Dr Christian Fludder

Dr Christian Fludder

Sleeping difficulties in children are not uncommon,(1) and we know what a lack of sleep can do to us. It makes everyone more irritable and sensitive.(2) It reduces our ability to provide the care we want due to being too tired to look after our child properly.(3)

And concerningly, reduced parental sleep is often associated with parental depression.(4,5)

This raises the all-important question then: why is my child not sleeping?

You ask that question on a site like this with many different health professionals and guess what? You end up with a lot of different answers.

Could it be a “Leap Week” or are they hitting a “Sleep Regression” stage?

Could it be something they have eaten?

Could it be a problem with the hormone that is used to fall asleep – Melatonin?

As a chiropractor, I tend look to the musculoskeletal system for a potential cause. Any why would that be involved? Well, I put it down to pain. See, infants have the capacity to feel discomfort in pretty much the same way as adults.(6) Could they be feeling discomfort?

This is where it’s so important to understand how critical sleep is to our system. There are processes at play that we are only just beginning to understand – one of the most recent findings is that of the glymphatic system; an entire network of microvessels inside our brain aimed at removing waste products from the days thought processes.(7) Under the age of two years a child’s brain is making roughly 1.8 million connections per second – that’s a potential of a lot of waste product from all that thinking! Think also about the amount of sleep a child needs to get; as a newborn we would expect around 16 to 18 hours of sleep (and this is almost split perfectly between night and day as night and day are not fully established yet)(8). This reduces to around 13 hours a day for the two-year-old, that also includes a little nap during the day(8).

So let me take you through my train of thought here.

  1. Are they sleeping well in the daytime but poorly overnight?

    What do we do more at night? Sleeping is rest and digest; this makes me think that in the infants not sleeping properly overnight there could be a digestive issue in play. This is further influenced by what we eat and how we perceive gut sensation. Yes, what you eat as a breastfeeding parent can influence what your baby is getting into their system. (9) Even different formulas have different ingredients which may influence your childs’ gut. But there is a catch here: gut sensation could be a reflection of your child’s nervous system balance, which could be influenced by the musculoskeletal system! (I’ll go into this more in a future post!)

  2. Are they sleeping poorly in the daytime but well overnight?

    This I attribute more to musculoskeletal pain. When we are awake during the day we may be more sensitised to things that we are feeling in our body, and as such, it is harder for us to fall to sleep. Think about that time that you sprained your ankle; it’s not always easy trying to fall back to sleep again when you’re aware of the discomfort. And then, after a day of sleeping very poorly – well guess what – baby is absolutely exhausted and tends to sleep better overnight.

  3. They are just sleeping poorly at all times.

Congratulations you hit the jackpot. This one could be a combination of all the above!

So what can be done? Well, the good news is you are already on this site looking for information about sleep and sleeping difficulties in children. Talk to your health care professional; your GP or Child Health Nurse. There is an entire subgroup of professionals called sleep consultants who are available to provide their expertise on this particular subject. And if you’re suspicious that they may be a musculoskeletal component to their sleeping behaviour, bring this up with your health care provider who works with the musculoskeletal system – physiotherapists, osteopaths and chiropractors among others – who have a focus on the paediatric population.

If you would like to know more, I do have some short YouTube videos which you are welcome to watch:

Anxiety, Sleep Difficulty and the Vagus
Sleep Awareness 2018

Thank you very much for reading, and I hope this has been helpful for you.

Sincerely,

Christian Fludder

 

References:

  1. Byars KC, Yolton K, Rausch J, Lanphear B, Beebe DW. Prevalence, Patterns, and Persistence of Sleep Problems in the First 3 Years of Life. Pediatrics [Internet]. 2012 Feb [cited 2022 Aug 1];129(2):e276. Available from: /pmc/articles/PMC3357046/
  2. Huber FA, Toledo TA, Newsom G, Rhudy JL. The relationship between sleep quality and emotional modulation of spinal, supraspinal, and perceptual measures of pain. Biological Psychology. 2022 May 1;171:108352.
  3. Valla L, Småstuen MC, Andenæs R, Misvær N, Olbjørn C, Helseth S. Association between colic and sleep problems in infancy and subsequent development, emotional and behavioral problems: a longitudinal study. BMC Pediatrics. 2021 Dec 1;21(1).
  4. Hiscock H, Cook F, Bayer J, Le HND, Mensah F, Cann W, et al. Preventing Early Infant Sleep and Crying Problems and Postnatal Depression: A Randomized Trial. Pediatrics [Internet]. 2014 Feb 1 [cited 2022 Aug 1];133(2):e346–54. Available from: /pediatrics/article/133/2/e346/30892/Preventing-Early-Infant-Sleep-and-Crying-Problems
  5. Khatun F, Lee TW, Rani E, Biswash G, Raha P, Kim S. The Relationships among Postpartum Fatigue, Depressive Mood, Self-care Agency, and Self-care Action of First-time Mothers in Bangladesh. Korean Journal of Women Health Nursing [Internet]. 2018 Mar 20 [cited 2022 Aug 1];24(1):49–57. Available from: https://synapse.koreamed.org/articles/1094764
  6. Goksan S, Hartley C, Emery F, Cockrill N, Poorun R, Moultrie F, et al. fMRI reveals neural activity overlap between adult and infant pain. Elife [Internet]. 2015 Apr 21 [cited 2019 May 22];4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25895592
  7. Jessen NA, Munk ASF, Lundgaard I, Nedergaard M. The Glymphatic System: A Beginner’s Guide. Neurochemical Research 2015 40:12 [Internet]. 2015 May 7 [cited 2022 Aug 1];40(12):2583–99. Available from: https://link.springer.com/article/10.1007/s11064-015-1581-6
  8. Kliegman R, Stanton B, st. Geme JW, Schor NF, Behrman RE. Nelson’s Pediatrics. 19th ed. Philadelphia: Elsevier; 2011.
  9. Hill DJ, Hosking NR, Carlin JB, Francis DEM, Brown J, Speirs B. Colic in breast fed infants is due to hypersensitivity to dietary proteins excreted in breast milk. Journal of Allergy and Clinical Immunology. 2004 Feb 1;113(2):S338.