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ALEX COHEN, host:

This is DAY TO DAY from NPR News. I'm Alex Cohen.

MADELEINE BRAND, host:

I'm Madeleine Brand.

One of the first questions new parents get asked: How's the baby sleeping? Well, that really means how well are you sleeping. As every parent knows, when a child can't sleep, everyone suffers. In fact, parents can develop real health problems. A new study shows that mothers are especially at risk when their children cannot sleep.

Dr. Sydney Spiesel is here with the results of that study. He's a practicing pediatrician and also our resident medical expert. Hi, Syd.

Dr. SYDNEY SPIESEL (Pediatrician, Yale Medical School): Hi, Madeleine. Nice to be here.

BRAND: Well, this was a huge study, some 10,000 children, and what did the study find in terms of how many kids suffer from sleep problems?

Dr. SPIESEL: Well, if we exclude the kids with mild sleep problems, which the researchers did, they found that about 15 percent of both infants and 15 of percent of preschoolers have what somebody called a sleep problem, significant sleep problem.

COHEN: How would you define a sleep problem?

Dr. SPIESEL: A sleep problem is a kid who is having trouble going to sleep or who comes and annoys the parents, trouble falling asleep, who wakes up in the middle of the night, some problem in sleep that's going to wind up intruding on the parent's life.

COHEN: So what does this mean for the parents? What kind of health effects is this having?

Dr. SPIESEL: What the study showed is that if you talk - if we limit ourselves just to infants, both mothers and fathers who have children with sleep problems experience are substantially more likely to have poor general health. Mothers, interestingly, but not fathers, seem to have a special risk of having significant mental health problems.

If you look at mothers who were not depressed before the babies were born, they are at much greater risk for developing significant serious mental health problems if their babies have sleep problems. If they were already depressed before the babies were born, it's hard to separate out. Those conditions seem to have continued, but you can't tell whether there's an association with the sleep problem or not.

COHEN: So basically, because the parents aren't getting enough sleep, they're just not as healthy?

Dr. SPIESEL: That seems to be the case or at least there is an association there. What follows from what isn't clear.

COHEN: So we're not talking about a reverse cause and effect, in other words, parents with poor health cause the sleep problems in children?

Dr. SPIESEL: All we can say from the Australian study is there is an association. I immediately interpreted that association as falling in the direction of the poor sleep leading to poor health. But I think that, you know, the other possibility has to be considered.

COHEN: Well, so what do you recommend for parents whose infants keep waking them up, or small children?

Dr. SPIESEL: One reason that kids wake up at night because everybody likes company in the middle of the night. You know, warm and cuddly company. When they wake up, they're rewarded by getting that. And so my main prescription is to decrease the reward, to always let the kid fuss for about five minutes before you get the child. Although I'm not a proponent of letting the kid go for a long time.

I think they wind up getting too anxious and you never chill them out after that. But then when you finally go get them, not being excessively nice. You know if it's a cold night, pick them up so that - collect some icicles on their tush. Don't hug them and mold them to your body and tell them that they're the finest baby in the entire known universe.

And actually, if they're in the habit of being bottle-fed or nursed in the middle of the night, I would instead substitute just a bottle of plain water, at the very least it's going to develop a fine pitching arm in the kids' hands.

COHEN: Yeah, I know that.

(Soundbite of laughter)

COHEN: I know that from experience. Well, this is for kids; we have to make clear this is for kids older than four months.

Dr. SPIESEL: Yeah. I usually use about four months as the dividing line here. I think younger kids can't be expected to sleep through the night and I don't think we ought to do this to very young kids.

COHEN: Opinion from Dr. Sydney Spiesel. He's a pediatrician and he also is a professor at the Yale Medical School. You can read his "Medical Examiner" column at Slate.com. Thanks, Syd.

Dr. SPIESEL: Thank you.

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