where they can think about what their answers might be.
Dr Laura (22:36)
you
Fallon Cook (22:43)
you know, what they're actually doing is thinking about a really positive, lovely experience. And the memory of the nightmare is starting to really reduce. So sometimes we just have to kind of refocus their thoughts a little bit on something more positive β or just getting them out of their room. Yeah. Having a little drink of something, or maybe it's looking at the night sky just to break that circuit and help them calm down and get ready for sleep.
So I think that's a bunch of really good tips there for parents, but I would still say if nightmares are really persisting and they're quite frequent or quite severe, β have a chat to your GP about that. It's always good to get some extra supports.
Dr Laura (23:16)
Mm-hmm. Yeah.
Absolutely. And there's a bunch
of other β techniques that we use for nightmares in older children and teenagers and even adults as well, but which simply are just not going to be appropriate for us to talk about here. β But know that there are β other strategies out there if your child is experiencing β persistent and worrying nightmares.
Fallon Cook (23:43)
Mm.
Yeah. Another thing I think is really useful to talk about too, cause this is quite reasonably common, β confusion or arousals, which are really similar to night terrors, but just without the fear. So you might notice that your toddler wakes, well, they're not awake, but they appear to be awake. β they might be really confused, not really making any sense. They'll feel a little bit unreachable. β and they might cry or mumble, grumble, grizzle, that sort of thing.
Dr Laura (23:55)
Mmm.
Mmm.
Fallon Cook (24:13)
β that it's essentially like a night terror, but without the fear and the same sort of approach again, you don't need to be super hands on. You don't need to, you know, go and try and pick them up, just keep an eye on them. β and just know that it's generally not a problem and it's something that resolves over time as well. β what about sleep talking and sleepwalking though, since that's where we kind of started our discussion was with their random call outs in the night and walking into car parks. β what do we tend to suggest to families?
Dr Laura (24:16)
Mmm.
Yes.
Yeah
Yes!
Yeah, look, there isn't a great deal that can be done for sleepwalking and sleep talking. Essentially, we need to make sure that our toddlers are safe, particularly in the instance of sleepwalking. So if your toddler is still in a cot and they're not showing any signs of climbing out of it, that's probably the safest place for them to be. And if they're walking around the cot, that's okay.
Fallon Cook (24:56)
Mmm.
Mmm.
Dr Laura (25:12)
If they are climbing out of their cot in their sleep, then we definitely need to put them into a bed and then put a safety gate on the bedroom door so that they β can't go wandering around the house in the sleep and make sure that the room is β safe as well so that they can't injure themselves. β And with the sleep talking, yeah, try and get some little recordings of them. β
Fallon Cook (25:40)
Yes, I was going to say that too.
In my house, we recorded every now and then we have a good laugh together the next day at whatever they were chatting about in their sleep. My kids have all sleep talked on school camps as well. So the next day their cabin mates would be like, what were you talking about at 1am in the morning?
Dr Laura (25:43)
Because it's so funny.
Yeah.
Yeah, so fun. Of course, if you
have a child who's ultra sensitive, or not ultra sensitive, anyway, if your child is just a little bit sensitive and you don't, mean, Fallon and I, we are slightly delirious because it is, is half past nine o'clock at night, as we record this. But in all seriousness, if your child is a little bit sensitive, it's, you of course, don't record it, don't say anything, they don't need to know about it. As they get older, it might be something that you talk to them about.
Fallon Cook (26:13)
Hmm.
Dr Laura (26:27)
So when they do have sleepovers at somebody else's house or they go on camp so that they know their friends know, and it's not something that is going to then take them by surprise that they might be teased about. yeah, again, it's one of those things that might reduce as they get older, but nothing to worry about. If you are worried and it is your feeling that you want to talk to someone about it, then just have a chat with your GP.
Fallon Cook (26:30)
Hmm.
Yeah.
Yeah, absolutely.
Well, that kind of rounds out our whistle stop tour of parasomnias, which are so fascinating, so interesting. And yeah, there needs to be so much more research done. But hopefully that was reassuring and maybe gave you a few tips on things you could try. All right, we've got a bunch of parent questions now that we're going to whiz through. How about I start with Philippa? Philippa has a five month old baby and is using the quick fade approach.
Dr Laura (27:01)
they are, yeah.
Mmm.
Yeah. Hmm. Okay.
Fallon Cook (27:22)
She's seen good progress with naps but is struggling with nights, so they sometimes co-sleep. Settling on some nights is easy, but other nights it can take 30 to 90 minutes, or there could be one or two false starts. Her baby has a sleep need of around about 13 hours. She naps for two and a half hours across three naps, and overnight sleep is from 8 p.m. to 7 a.m. with one overnight feed, which takes about half an hour.
Dr Laura (27:22)
Mm-hmm.
Mm.
Mm-hmm.
Fallon Cook (27:48)
β
Philippa wants to know what they can do to improve the nights. She adds that she's nervous about reducing the day's sleep, so wonders if she should re-track the unique sleep needs and possibly move wake up time to 6am. She knows we advise to be consistent, but thinks if they don't co-sleep, her baby will end up just not sleeping. And she also wondered if separation anxiety could be a factor at this age. What do you reckon?
Dr Laura (28:07)
Mm.
Hmm.
Very unlikely that separation anxiety is a factor. So at five months of age, I'll just be ruling that rule that out, Philippa. Okay. The fact that Philippa is saying it's around 13 hours and that there are these false starts and some of those resettles are taking an hour and a half. That's, that's a long time. So Philippa, must be shattered.
Fallon Cook (28:18)
you
Roll it out.
Mmm, a long time.
Dr Laura (28:40)
does make me think sleep pressure might not be quite high enough at the start of the night. So I definitely would be retracking your baby's unique sleep needs. They do change incredibly quickly in those first few months. So, you know, if you last tracked your baby's sleep, three weeks ago, Philippa, four weeks ago, there is a good chance it has changed.
Fallon Cook (28:47)
Hmm.
Dr Laura (29:05)
So perhaps your baby actually only has a 12, 12 and a half hour sleep need at this age. I would be tracking that first before you make that decision about moving wake up time to six, because if your child does actually sleep for 13 hours, we don't want to be changing that. And instead, I'd be thinking about being 100 % consistent at bedtime.
Fallon Cook (29:11)
Hmm.
Yeah.
Yeah.
Dr Laura (29:29)
β with the quick fade approach or even because your baby already can now settle independently for the maps. β we know that, β your baby can fall asleep easily, β in independently. may be that just that final push is needed at the start of the night. either continuing the quick fade or switching to, β the quicker approach, β just to get you over the line at the start of the night. What do you think Fallon?
Fallon Cook (29:49)
Hmm.
Hmm. Yeah.
I think be really precise with measuring the unique sleep needs of your baby, because there's a chance that once you identify those, you adjust the daily rhythm to precisely fit their sleep needs that a baby who sometimes self settles, they'll often then just start self settling all the time, you know? And so you might not even need to do a lot of hard work on the settling. It might just be getting that sleep pressure piece of the puzzle just right will be enough to kind of
Dr Laura (30:15)
Yeah.
Hmm.
Fallon Cook (30:23)
get that momentum for the settling to all come together. Hopefully fingers crossed nice and easily for you, Philippa. β
Dr Laura (30:25)
Yes.
Yeah, you're pretty close, Philippa, so
let us know how you get on. Our next question is from Sarah, who has a nine-month-old. Sarah has recently adjusted his schedule, which significantly improved night wakings and settling. So awesome. So Sarah did what we've just been suggesting might work for Philippa. However, Sarah says he still wakes two to four times a night. About half of the time, he quickly resettles independently.
Fallon Cook (30:34)
Yeah.
Great. Yeah.
Dr Laura (30:58)
Otherwise, Sarah offers really minimal hands-on support and he quickly returns to sleep. Sarah asks if these brief night wakes are a sign that he doesn't have enough sleep pressure. She adds, he had seemed he had been seeming quite tired during the day and is very tired when we put him to sleep. So I was thinking of soon adding another half hour back into the daily rhythm. But I obviously don't want the night's sleep to worsen. What do think she should do?
Fallon Cook (31:25)
Hmm.
Yeah, the night wakes, if they're that brief, then yeah, it makes me think, it might not be a sleep pressure problem. It might just be that this baby knows well. Sometimes if I call out a little louder than normal, you know, mum will come in, I'll get a little bit of reassurance and that's kind of nice. So it might just be that he's enjoying that. I mean, you could look at just.
like each night maybe holding off an extra minute and just sort of see what he does because he sounds like he's a great self-settler and sometimes when we wait an extra minute they really surprise us and just start to go back to sleep. So yeah you could think about tinkering with that and definitely what we always suggest to families is to trial adding 30 minutes more back into the daily rhythm. If everything's been going pretty well just try adding that bit more sleep to the same time each day
Dr Laura (31:52)
Hmm.
Fallon Cook (32:14)
β and see how things go. And if the night's drastically worse and our settling becomes really challenging, you've got your answer. Yeah. You may be overdoing it a little bit and you can dial it back. β but if you offer that extra 30 minutes and they take it, you know, that actually sleep an extra 30 minutes and all the rest of their sleep is fine. Well, wonderful. I definitely want to try and see if they can do it. So, β it sounds like Sarah's at a point where she could definitely give that a try. β
Dr Laura (32:14)
Hmm.
Hmm.
Brilliant. Yeah.
Fallon Cook (32:41)
And I think with those overnight wakes, just, just try and see if you can wean off that bit of support. He might actually find that he can, he can manage to get himself back to sleep. Sometimes it just takes them a bit of practice to get there. Um, so it's like you're doing an awesome job though, Sarah. That's awesome.
Dr Laura (32:51)
you
Yeah.
Okay, our next question is from Gemma. Gemma is using the supported accelerated approach with her five and a half month old. She's been able to stop co-sleeping and the hourly overnight wakes have been replaced with a six hour stretch at the start of the night. Yeah, that's awesome. So Gemma wants to know, is it okay to continue cot settling only at night while still feeding to sleep or using the front pack, which I guess is a carrier.
Fallon Cook (33:13)
β heaven. That's awesome.
Dr Laura (33:28)
for naps or will this confuse her baby? Her baby has lower sleep needs and struggles with day sleep unless fed to sleep and so far pram and car naps have been unsuccessful. What do you reckon?
Fallon Cook (33:42)
Hmm.
Look, generally I would say avoid confusion. You know, use the same settling around the clock,
it's always good if we're really consistent day and night, but some babies will have none of that. they, β such FOMO babies, they just want to be awake all day and we can try to, β you know, settle them in the cot and it just doesn't go very well. So if that's the case.
Dr Laura (33:56)
Hmm.
Mm.
Fallon Cook (34:07)
Look, I'm gonna always be thinking of several things. So why are they self settling in the cot at night and not in the daytime? So often it's because in the daytime, there's a bit of light in the room and they're like, well, no, if there's light, I've got things to do and I don't fall asleep here. And sometimes all we do is put up blackout blinds. They go into that dark environment and they just go, β yeah, when it's this dark, I just fall asleep in my cot. So you could experiment with the light a little bit. But it could just also be that you just.
Dr Laura (34:20)
Hmm.
Mm-hmm.
Mmm.
Fallon Cook (34:36)
wait and see if it becomes a problem. know, it might be that you, you know, every baby's different. Some of them will be like, yeah, sure. I can do one thing in the day and something different at night time. β yeah, it could be a case of just waiting and seeing. And if it does start to become a problem, maybe if the night settling starts to worsen or become more challenging, then you know, you've got to have that consistency around the clock. β and you can quickly move on that. Although a lot of parents will decide, look, I just don't want to risk it. I don't want to risk them.
Dr Laura (34:43)
Mm-hmm.
Hmm.
Fallon Cook (35:04)
suddenly deciding, well, hang on, it might be nighttime, but I'd love a feed to sleep. Thank you very much. They don't want to risk that. So they'd rather work on the cot settling now just for the day naps instead of, you know, waiting until the nights are also challenging and then having to work on it around the clock. So I've thrown every option under the sun out there. Well, what would you say, Laura?
Dr Laura (35:08)
Mmm.
Mmm.
Yeah, yeah,
look, I really like all of those answers that you gave. And I think for Gemma, it's a case of just seeing what works for her baby. And it sounds like her baby's doing that good six hour stretch overnight. So it will be linking loads of sleep cycles independently. And if Gemma enjoys doing the feed to sleep during the day, it's not causing the nights to go off the boil and for things to fall over, then carry on doing it.
because it isn't confusing your baby at this point. But it may be as your baby gets older and becomes more aware of what's going on, then maybe it will be a little bit more confusing. And at that point, you know what to do. You've already been able to use a supported accelerated approach at night time. So then you just use it for the day times as well and just be prepared. Your baby will be a bit older, a little bit more vocal perhaps than they were when they were a little bit younger. So just be prepared for those.
Fallon Cook (36:07)
Mmm.
Dr Laura (36:19)
settles to be a little bit tricky when you start to use it for the day naps. But your baby will get there because she's doing it overnight as well. yeah, if it's working for you now, carry on doing it. If it's not, or if it stops working, then you've got the tools to make those changes when you're ready.
Fallon Cook (36:29)
Hmm.
Yeah, I think that's great advice. Vanessa has a 26 month old, so just over two years, who sleeps in a cot. She wants to know when and how they should introduce toddler pillows and blankets or dooners. Her toddler still loves his sleeping bag and they're wondering if they can kind of use it alongside a blanket if the weather permits. And also wondered what are the options for when a toddler still sleeps in a cot at home but has outgrown their porter cot when traveling.
Dr Laura (36:45)
Mm-hmm.
Okay. Great questions, Vanessa. So the β guidance from Red Nose Australia is to avoid using pillows or dooners whilst your baby or your toddler, sorry, baby or toddler is still in a cot and to only introduce a pillow or a doona once they are in a bed. no pillows or cot, sorry.
Let me say that again, no pillows or dooners at all in the cot for the first 12 months. Then thinking about toddlers, still they advise no pillows or dooners in a cot β and introducing a pillow or a doona once your toddler is out of a cot and in a bed. And that's because first of all, there's risk of suffocation. Secondly, for β older babies and toddlers, it's a case of
Fallon Cook (37:37)
You
Mm.
Dr Laura (38:05)
some β little rascals out there might roll up the doona and then put the pillow on top and use it as a stepping stone to try and get themselves out of the cot in the night and can hurt themselves. So we're not just thinking suffocation, we're thinking about whether there's any mischief that they can get up to with those pillows or doonas. Yeah.
Fallon Cook (38:18)
Mmm, yeah.
Hmm.
Yeah. And then in terms of the portico, you know, when traveling, I would say if they don't fit in anymore, often to parents a bit worried about putting them into a single bed, you know, at some hotel or place that you're staying at. If they're, they're not used to having to be aware of the limits of that sleep space. Often that's when they will fall out of bed quite easily. I would set up a floor bed when you're traveling. It might just be that you pull a mattress off a bed and just put it on the floor. β
Dr Laura (38:43)
Hmm.
Mm.
Mm-hmm.
Fallon Cook (38:58)
Or I think I've talked about before, how when I did a big trip overseas, my youngest just had the cushions from the couch, would just push a couple of those together on the floor and just do a little makeshift bed for her. And she loved that. β but yeah, you really just don't have an option if they've outgrown the portico. It's going to be a case of just trying to find another safe way to sleep them. and yeah, it definitely comes with its challenges, but they get used to it pretty quick. They realize that, you know, it's sleep time. Nothing fun is going to happen if I get up and run around.
Dr Laura (39:08)
yeah.
Yeah.
Mm-hmm.
Fallon Cook (39:27)
but they might just need a little bit more hands-on support when traveling just to kind of keep them in one place until they're asleep. Yeah.
Dr Laura (39:27)
Mm-hmm.
Yeah. Awesome.
Okay. We have a question from Taniha who has a two year, four month old who has started waking at 3am and is then either awake or lightly dozing for between an hour and a half to two hours as Taniha or her partner stay by his side. He gets upset if they leave before he's fast asleep again. So they've tried dropping his 30 minute nap.
And they tried that for a week, but the night waits persisted and he actually found it really hard not to fall asleep in the day. So he was falling asleep in the corner of the room at daycare. So they have reintroduced the nap and instead are working on reducing their presence as he falls asleep at the start of the night, because he still needs them in his room as he falls asleep. And they're wondering if that is actually what
may be causing that 3am wake. His overnight sleep is from 8pm until 7 in the morning and thereafter our advice on whether it's a combination of sleep pressure and maybe a sleep association that is causing the situation that they're in.
Fallon Cook (40:50)
Yeah, I think it probably is a bit from column A and a bit from column B. It sounds like he's really close to being ready to drop that nap. And he's certainly in an age where a lot of toddlers will drop their nap. You gave it a try. It didn't quite work out, but he might be two or three weeks away from being ready. So in another few weeks, try it again, because you know, when they're really, you know, they're dozing, they're not really getting into deep sleep for a couple of hours at the end of the night.
Dr Laura (40:50)
you
Yeah.
Hmm. Hmm.
Fallon Cook (41:17)
I mean, it sounds like that sleep drive is getting a little low and that nap's probably going to have to be dropped pretty soon. But definitely at that age, if they fall asleep with you nearby, even if you're just in the room, you're not doing anything, you're just over there, you know, sitting on a chair, β they'll have their deep sleep at the start of the night. And then they start to wake up and do that systems check. And if you're not there, toddlers can find that really unsettling.
Dr Laura (41:21)
Yeah.
Fallon Cook (41:40)
They're just like, you know, you were here when I fell asleep. Where the heck do you think? They don't understand that we also have to go to sleep. They couldn't get less about that. They thought you were going to sit in that chair all night watching them. What else would you have to do? Yeah. Yeah. Exactly. The audacity. So yeah, I think you're absolutely on the right track and gradually phasing out your presence at bedtime. And I think it's going to be working on those two things in combination. So.
Dr Laura (41:41)
Yeah.
I hate it yet. β How very dare you.
Mm-hmm.
Fallon Cook (42:09)
β I'm imagining they're probably feeling pretty tired at this point, but I would say you're pretty close to that point where he'll drop that day nap. He'll build his confidence falling asleep without needing you in the room and it will all start to come together. So my fingers are across.
Dr Laura (42:23)
Yeah, awesome. Okay,
who have we got next?
Fallon Cook (42:30)
Katie. β
Dr Laura (42:31)
Okay, so Katie has a six and a half month old baby girl and she says that sometimes my daughter will babble in the night or very early morning and after about 10 minutes or so puts herself back to sleep. Occasionally when she goes quiet, I'll turn on my phone light to check she's okay and I find she's awake and silently staring at me. She says, is this okay? Am I causing any issues by not going to her when she babbles and is awake?
Katie adds that if she cries or seems unsettled in the night, they respond straight away, either resettling in the cot or depending on the time, getting her up for her overnight feed. I think this is a quick one, isn't it? Yeah.
Fallon Cook (43:14)
I love this question. Yeah, so it's perfectly
fine if she's really happy. She's not bothered being there. It's absolutely fine and you don't need to worry about it. But I would just be thinking, just keep an eye on that daily rhythm because sometimes as they get older, if they're spending a lot of time awake in their cot at night, they start to get really frustrated. And then eventually that turns into them not wanting to go into their cot at the start of the night. They're just associating their cot with being awake and bored for a long amount of time.
Dr Laura (43:43)
Hmm.
Fallon Cook (43:43)
rather than
associating their cot as being sort of a lovely place to fall asleep. So just keep an eye on it. Like if it's really hanging around, just tweak that daily rhythm a little bit and hopefully you'll see that, yeah, she's sleeping through and not having any long stretches awake. Yeah, so it probably is a bit of a short sweet answer. Would you add anything to that, Laura?
Dr Laura (43:47)
Hmm.
Yeah, no,
I think that's fine. I think you're spot on the money. So good luck, Katie. Yeah, you might just need to tweak the bedtime by 10 minutes and see how you go. Okay, we have a question from Rebecca. And Rebecca wrote in to say that she tried what she calls the advanced sleep method for the first time. And within five minutes, her little one vomited.
Fallon Cook (44:06)
Mmm. β
Mmm.
Dr Laura (44:28)
and she asks whether she should try a different approach. What do think?
Fallon Cook (44:33)
Okay,
so we don't have an approach called the advanced sleep method, but a lot of our toddler approaches have the word advanced in them. So it could be, could be that this is a toddler. I'm not sure. But look, regardless of what the approach is, there's a couple of things I would say. The first would be, of course, try a different approach. If we find it just overwhelmingly hard and it sounds like your baby or your toddler was, you know, reacted pretty strongly to whatever the approach was that you were trying to use.
Dr Laura (44:38)
Mm.
Mm-hmm.
Mmm.
Fallon Cook (45:03)
Absolutely consider a really gradual approach. Give them lots of time to warm up to the idea. Could be something like the slow fade or the advanced slow fade β approach. So you're just really building up their skills and different sleep associations as you gently make a transition to cot settling. So definitely consider other approaches. But I will also add that babies and toddlers vomit very, very easily. So
Dr Laura (45:22)
Mm.
Fallon Cook (45:29)
As an adult, if you're crying, you would have to cry incredibly hard to trigger a gagging vomiting reflex. But for babies and toddlers, they can do it so easily. Like we've all been there, they have a big feed and then they start to have a bit of a cry about something and then suddenly, look, there's the feed. Like it's so sensitive for them. So all I would say is
Dr Laura (45:37)
Mm-hmm.
Mm-hmm.
Yes. Yeah. they're giggling.
They're giggling at their brother or sister, making them laugh. It doesn't have to be crying. Out it comes. Yeah. Yeah.
Fallon Cook (45:52)
Yeah, and then, yeah, exactly.
They're really sensitive to it. So of course it's unpleasant when they have a vomit. Try not to be, β frightened by it, I suppose. Try not to be overwhelmed by it because it can happen really easily in babies. Doesn't necessarily mean that there's something, excuse me, really drastically wrong. β but absolutely you could consider a slower approach if it was a very extreme reaction for your baby or toddler. β
Dr Laura (46:13)
Mm.
you
Fallon Cook (46:20)
So I hope that helps. think just knowing that they've got that really sensitive gag reflex β can just help parents to kind of go, okay, they're okay. They've just, you know, this is more of a physiological thing that's happened. And at any time you can reassess what approach you're using, adapt it, look through the different modifications you can apply and see if you can find one that feels like a good fit for you and a good fit for your baby or toddler as well.
Dr Laura (46:41)
Mm.
Yeah, good
luck Rebecca. Let us know what you decided to switch to and how you got on and how your little one adapted. So be brave, you'll be all right.
Fallon Cook (46:56)
Yeah,
yeah, yeah. If you need some extra support, book in for a coaching call. β Yeah, often it's great just to talk through the different options with parents and work out what the best fit is. Awesome. And lucky last is Ash. So Ash has a toddler who's another two year and four month old. They're all around that age in this episode. He has recently experienced a major setback in his sleep.
Dr Laura (47:02)
Hmm.
Hmm.
Mm-hmm.
Yeah.
Fallon Cook (47:22)
So previously he fell asleep in his cot while holding mum or dad's hand, but now will only fall asleep in mum's arms and wakes in a panic if placed in the cot. He refuses dad at bedtime, screams and even retches. again, like the vomiting type thing when he's placed in the cot and he has tried to climb out of the cot as well. β Ash says, any attempts to fade out or leave the room are met with intense distress. Bringing him into their bed leads to very poor sleep for everyone.
Dr Laura (47:36)
β Yeah.
you
Fallon Cook (47:52)
Ash is working full time, six months pregnant and concerned about the sustainability and the impact that it's going to have on the new baby when they arrive. They've also recently moved house and their toddler says he just wants mummy or cuddles. Ash wants to know what should they do to help their toddler return to independent sleep? Could the recent house move and the upcoming new baby be contributing to this intense regression?
Dr Laura (48:17)
β gosh Ash you have a lot going on in your house. β Yeah I really... It is! Yeah those are big enough changes for adults β and add it know what it's like for a little toddler. Those are really big things happening in his little life. It there's not I should add it's not unusual you haven't done anything wrong.
Fallon Cook (48:22)
Yeah. It's a recipe for separation anxiety. All those big changes. Yeah. It's tough.
Mm.
Dr Laura (48:47)
many toddlers move house and their mums get pregnant with their siblings. So they're very common occurrences for toddlers, but that doesn't mean that it's not hard for them. So I suspect their mum being pregnant and the recent house move have played into the sleep challenges that Ash's toddler is now experiencing.
β So let's think about how to get you out of this situation that you're in so that you can be better rested for the last few months of your pregnancy. β And so that your toddler also is getting better sleep. I am immediately thinking β it's probably time to move your toddler out of the cot because you're saying that he's tried to climb out of the cot. And I know the email is actually longer.
And I think that he has actually managed to climb out of the cot. If your toddler is trying to climb out of it, but it's just nowhere close, there's no way that they're going to do it. Then you don't need to move them out of the cot. But in this instance, think this β Ashes toddler is actually able to get out and therefore it becomes a safety issue. So I would be taking the side off the cot and turning into a toddler bed, or if you have another β
Fallon Cook (49:46)
Mmm.
Mm.
Dr Laura (50:11)
bed ready to go, then move him to a bed. And then I would be β going quite gradually. He's had a lot of big changes. You're describing him as having intense distress. This is not the time to be ripping the bandaid off. β I think that we need to go β quite gradually with your toddler, Ash, and think about putting a spare bed in the same bedroom, like alongside your toddler's bed.
β and using something like the co-sleeping fade out method where you support your toddler to sleep β on a different sleep space, but alongside each other. And then you start to β wean β him off your physical touch and then out of the room β really, really gradually and being respectful of the big intense emotions that he's feeling right now.
Fallon Cook (50:45)
Mmm.
Hmm
Dr Laura (51:06)
You've got a few months up your sleeve
before the new baby arrives. So I think slow and steady is definitely going to win the race in this instance. What do you think, Fallon?
Fallon Cook (51:15)
Hmm.
Yeah, I think co-sleeping fade out could be a really good option. And a lot of people even start that from their toddler and the parents sharing the same bed in the toddler's room. β so that you can start out really, really close and then kind of gradually move away from there if you need to. But the one thing I would a hundred percent say is Ash, you are growing a baby and this is a job for dad. This is a job for dad to manage. Ash, we have to protect your sleep.
Dr Laura (51:26)
Hmm.
Hmm
Fallon Cook (51:44)
If it's at all possible for dad to be the one who is in there, giving him that support, leaning in, being there for him and doing that gradual phasing out. β I would highly recommend that because you, yeah, you're growing a baby. You really need your rest and also sharing a bed with, you know, two and a half year old who can, they can kick and thrash around quite a lot too. β You know, we've got to think about that as well. β When you're growing a baby, you want to kind of protect your belly as well.
Dr Laura (51:44)
Hmm.
Mm.
Yeah.
Yeah.
Mm.
Fallon Cook (52:12)
β
so I think that could be a good way to divide the labor in a way. β and I also agree, like, think separation anxiety is probably very high in this child. So something where you're present all night is a great idea, but maybe it's just a case of just getting him staying in his own room all night. And that's the first goal. And then it's working away from how much support you're giving him over time. β so check out that co-sleeping fade out approach. And it's the sort of situation where see how you go. If it's not coming together.
Dr Laura (52:29)
Mm.
Mmm.
Fallon Cook (52:41)
I would recommend a coaching a call for cases like this because you've got that bit of a deadline of a baby on the way. So if it's not coming together, we can always work up a plan together and figure out what we need to do to get you there. Amazing. What great questions this week. They're always great questions, but it's nice to have a few toddler ones as well.
Dr Laura (52:44)
Mm-hmm.
Mmm.
Okay. Yeah. Yeah. Yeah, I
love the toddler ones. I think a lot of our families have gone, they joined the baby program and their children and our toddlers and yeah, so we're getting more toddler questions now it seems. Yeah.
Fallon Cook (53:07)
Yeah.
It's lovely isn't it? We have so many
families that start out in the baby programs and then they just move through and keep coming back and we get to see these little ones grow up and what an honor it is beautiful. And in terms of our programs I wanted to say before we wrap up today's show, β a lot of our listeners will know that I did the β Sleep Baby Sleep webinars for the Raising Children's Network a couple of weeks ago. We did one focused on zero to three months and then another focused on four to 12 months.
Dr Laura (53:21)
Yeah.
Mm.
Fallon Cook (53:41)
And I was thinking, these are like, they're freely available resources for everyone. Anyone can go and watch those webinars. β but I thought I'm going to pop a link to them within the Sombol program. So if you're working through that sleep foundations chapter, you'll now see there's a lesson in there that just includes that link, because I think it's a really lovely chatty kind of, it's a Q and A session. It's a lovely overview, just looking at lots of different facets of sleep. β and I know for some parents, it's easier to digest information in that format. β
Dr Laura (53:53)
Mm.
Mmm.
Fallon Cook (54:09)
So it's great to have it available in a few different formats. Yeah. And I'm to pop a link in the show notes as I always do. If you would love to buy us a coffee, please do. We love coffee. It's a great way to show your support. Yeah. And of course, if you need help with sleep and settling for your baby or toddler, that is what we do every day of the week. Even at 9.30 PM at night on a Monday, we're still sitting here talking about sleep.
Dr Laura (54:20)
We do.
Yes.
Fallon Cook (54:38)
We've got Sombelle we also have the most amazing sleep clinics where we see parents actually all around the world via telehealth. get clients, we had a client from somewhere interesting the other day, didn't you? Where was it? Was it like Finland or something?
Dr Laura (54:49)
Ah yes, where were they?
Austria. Austria. Yeah. Yeah.
Fallon Cook (54:54)
β awesome. Yeah. Yep.
terrific. So yeah, it really doesn't matter where you are. β we can help you either through Sombelle or through the sleep clinic. So do go and check out our resources that are available and β know that we're here to help. So thanks everyone for tuning in.
Dr Laura (55:11)
Thanks everyone, bye bye.
