Adoption Related Sleep Challenges

All new parents probably struggle with a lack of sleep.  Although most expect this with a newborn… sometimes adoptive families are surprised to learn that an adopted child -of any age- can struggle with sleep issues during the first few weeks and even months at home.

So much depends on adequate, restorative and restful sleep. We’ve got important work to do at night including physical growth (80% of growth hormone is secreted while we sleep), to mental growth (integrating themes, lessons and memories of the day), to other functions that even experts don’t fully understand yet.  We all sleep in cycles, but children have unique sleep patterns.  Children of various ages require a certain amount of quality sleep to insure that development progresses as it should:

SleepingChart
Remember that attachment, bonding and teaching a child that a parent is trustworthy IS crucial… however, this puts adoptive families in an interesting predicament. A sleep-deprived parent is probably short on patience and flat-out exhausted.  In married families: remember that it’s important to divide up the nighttime wake up calls so that there isn’t only one parent bearing the burden.  (and no… it’s not appropriate to have the parent who isn’t employed outside of the home, taking care of all nighttime duties!) Have some talks and make plans for “worst case sleepless scenarios” before your child joins you. If you’re a single parent, tap into your support system. Nana’s, grandpa’s, best friends, etc. might love to help!

A few points which might insure future Zzzzzzz’s:

Take stock of the child’s former environment – if you have the opportunity.  Your child may be used to a communal room, specific lighting, noise levels, etc.   Creating a smooth transition into sleep at your home will require babysteps from this familiarity to your preferences.  Comfort objects should definitely be utilized (blanket, stuffed friend, or even a shirt or bed linen).  If the child doesn’t yet have one, now is a great time to introduce a “lovey” by making it part of a bedtime ritual.

Speaking of rituals… create one.  Sleep experts agree that creating associations tell our brains “it’s time to sleep” and a consistent routine is key.  A family bedtime ritual might consist of any of the following: quiet play, bath, pajamas, story time, a song, books… followed by bed.

Children who have been exposed to loss, chronic stress, multiple incidences of stressful events, or a significantly stressful one-time events are more prone to sleep disturbances and difficulties. Literature describes the sleep-wake cycle as one of the systems that is vulnerable and easily impacted by stress or trauma. Even in the best orphanages, institutional life can be a “chronic stress” because of the infant-caregiver ratio. The impact that multiple losses, (for example – birth parent to orphanage to foster home, to adoptive family), can have on children can be traumatic. Even for those children who don’t have lasting sleep problems, many internationally adopted children have difficulty in the first few weeks because they may be adjusting to a new time zone – in addition to experiencing a major and shocking change.

Know that night wakings are normal.  All children wake.  Statistics indicate that 70% of infants, 47% of toddlers, 36% of preschoolers and 14% of school-aged children wake and request parental intervention.  The less eventful the better: Keep calm & be brief.  Don’t turn on lights and be absolutely boring.

Some children have episodes of extreme terror, however the child is still in fact asleep. These are called “night terrors” and are different than typical nightmares or awakenings. Children can flail, panic, kick and show a gamut of behavior that may be truly atypical for them.  Many children have night terrors only when coming down with an illness.  Some do it on a chronic basis.  The incidents can be remarkably scary, intense and oddly…once it passes, the child will lay back down and go to sleep. Most experts recommend that you do not intervene with night terrors – other than to insure safety.  Children may not even be truly aware of your presence, and talking to them can be quite ineffective. The next morning, many will not even recall the incident occurred.

A good guideline for families is to not worry about or immediately expect their adopted child to sleep on their own for the first six to nine months of placement. The first one to two months, the child will be working on adjusting to their new environment on a sensory level – new sounds, sights, tastes, smells, and faces to adjust to. While they may have formed an “immediate dependency bond” (a bond that occurs rapidly to ensure a child’s survival) to one or both of the parents to get their basic needs met, the “real” attachment and bonding process usually doesn’t start happening until they have gotten very comfortable in their new environment. The attachment and bonding process continues to grow and strengthen over the first year of placement and beyond. Over the first several months, parents can relax and treat their child like a newborn, no matter how old they are – spoiling them and meeting their needs unconditionally.  Even at night.

Discuss your sleep challenges with your pediatrician and social worker! Our families have tried a great number of solutions and one of them may work for you too!

For further reading:
Sleep Information from the Center of Adoption Medicine:
http://adoptmed.org/topics/sleep-and-adoption.html”>http://adoptmed.org/topics/sleep-and-adoption.html

A book for reading about sleep challenges, that goes beyond the “cry it out” method:
http://www.amazon.com/Sleepless-America-Child-Misbehaving-Missing/dp/006073602X/ref=cm_cr_pr_product_top

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