Sleep-Onset Association Disorder

Linus of the iconic cartoon strip Peanuts has inspired adults and children alike with his stunning philosophical rants, all while sucking his thumb and holding onto his hallowed blanket. In fact, Linus cannot part with his blanket because of the inherent security it offers. Children such as Linus don’t only exist in the cartoon strip, however. Sometimes children in reality associate security with all sorts of inanimate objects or specific situations. With Sleep-Onset Association Disorder (SOAD), a child often wakes in the middle of the night and cannot fall back asleep if certain learned associations are not at hand. The child has learned, for example, to fall asleep in the presence of mom or dad or with a radio or a television. This list goes on, but such associative behavior can have detrimental effects on the entire family.

It’s normal for infants the world over to wake during the night, sometimes referred to as night waking. The trouble develops when the child does not (or is not able) to fall back asleep on his or her own. As far as what research has unearthed, this atypical circumstance is a learned behavior. Infants only know what they learn and parents can unknowingly initiate Sleep-Onset Association Disorder by providing a characteristically over-patterned sleeping atmosphere. What may seem like a loving gesture may, in effect, be setting up a pattern of sleep disaster.

We’ve all asked our child-rearing friends how their child sleeps. The response is habitually one of two answers: “My child is a good sleeper.” or “My child is a poor sleeper.” As a parent, you may wonder how is it that child ‘A’ sleeps better than child ‘B’? The answer is most likely environmental factors such as those aforementioned. Since there is no one reference to judge such arbitrary sleep behavior in children, most information comes from parents’ comments and concerns for their own children.

The threshold conditions of age, gender, race and natural development are not clearly defined. However, it is thought that over one-third of children (conventionally toddlers and preschoolers) awake enough to cause concern to parents, usually five to nine times per night. In spite of this, some infants sleep for the duration of the night as early as three or four months of age. When researchers have monitored perceived “normal” and “not normal” sleeping behavior in infants in a controlled cross-study, children between nine months and two years woke twice nightly on average. If you have deduced that you child may have Sleep-Onset Association Disorder, then there are treatment and management strategies.

Since parenting doesn’t come with a “How to” manual, we sometimes do not know the right course of action for conditions such as Sleep-Onset Association Disorder. The goal, then, is to restore sound sleep to our children. The best-case scenario is a child sleeping through the night with as little parental involvement as possible. One such management technique is checking on the child throughout the night. The parents, for instance, check in on the child during the first few weeks about six times without physically cradling the child. After this, the parents then check on the child only four times, and so forth. By week ten, the child has learned to self-soothe and is confident that their protectors (mom and dad) are close at hand. There are no exact methods, but following and adapting a similar routine within your family may relieve some troubling bedtime strain.

Here are some techniques thought to help infants and children with Sleep-Onset Association Disorder:

• Establish a bedtime routine to ensure the child knows it’s time to relax and prepare for sleep.
• Stick to a sleep schedule by going to bed at the same time seven days a week.
• Set limits to what you will allow and not allow during the bedtime routine. If you come in when the child begins to cry, s/he expects such behavior and will become frustrated when the routine is not adhered to.
• Put the infant or child to bed in the same bed every night.
• Do not allow the child to sleep in the parent’s bed.
• Periodically check on the child through the night.
• Develop a sleep-time voice, preliminary soothing the child before as part of the bedtime routine.
• Wake the child up each morning at the same time.
• Examine if your child should take naps or not, highly depending on age and maturity.
• Keep the bedroom dark, without lights creeping in under doors or through windows.
• Give your child plenty of love through the day, but let him or her self-soothe through the night.

See also Familial Advanced Sleep-Phase Syndrome

Sleep Disorders

Dyssomnias

Parsomnias

"It’s been a hard day’s night
I’ve been workin´ like a dog
It’s been a hard day’s night
And I’ll be sleepin´ like a log…. "

(John Lennon and Paul McCartney)