Sleep Deprivation and New Parents

New parents are easy to spot: The bloodshot eyes and dazed expressions are an instant tip-off. Although the birth of a child is a joyous event, many parents are taken aback by how exhausted they feel during those first weeks and months. Newborns usually require constant attention -- they need to eat every hour or two and have their diapers changed just about as often.

As a new parent, you may feel compelled to dedicate every available hour tending to your baby's needs. But don't forget that parents have needs, too -- especially when it comes to sleep.

Building up a sleep debt

According to the National Sleep Foundation, the average adult needs seven to nine hours of sleep every night. When you sleep only a couple of hours a night on an ongoing basis, you build up a "sleep debt" that can be hard to pay back. If your sleep debt persists over time, your health can suffer.

Fortunately, however, parents' sleep deprivation eases once their child begins sleeping through the night (six to eight hours). For about 90 percent of babies, this begins at around 3 months old, according to the Nemours Foundation.

How newborn sleep patterns affect parents

Newborns tend to sleep in fits and starts for 16 to 20 hours over a 24-hour period, so it's virtually impossible for a parent to get more than a couple hours of rest at a time. According to Dr. William C. Dement, a physician and sleep specialist, parents of newborns often lose about two hours of sleep per night until the baby is 5 months old. From then until their child hits 2 years old, parents usually lose an hour of sleep each night.

Nursing mothers often bear the brunt of sleep loss. Many newborns breastfeed as often as every hour or two, leaving their moms struggling to stay alert during the day. One sleep-deprived nursing mom, 26-year-old Christi S., describes her experience as "just sleepwalking, trying to make it from one feeding to the next."

Although nursing might mean weeks or months of interrupted sleep, the emotional rewards can make it worthwhile. Christie S. says that after her daughter began sleeping through the night, she found herself missing those bleary-eyed late-night feedings, because she had treasured their quiet time together.

Bottlefeeding parents must also learn to cope with frequent sleep interruptions. You have to rouse yourself and go to the kitchen to get supplies, so it may be even worse at first. However, one benefit of bottlefeeding is that someone other than the mother can help with feedings and share the burden of sleep loss.

Even if your baby is primarily breastfed, you might decide to use bottles filled with formula or expressed breast milk at night in order to get a few hours of rest. Mandy Y., a 28-year-old mother of one, says that when her fatigue became too much for her, she overcame her apprehension about using formula and asked her husband to help with nighttime feedings.

What do I do when the house is a mess, the baby's screaming, and I'm exhausted?

It's a fact: Life will be a bit chaotic for the first few months. But new parenthood is not the time to try to live up to the unrealistic ideal of the "perfect parent." Some new moms feel intense pressure to meet their baby's every need, maintain a spotless house, and cook three meals a day -- all while dealing with postpartum physical discomfort and hormone-related mood changes. Letting go of these impossible ideals and asking for help can let new parents relax, rest, and focus on those precious early moments with their baby.

Says Mandy Y., "While I had originally wanted to do all the child-rearing duties on my own, I couldn't. I had to be humble and give up my unrealistic expectations of what motherhood was really about. ... This is not a race, there is no prize for the person who gets up the most at night, and who breastfeeds the longest... This is about tending to your child and keeping your sanity."

Can I train my newborn to sleep on a schedule?

It's not a good idea. In his book The Promise of Sleep, Dement explains that newborns' biological clocks are immature and need time to develop, so it's not a good idea to force them into a regular pattern of sleeping and wakefulness. However, he also believes that the same sleep cues that work for adults should work for infants as they mature. Cues like letting light in the baby's room in the morning, dimming lights in the evening, and maintaining a regular feeding and activity schedule should help coordinate the baby's biological clock with the 24-hour day as she grows older.

The benefits of napping

A parent loses about 350 hours of sleep at night over her baby's first year. Napping is a great way to reduce your sleep debt. If you've gone awhile without getting good-quality rest, the sleep you do get -- even during a nap -- will become more effective. You'll fall asleep more quickly and sleep more soundly, so you'll actually get more sleep and refreshment for the shorter amount of time spent in bed.

Of course, when you're sleep-deprived, the longer the nap, the better. Dement and his team of researchers found that a 45-minute nap improved alertness for six hours after the nap. Another team of researchers found that a "prophylactic" -- or preventative -- nap of one to two hours helped people function better. Even 20 minutes can make a big difference for many people.

How to get more rest

• As tempting as it is, don't try to catch up on chores while the baby is sleeping. Instead, turn off your phone and lie down in a quiet, darkened room.
• Create a relaxing environment by using a mattress with plenty of support and setting a comfortable room temperature.
• Ask your partner, a family member, or a friend to watch the baby while you nap. Your helper might also pitch in with housecleaning, cooking, laundry, or babysitting older children.
• While trying to nap, resist the urge to peek at the clock. Some sleep experts say that focusing on how much time you have left to sleep, or how many times you woke up last night and for how long can cause anxiety and lead to insomnia.
• Avoid caffeine, alcohol, and nicotine. Nicotine and caffeine are stimulants, and while alcohol may help you fall asleep, it actually increases wakefulness during the night.
• Avoid exercising within three hours of bedtime. The physiological stimulation disturbs the sleep process. (Although, if that's the only time you have to exercise, you have to decide if it's worth the trade-off.)
• If you're nursing, learn how to feed your baby while lying down on your side. Many mothers find this to be a very restful position, especially at night.
• If you use formula, have bottles of room-temperature water and powdered formula next to your baby's crib or at your bedside. In fact, prefilling several bottles with powdered formula might save you some time. Avoiding nighttime trips to the kitchen can help save your energy.
• Consider putting the baby's crib or bassinet next to your bed -- this will save a lot of nighttime trips to the nursery.
• Working parents might consider cat naps at lunch time. Bethany Scheck, mother of an 18-month-old daughter, found that napping in her car during lunch and eating at her desk afterwards was a good way to catch up on sleep.
• Limit the number of visitors you have during those first few weeks or months. Having to entertain a steady flow of guests can take time away from your naps and from bonding with baby.
• If you have a spouse or partner, remember that you're in this together. Try sleeping in shifts, and have your partner take over some of the nighttime feedings. If you're nursing exclusively, your partner can help by bringing the baby for breastfeedings, changing her diaper, and rocking her to sleep afterwards.
• If you can afford it, hire a weekly housecleaning service for a month or two (or more!). It can allow you to avoid strenuous chores while you recuperate and adjust to having a new child.
• If you haven't yet given birth, lower your sleep debt now by getting extra sleep in advance, so that after your baby arrives, the sleep deprivation won't feel as overwhelming. Sleeping more now can mean the difference later between feeling merely sluggish and feeling truly awful.

Consider co-sleeping

Some parents advocate "co-sleeping," a practice in which parents and baby share a bed. Researchers have found that co-sleeping (or the same room) can promote bonding and regulate both mothers and baby's sleep patterns.

Some controversy surrounding the practice of co-sleeping, however. A U.S. Consumer Product Safety Commission study found that over an eight-year period, 515 infants were accidentally smothered in adult beds -- a figure that proponents of co-sleeping point out is comparable to annual deaths from crib injuries. Most of the deaths occurred in infants three months old or younger, and many occurred when the babies were placed face down on waterbeds or accidentally trapped in spaces between the frame or in gaps between the headboard, footboard, and/or the wall.

If you do want to co-sleep with your baby, you need to take certain precautions. Experts recommend avoiding co-sleeping if your baby is premature or very small, if either parent smokes, or if there will be other children or pets sleeping in the bed.

Many doctors also recommend waiting until your baby is over three months of age (you can put a cradle or cot next to your bed until he's older). Avoid smoking, alcohol, or medications that cause drowsiness and confusion. Don't use a waterbed or a very soft mattress, make sure that there's no space between the headboard, footboard and mattress (or the wall and mattress), and check to see that the baby sleeps on his back with no loose pillows, loose-fitting bed linens, stuffed animals or soft bedding that could suffocate.

Dangerous consequences of sleep deprivation

When sleep deprivation is not addressed, the consequences can sometimes be devastating. The National Commission on Sleep Disorders Research found that infant abuse may be more likely for sleep-deprived parents, who may feel they are at their wits' end and shake or hit a crying infant. Also, co-sleeping parents who are exhausted may be less aware of the baby sleeping next to them. Sleep deprivation tragedies can occur outside the home as well. The National Sleep Foundation states that more than 1,500 people die every year due to fatigue-related vehicle crashes.

And there's yet another reason to get as much rest as you can: Sleep deprivation can be a contributing factor in postpartum depression. If your fatigue is overwhelming and you experience the "baby blues" for longer than two weeks after delivery, be sure to see your physician.

What if I can't fall asleep?

Weary parents who are unable to fall asleep may have insomnia. Try visualizing a relaxing image, such as sitting on a secluded beach while listening to crashing ocean waves. If you don't fall asleep within 15 to 20 minutes, get out of bed, go to another room, and do something soothing, such as listening to music or reading. Go back to bed when you feel sleepy, and resist the urge to watch the clock.

New parents have the best of intentions when they push themselves to the limit while taking care of their baby during those first hectic months. But doing so without getting enough rest or receiving outside help can be a recipe for disaster. Do the best thing for your family by remembering one of the fundamentals of good parenting: Take good care of yourself so that you can take good care of your baby.

References

Interview with new parents Christi Ssr, Bethany S, and Mandy Y.

National Sleep Foundation. Myths and Facts About Sleep. http://www.sleepfoundation.org/NSAW/pk_myths.cfm

Nemours Foundation. A Guide for First-Time Parents: Sleeping Basics. http://www.kidshealth.org/parent/pregnancy_newborn/pregnancy/guide_parents_p4.html

La Leche League. Frequently Asked

National Sleep Foundation. Helping Yourself to a Good Night's Sleep. http://www.sleepfoundation.org/publications/goodnights.cfm

La Leche League. Dealing With Sleep Deprivation. http://www.lalecheleague.org/NB/NBSepOct00p174.html

Arnestad, M., et al. Changes in the epidemiological pattern of sudden infant death syndrome in southeast Norway: implications for future prevention and research. Archives of Disease in Childhood;85:108-115.

La Leche League. Frequently Asked Questions: Should I Sleep With My Baby? http://www.lalecheleague.org/FAQ/cosleep.html

Nemours Foundation. Birth of a Second Child: Tips to Help You Cope. http://www.kidshealth.org/parent/pregnancy_newborn/pregnancy/second_child_p4.html

AskDrSears.com. Sleeping Safely With Your Baby. http://www.askdrsears.com/html/10/t102200.asp

National Sleep Foundation. Let Sleep Work For You. http://www.sleepfoundation.org/publications/letsleepwork.cfm

Merck Manual of Medical Information, Second Home Edition Online. Depression. http://www.merck.com/mmhe/sec22/ch262/ch262g.html

American Academy of Family Physicians. Baby Basics: Diapering Your Baby. http://www.kidshealth.org/

The Mayo Clinic. Infant feeding and nutrition: Your newborn's needs. http://www.mayoclinic.com/

March of Dimes. Sleeping With Your Baby (Co-Sleeping). http://www.marchofdimes.com/pnhec/298_29656.asp

The Promise of Sleep. William C. Dement, MD, PhD. Dell Publishing.