146: The Rested Child with Dr. Chris Winter

Sleep!  It’s a topic that’s on pretty much every parent’s mind.  We’ve already looked at this from a cultural perspective, where we learned our Western approach to sleep is by no means universal, and that this can result in quite a few of the problems we face in getting our children to sleep.   In this episode we dive deep into the practicalities of sleep with Dr. Chris Winter, who has practiced sleep medicine and neurology since 2004.  His first book, The Sleep Solution, Why Your Sleep Is Broken and How To Fix It (affiliate link) was focused on adults’ sleep challenges, and I’ve been putting the ideas in it into practice and have been getting better sleep as a result.   His new book is The Rested Child: Why Your Tired, Wired, or Irritable Child May Have a Sleep Disorder--And How to Help (affiliate link), and is based on Dr. Winters’ almost two decades of experience of evaluating children in the sleep clinic that he founded.   We’ll look at ways that you can get more sleep (or maybe even more rest that feels almost as restful as sleep), whether you can shift your (or your child’s!) sleep patterns, how to banish bedtime struggles for good, and so much more!   This episode is for all parents, but especially for those who are expecting or have a child under the age of one, and who are desperately trying to get more sleep (or worried about being in that phase of life in the near future!).  We’ll help you get started on the right foot so you can know you’re doing the best for your child - and for yourself as well.   If you are expecting or have a child under one and you’d like to join the Right From The Start course to help you find the path that’s right for you and your child on sleep and feeding and independent play and brain development and not lose yourself in the process, then we’d love to have you join us. Get notified when doors reopen. Click the banner to learn more.     Dr. Chris Winter's Books:

The Rested Child: Why Your Tired, Wired, or Irritable Child May Have a Sleep Disorder--and How to Help

The Sleep Solution: Why Your Sleep is Broken and How to Fix It (Affiliate links).

    [accordion] [accordion-item title="Click here to read the full transcript"] Jen Lumanlan  00:02 Hi, I'm Jen and I host the Your Parenting Mojo podcast. We all want our children to lead fulfilling lives. But it can be so hard to keep up with the latest scientific research on child development and figure out whether and how to incorporate it into our own approach to parenting. Here at Your Parenting Mojo, I do the work for you by critically examining strategies and tools related to parenting and child development that are grounded in scientific research and principles of respectful parenting. If you'd like to be notified when new episodes are released, and get a free guide called 13 reasons why your child won't listen to you, and what to do about each one, just head over to yourparentingmojo.com/subscribe. You can also continue the conversation about the show with other listeners and the Your Parenting Mojo Facebook group. I do hope you'll join us.   Jen Lumanlan  01:00 Hello, and welcome to the Your Parenting Mojo Podcast. Today we're going to talk about a topic that I know interests parents everywhere and that is sleep. We've already covered this on the show from the perspective of looking at cross-cultural ideas about sleep. But today we're here with an expert who's going to give us some practical ideas about how to get more sleep. Now I know that sleep is an important topic to parents with children of all ages, but it's especially important to expecting parents and those with newborns. And if that describes you right now, I also wanted to let you know that the Right From The Start course is reopening for enrollment on Sunday, October 24th. I run this course with the amazing Hannah and Kelty of the upbringing podcast. And I truly love doing it with them. Because our skill sets complement each other so well. I bring all the research-based information you've come to expect from this show as well as 100 hours of coaching, training, and a good deal of experience in coaching parents over the years. And they bring a lot of training and topics relevant to new parents. But the reason that I wanted to work with them specifically on the course is that they're trained in resources for infant educators or RIE methods, but they aren't RIE associates, which means they help parents to take what they find useful out of RIE rather than seeing it as a prescriptive set of tools. And of course, as twins themselves and being the parents of four children between them, they've just about seen it all from the perspective of siblings, so they can offer a lot of guidance to parents who aren't new at the parenting thing, but who also know that they can't do things the same as they did them with their previous child, or they don't want to do them like that. So the course has 10 modules and runs over nine weeks, all of the content is available in video and audio, and there are transcripts as well so you can learn in the way that you learn best. We have a supportive community of parents who are on this journey with you that isn't on Facebook. And we also meet for group coaching calls regularly as well. The parents who have taken the course tell us that they got the knowledge they knew they needed, but what they didn't even know they needed was the community of parents who really do get to know each other and us as well on the coaching calls, who offer support and guidance related to whatever struggles we're facing during this period in our lives from trying to figure out who you are as a person with a newborn to your shifting relationship with your partner, and your own parents as well to navigating difficult sibling behavior. We cover it all. So if you're expecting a child or you have one under one year old, the right from the start course was designed for you and I'm as I'm sure you can tell, it doesn't mean that we're going to tell you the one right way to raise a child but rather to help you find the right way for you. So once again, enrollment is open starting Sunday, October 24th. And we start as a group on Monday, November 8th, you can learn more and sign up at yourparentingmojo.com/rightfrom thestart. So our guest today Dr. Chris Winter is a board-certified neurologist and a double board-certified sleep specialist who is in private practice in Charlottesville, Virginia. He consults with athletes on improving their sleep and his first book The Sleep Solution: Why your sleep is broken and how to fix it, was geared towards adults’ challenges with sleep. His new book just published in August is called the Rested Child: Why your tired wired and irritable child may have a sleep disorder and what to do about it. So today we're going to talk about sleep for children, sleep for parents’ and sleep for everybody. Welcome, Chris. It's so great to have you here.   Dr. Winter  04:20 Thank you so much for having me. It's an honor.   Jen Lumanlan  04:24 So I would like to start by addressing the elephant in the room because I know that parents who are listening to this I want to know your stance on these topics because they want to know if this person's approach is aligned with things that I believe about sleeping, about raising my children, and about my values and beliefs. So bed-sharing. I will say that I found your approach in the book to be a little bit flippant and I will quote what you said, “We used to sleep piled on top of one another in a cave, I suppose. But we also used to banish people with leprosy and smoke cigarettes in operating rooms. We evolve.” And that to me sort of implies the only backwards people in backwards countries, you haven't yet seen the light in the sort of Western, educated, industrialized, rich, democratic approach to sleep, they're just, you know, our approach is clearly superior, and they're missing out on some important development. When actually I know the research has shown that people who live in those countries, you asked them about their children's sleep problems, and they're like, “What sleep problems?” So tell me more about your stance on bed sharing and where that came from, and what you believe about it.   Dr. Winter  05:30 Sure. So, I think it's important to define evolve, because you're putting a judgment on it, when in fact, evolve just means take something that's simple and make it more complicated. And we do that very well in this country. I used to be able to fix my own car, I cannot do that anymore, because the cars have evolved to the point now where it doesn't allow that to happen. So I do think that sleep was very simple in the past, and it's become very complicated. People did sleep in one room at some point in the past, and now you have a nice house in Gwinnett County, you know, Atlanta, and every one of your seven kids have their own bedroom and their own situation. So I'm not here to pass judgment on anything, my stance on co-sleeping is, you do what's right for your family and your children, I don't really have an opinion on it one way or the other. Outside of two things. One, I do think that it is important to be careful with little children when you sleep with them just out of a danger perspective and I don't think that's particularly radical, although I do think it took a while for the American Academy of Pediatrics to really come out with a position on it just because of this kind of, you know, feelings about it. It’s deeply personal to people the way they sleep, so I personally believe that it's probably not a great idea to sleep in a bed with a child under the age of one. Just because, you know, I think that we have seen bad outcomes. I've seen, I think, as of today, 32,233 people in my clinic, and four of them have had issues where children have perished in the night because of a family member role on top of them. That's a very, very, very small percentage, far less than what you know, would be quoted for SIDS. So to me if a parent understands that, and it's very important to them to take that risk. I'm not really here to judge that. I can say that of the people that we spoke to when that happened, including a family member of somebody who works for me, it was deeply traumatic, and something that they never wanted to repeat again. I think that's different, though, then a family bed or co-sleeping, I mean, I think that's a very different situation. The other bias that I have is that of those 32,000 people that have come to my clinic, I have yet to encounter somebody who says, “I'm sleeping with all four of my children and it's going great. I just wondered if you give me some tips on how to make it even better.” The vast majority of people that we're seeing are sort of the opposite. It's like help us to make the situation that we've chosen, which is to not have a child in bed with us, more functional and better. So I’m here to support anybody. I think that the people who are co-sleeping and doing well with it, don't really have to see me or by the book. And I think co-sleeping can be really helpful because when you look at some of the disorders of sleep that we talked about in the book, there's sort of a mystery to the parent or parents that aren't with their children until they share the hotel room, until they go to grandmother's house, and share a bed because grandma has one spare bedroom, where they're like, “Dear God, my child does this thing at night. We had no idea.” So, you know, even if you're somebody who believes not, you're not in co-sleeping, it might not be a bad idea once a month to kind of check-in like, “We're all sleeping together to make sure we're not harboring bad sleep problems.” And so anyway, I think and then the only other thing I would say that again, there's a selection bias here too, is that when kids come to have sleep studies apparent we make a parent accompany them. And so our sleep centers and hotels, it's very comfortable that the child has a bed and the parent has a bed in this you know Hotel it truly, it's a Hilton Hotel. It's amazing how many times the parent is the one diagnosed with the sleep problem. The tech will say, “The kids are okay, dad is suffocating 38 times an hour kind of thing,” so I do sometimes wonder if, you know, if you're going to co-sleep it might be a good idea to make sure your sleep is really healthy and positive before you subject your child to it, but that's a small percentage, probably.   Jen Lumanlan  09:52 Yeah. Okay, cool. Well, thanks for clarifying that. And I guess my stance on co-sleeping has always been, I don't believe It's currently being itself, it's necessarily dangerous. It's currently being in the way that we tend to do it in this country, on a soft bed with a duvet and pillows and above the level of the floor, so the child could potentially roll off the bed. There is some potential danger of rolling onto the child, but my hypothesis based on the research that I have read is that the danger of that happening is much less than the danger of the child suffocating from a pillow or from getting a duvet on them, or rolling off the bed, or something else happening that's based on the practices that we use when we sleep. And that if we didn't use those practices, if we use practices that are more like the practices used where people do co-sleep routinely, then chances are that would be much, much less dangerous. Do you agree with that perspective?   Dr. Winter  10:50 Yeah, that's probably very true. You know, a lot of the things that we talked about in terms of having bumpers and cribs, and soft pillows, and stuffed animals, you know, really having a hard surface and a simple surface, and, you know, just and creating things that make you as the parent comfortable, or we co-slept with our kids, they were just in a little bassinet, kind of like you described next to our bed just because I am not interested in sleeping on the floor, even though it might be better. And I know from experience that my wife would sometimes say, it's truly disturbing how deep, deeply you sleep sometimes, because she's been screaming for 30 minutes, and you haven't moved to the point where when I was in residency, my wife would not let me be at home with the kids while I was sleeping unless I was sleeping literally on the floor, as you said, in the nursery away from them, so they could like throw stuff out of the nursery onto my head to wake me out just because I was always, even just kind of on a couch, which is the worst place you sitting there watching TV and you kind of drift off with them on your stomach, like, I was always very paranoid about that. Absolutely. But I would agree with everything you said.   Jen Lumanlan  12:03 Okay, I can fully empathize with your wife, too.   Dr. Winter  12:07 Yeah, she really feels like I mean, I probably shouldn't announce this. But if people came into the house and announced at night, I would be no help in terms of dealing with the situation. I'm not sure what she thinks I could do in that situation but might be better to sleep through it. I don't know.   Jen Lumanlan  12:22 Yeah, maybe. And then you do sort of casually toss out this idea that if we start out co-sleeping, then children are going to refuse to sleep on their own later. And you have this little footnote that says, “Sweetie, can you take your laptop somewhere else to do your calculus homework? Daddy and I need to sleep.” And I have this statistic that quotes a paper that “researchers suggest co-sleeping children slept fewer hours had more sleep disturbances and bedtime resistance, more behavioral and emotional problems than independent sleepers,” but that study involved school-aged children, and also found that the anxiety and nighttime fears predicted co-sleeping rather than the co-sleeping was generating anxiety and fears. So it seemed to me as though it was unlikely that co-sleeping was going to cause behavioral and emotional problems, which is what I understood when I was reading that in your book. What do you think about that?   Dr. Winter  13:10 I don't think it causes it. Again, it's just a matter of what does the parent want? And most parents are probably not letting those it's sort of like, oh, no, I remember having a conversation about parents when they said you're too old for a blanket. I have no idea why they chose that particular Tuesday to just take it away from me. My guess is at some point, I would have not been that interested in the blanket, we never told our kids to stop. We call them booze. Okay, no more booze because you're this particular age. So again, I think the footnote was more in line with at some point, parents are like, we don't want to let this sort of play out naturally, I have no doubt in my mind that it always does. I mean, I've never met a family who said, “He's 17. He's still in the bed with us and we really just losing our patience. So to me, that's more about at some point, most co-sleeping families that are coming to see us have decided we're done with it; It's affecting our intimacy, and we want to have some time by ourselves at the end of the night that don't involve the kids in the bed with us. I had an NBA player that had two children in bed, one went to bed every 3rd or 4th nights and he was like, “This is affecting my career because I'm having to get up and change sheets every night. My wife is like that's okay, because this is what we're going to do.” So, again, these are probably true, It’s just I think it's hard to find some parents with the courage to let it play out. They kind of want their lives back. And to your point, that's a big problem when it comes to sleep, I mean, one of my mentors said, you know, most kids sleep problems are parents’ sleep problems, and it's an expectation that we have of our kid that's not meeting our needs, “I've got a lot of work to do. And I'm falling behind and watching episodes of white lotus. So I gotta get this kid in her bed so I can do what I need to do.” If your expectation is they can be in bed with me, they might sleep, they might not, everything. Even adult sleep gets better. So a lot of what we're managing is now, that's why you said what is your stance on sleep training, I love that term as if we're doing like, the parents that didn't train their kids to sleep and now they can't, you know, I mean, it's, it's not swimming, for God's sakes, like they're going to sleep, they may sleep differently than what you would expect or on a different schedule. But the idea that we're training them, we're just kind of guiding some little parameters here and there. So it's interesting the way we think about these things, kids are good sleepers and good eaters, and good breeders and good drinkers, like we just kind of need to step back and let it happen and be on the lookout for problems in those areas. But our dominion over the situation, I think, is a lot less than what we think it is.   Jen Lumanlan  16:00 Yeah, and I wanted to translate what you're saying into language that I think will be familiar to people who are longtime listeners of the show, we're really talking about needs...