What really goes on at sleep school
Image from istockphoto.
The first time we went to sleep school we were kicked out after a day. Just as I had settled into a relaxed pose in my bedroom with a magazine, one of the nurses mentioned that my one-year-old seemed a bit warm – and when a thermometer showed a 38 degree temp it was back home for us. I left in tears.
14 months of sleep deprivation had taken its toll, and as a family we were exhausted. Although she had been a content baby, sleeping in 4-6 hour stretches after the first few weeks, she continued to wake up two or three times a night as she grew. We waited until she started solids. No change. We attempted self-settling. No change. Lucinda’s first birthday came and went. Before we went on holidays over the New Year, I saw a GP who recommended sedation with an anti-histamine, just to give us a break. My daughter rolled around her cot giggling for an hour, then passed out, only to wake up four hours later, as usual.
When their little ones are finally asleep parents tend to huddle in the meal room clutching cups of tea and comparing war stories.
Luckily, my GP had also referred me on to Tresillian’s residential program. Although our initial visit was cut short I felt that the routine the nurses had given me was doable at home, so once Lucinda recovered from her illness we tried it at home. No more bottles overnight, settling in to the cot awake, no breastfeeding to sleep... all the crutches went out the window. My daughter banged her head on her cot bars and cried and cried – while we were right there with her – and after a week it worked. Phew!
But another weekend away, a few more minor illnesses and we were back to where we started. The routine we tried last time wasn’t working. In fact, she seemed to be waking up more distressed than ever, and crying for hours overnight while we tried to comfort her. Alarmed by this, we visited two doctors and a chiropractor to find a reason for her night-time discomfort. We tried sinus sprays and stool softeners and joint manipulation, to try to make her more comfortable at night.
Eventually, we were told that there was absolutely nothing physically wrong with her and that it was purely a sleep issue. So back to sleep school we went. Tresillian gave me the next available vacancy.
Australia’s largest child and family health organisation, Tresillian offers help to parents over the phone, or at one of three residential care centres in Sydney, with funding provided by the NSW health department. They also have a live online advice service, funded by Johnson's Baby. Parents are offered either a day stay or a more intensive 5 day session. We went for the long one.
Tresillian’s Inner west facility in Canterbury offers about 14 bedrooms, each with an ensuite and a small annexe for the baby to sleep. Partners are welcome as are young siblings if no other care options are available. During my stay, it was heartening to see many dads participating in the program, rather than enjoying a sleep-in at home!
The rooms are comfortable enough (although a doona from home would have helped) and parents also have access to a meal room, toy room and outdoor play area.
All meals for parent and child are provided at the centre, with adult meals provided by a service which also supplies public hospital food. Needless to say, it’s not flash. However, plenty of snacks are available and with dozens of takeaway restaurants nearby, ordering in is an option. But really, who cares about the food when you don’t have to cook it and clean up afterwards?
The first day and night, sleep and settling is done by the Tresillian nurses so that they can observe the baby’s sleep patterns and also so parents can relax, resting up before they take control of settling on the second day. If a baby requires feeding overnight, nurses wake the parent to provide the breast or bottle feed.
As she did for me at home, Lucie cried and resisted nap time and bedtime, crying for about half an hour with nurses checking on her at 10-minute intervals and putting her back in her toddler bed. When I was told that she finally fell asleep exhausted on the floor, I felt awful. Was I doing the right thing? I woke at 6am worried that she’d cried all night, however the nurses said that she’d woken at 5am then gone straight back to sleep again with verbal direction, i.e. “go to bed”, “lie down” etc.
Nurses tailor routines and techniques to the age of the baby, so for younger babies “hands-on” settling is encouraged, while toddlers will be given verbal direction and left to self-settle for short periods.
When their little ones are finally asleep parents huddled in the meal room clutching cups of tea and comparing war stories. One baby only slept 45 minutes at a time. For eight months. Others had come from as far away as Coffs Harbour, as such facilities aren’t available in rural areas.
On day two, Lucie’s bed was moved next to my room and it was my turn to try the settling technique. We tried verbal direction first, although she would not stay in her bed. Next step was leaving her to cry with the door closed, then going in, returning her to bed and repeating the verbal direction. She continued to headbang, and I was assured that this is normal, although uncommon behaviour in toddlers and that she would not cause injury to herself. Still, the routine was working, and she would settle to sleep in about 30 minutes. Overnight though, she continued to be harder to settle, and it would take at least an hour.
Another feature of day two is a visit with a social worker. This provides parents with the opportunity to talk about their parenting issues and the effect of lack of sleep on the family household. I found this session very useful and was able to workshop some ideas to receive more support and downtime, in order to better manage my stress levels.
Tresillian family centres also run group sessions with social workers and other professionals during a stay to provide further information and support to parents – it’s always heartening to know that there are others in the same boat.
Day three fell on a Sunday, so my husband came into to have a try at the technique himself. We managed to settle her for naps and bedtimes in less than 30 mins, which was very encouraging. Another technique we tried was standing or sitting in the doorway without making eye contact, so as not to upset her by closing the door. This had variable success, but I found it less stressful than standing on the other side of the door.
Day four was spent reading, going for walks and playing. The opportunity to do little else but play and bond my daughter was wonderful, especially as I usually have to share her with work and an older brother. We also saw the on-staff paediatrician to rule out any physical problems.
Unfortunately, night four was the worst night yet! Lucie woke at 10.30, 1am and 5am, taking at least 40 mins to settle each time. As 6am loomed, the nurses kindly offered to take her to the nurses’ desk and keep her happy colouring in, while I attempted to catch an extra hour’s sleep before breakfast. Over breakfast I felt a little despondent, hearing stories from other parents who’d had total success with their little ones. Mr 45-minutes, for example, finally slept through on his last night!
I drove home mindful of the advice from the nurses that the sleep issues may take two to four weeks to resolve even following the routine.
So here we are almost a month later and I’m sorry to say that she is still waking at least once overnight. Fortunately, she usually settles for naps and bedtime without tears now and we have dropped overnight bottles - which were all goals of our stay.
After three weeks of controlled crying overnight with no success we decided to try a more gentle approach and now have a mattress on the floor in her bedroom for when she needs comforting in the small hours.
Every child is different
Because everyone’s experience of sleep school is different, I’ve asked a few other mums I’ve kept in contact with since our stay to share their stories.
Janelle, mum of ten-month-old Jack, said that her stay was “a success story” and that her life has changed. “Apart from him having a fever and infected throat this week he has been sleeping through,“ she said.
Rena, mum of four-month-old Nicholas , said that his “night sleep is definitely a lot better than what it was pre-Tresillian - I'm pretty sure it's because of the new environment he is in now (i.e, not in our bedroom, and more tightly wrapped than what he was previously)”. But she cautioned that “He is much harder to get down for day sleeps now - he requires more patting than what he did and a lot more comforting... poor kid I think all the crying has scarred him!!”
Justine, mum of 10-month-old Callum, said agrees with Rena. “Although we regress a few days here and there, his night sleeping has improved and I was able to kick the feed back to sleep habit. I do believe the whole experience taught Callum that boob doesn't equal bed and it has helped me be a bit firmer with him. I have come to terms with the fact that people who get 2 x 2-hour sleeps and sleeping all night through are just lucky.”
Justine added that “I did actually enjoy my time at Tresillian as it was a break from trying to juggle house work, being back at work and trying to be the best mum to Callum that I can be. It was nice to just enjoy him for a few days. I also got to realise that [my partner] and I are not the only parents on struggle street but there are lots of us. It was great to be able to talk to everyone and know that it's ok to ask for help and there is no right and wrong way, it's finding the best way that fits our life.”
Imogene's son Henry, 10 months, still wakes up overnight. Although he settles better, and is waking less, she admits she found the experience emotionally draining.
“If I could tell people ONE thing before they went to sleep school, is to be prepared to suddenly be grieving the breastfeeding you were resenting overnight, and to be prepared for a clingy, withdrawn baby - in short be prepared to have to re-work your whole relationship with your baby a bit," she said.
"We get so focussed on the "sleep problem" we think it can be isolated from everything else going on between you and your baby/toddler.” She suggested that parents should have the opportunity to chat to a social worker at the end of their stay as well.
Like me, Imogene has decided to adopt the attitude that, “this is just the way things are until they aren't, so just try to think of ways to not let it completely control your life. “
After all, all babies sleep through eventually, don’t they?