The Sleep Edit

Latest Episodes:

Episode 10: Mailbag Episode Oct 27, 2024

In this mailbag episode, Dr. Canapari and Arielle respond to listener questions covering infant sleep, early waking, transitioning from co-sleeping, travel disruptions, nighttime fears, sleep disorders, and more. From “first daylight savings” tips to strategies for toddlers with anxiety, each answer offers practical insights for a wide range of pediatric sleep challenges.

Chapters:

[00:01:09] Intro

[00:01:14] Infant Sleep Patterns and Challenges

• [00:01:33] Lauren: When do babies start dreaming?

• [00:03:00] Susan: Tips for differentiating between waking to feed and needing sleep in a 5-month-old?

• [00:06:26] Andrea: How to sleep train at night when daycare sleep is limited?

• [00:08:07] Chelsea: Avoiding early wakings for a sleep-trained 6.5-month-old.

• [00:10:25] Kaitlin: Daylight savings time tips for a 7-month-old.

• [00:14:37] Kayleigh: Breaking the cycle of middle-of-the-night babbling and crying in a 9-month-old.

• [00:18:07] Francia: How to sleep train an 8-month-old.

[00:19:30] Early Morning Waking and Sleep Regressions

• [00:19:30] Brittany: How to handle nighttime wakings to maintain sleep progress.

• [00:21:34] Chelsea: Troubleshooting early morning wakings for a sleep-trained 6.5-month-old.

• [00:22:02] Hunter: Strategies for a 6- and 4-year-old who wake very early.

• [00:23:00] Pauline: Addressing early waking for kids with ASD who take melatonin.

[00:28:00] Co-Sleeping and Sleep Transitions

• [00:28:00] Holly: Transitioning a 2-year-old from co-sleeping to independent sleeping.

• [00:31:57] Ashley: Transitioning from co-sleeping with a 3-year-old for better parent comfort.

• [00:34:34] Katy: Encouraging a 3-year-old to stay in her own bed at night.

• [00:35:00] Kimberly: Addressing frequent night wakings and crying in a 3-year-old.

• [00:40:00] Holly: How to get a 3-year-old to stop using a parent as part of their sleep routine.

[00:42:20] Travel and Disruptions in Routine

• [00:42:20] Abby: Helping a 10-month-old sleep better while traveling.

[00:44:10] Nighttime Anxiety and Sleep Fears

• [00:44:10] Andrea: Supporting a 4-year-old who is afraid to sleep alone.

• [00:45:39] Stephanie: Determining when it’s necessary to help a 2-year-old fall back asleep.

• [00:46:59] Lesley: Strategies for helping a 7-year-old grandchild stay asleep until morning.

• [00:48:39] Dr. Ula: Assisting a 19-month-old who needs comfort to sleep through the night.

[00:51:00] Sleep Disorders and Medical Concerns

• [00:51:00] Sarah: Can REM Sleep Behavior Disorder lead to complex sleep actions like opening doors?

• [00:52:53] Wenjing: Tips for transitioning a 7-month-old with reflux to crib sleep.

[00:55:00] Sleep Training Questions

• [00:55:00] Amelia, Juan, and Baby Tonio: Ending bedtime crying after sleep training.

Episode 9: Insomnia in Grown-Ups, with Dr. Shelby Harris Aug 28, 2024

In this episode of the Sleep Edit podcast, we welcome Dr. Shelby Harris, a leading expert in behavioral sleep medicine. Often, parents are struggling even after their kid's sleep problems are addressed. We talk about the common sleep challenges faced by parents focusing on the impact of stress, hormonal changes, and modern technology on sleep quality. Dr. Harris provides insights into the diagnosis and treatment of insomnia, emphasizing cognitive behavioral therapy for insomnia (CBTI) and its effectiveness over medication for long-term improvement. The conversation also explores the practicalities of sleep hygiene, sleep restriction, and the influence of consumer sleep tracking technologies.

Time stamps:

Episode 8: Things That Go Bump in the Night with Dr. Sujay Kansagra Jul 08, 2024

In this episode of the Sleep Edit, Craig and Arielle are thrilled to welcome Dr. Sujay Kansagra of Duke University to discuss the weird and wonderful world of parasomnias, restless leg syndrome, and restless sleep disorder in children. Parasomnias include NREM parasomnias (sleep walking, hypnic jerks, night terrors) and REM parasomnias (sleep paralysis and nightmares).

00:00 Introduction and Disclaimer
01:09 Parenting Anecdotes and Guest Introduction
02:22 Journey into Medical Social Media
05:21 The Importance of Engaging Content
10:50 Understanding Parasomnias
15:25 Non-REM vs REM Parasomnias
24:26 Night Terrors and Sleepwalking
28:17 Fever Dreams and Sleep Disruptions
28:58 Genetic Predispositions and Sleep Studies
29:21 Scheduled Awakenings and Melatonin
30:23 Nightmares vs. Night Terrors
31:39 Sleepwalking Safety Tips
37:43 Understanding Restless Leg Syndrome
48:58 Restless Sleep Disorder
53:38 Final Thoughts and Parenting Advice

Dr. Sujay Kansagra at Duke Health
Sujay’s Instagram profile
Sujay's time zone video
“I am the research”
His excellent sleep book
The rest of his links
Night terrors, sleep walking, and sleep talking in children by Dr. Canapari
Restless leg syndrome in children by Dr. Canapari

Episode 7: Newborn Sleep Insights May 06, 2024

Today, Craig and Arielle unpack the often mystifying world of newborn sleep—those crucial first three months. The inspiration for this episode was Craig's new niece, who was 2 weeks old at the time of recording. Whether you're navigating the unpredictable waters of infant sleep or just curious about what's normal, this episode promises to arm you with the insights you need to feel a bit more in control—or at least to understand that sometimes, chaos is just part of the parenting package.

[00:00:00] Introduction and disclaimer
[00:01:09] Welcoming listeners back and introducing the episode's focus on newborn sleep
[00:02:12] Discussion on the erratic nature of newborn sleep
[00:03:22] Personal story about sleep expectations with a newborn
[00:08:21] Explanation of active sleep in newborns and advice for parents
[00:10:41] Impact of external factors like maternity and paternity leave on sleep
[00:14:26] Transition to detailed discussion on sleep cues and signs of tiredness in newborns
[00:21:08] Exploring the science of sleep cycles and the development of circadian rhythms
[00:26:35] Discussion on the "witching hour" and strategies to cope with it
[00:32:23] Month-by-month sleep development and expectations
[00:37:38] Review of sleep tools and technologies affecting newborn sleep
[00:42:35] Closing remarks and where to find more resources

Notable Quotes:

Craig Canapari MD: "Things will get better with time, even if you're really struggling. It's funny, my older son was one of those babies that we took him home from the hospital. My wife had a c-section the first night. And he slept six hours overnight."
Arielle Greenleaf: "I think one of the biggest things I wish I had known back in the day was I didn't know really about active sleep. And so I think when she was coming, she's going through that, what did you call it?"
Arielle Greenleaf: "I always tell newborn parents, don't rush. They will tell you if they need you. They will, they have lungs and they can scream."
Craig Canapari MD: "A newborn, that could be anywhere from 13 to 14 hours per or 20 hours within a 24 hour period. So if you have a baby who's natural sleep needs at that point is 20 hours a day, you are gonna feel like a parenting genius."

Links and Resources:

Connect with Us! Send us an email about questions, feedback, or ideas for future topics.

Ask us anything #1 (Ep 6) Apr 02, 2024

In our first mailbag episode, Arielle and I take a deep dive into your most pressing sleep-related questions, from the perfect setup for your toddler's room to managing sleep challenges in children with autism. We took YOUR questions from email and Instagram.

Timestamps:

[00:02:00] "What should the light setup be in a toddler's room?"
[00:03:23] "Can you immediately stop using a pacifier when sleep training?"
[00:05:39] "How to introduce room sharing?"
[00:08:31] "Tips for jet lag when flying overseas with kids?"
[00:11:30] "How much movement during sleep is typical in an elementary schooler?"
[00:15:05] "Is it okay to use melatonin for sleep issues in kids?"
[00:22:44] "How to manage bedtime for children with autism?"
[00:28:47] "Dealing with night nursing and weaning issues."
[00:36:00] "How do we break the cycle of bottle feeding and rocking to sleep for a 2-year-old?"
[00:39:00] "Will removing a nighttime sleep crutch result in split nights?"
[00:51:27] "Should weekend naps match daycare schedule for a 6-month-old?"
[00:53:10] "Recommendations for a 3-year-old inconsistent in taking naps."
[00:55:00] "How to handle a baby's strong preference for one parent at bedtime."
[00:57:16] "Helping a 6-year-old with congenital heart disease to sleep better."

Notable Quotes from the Episode:

"It should be dark enough in your kid's room that you can't read a book by the light." - Dr. Craig Canapari
"The sooner you can eliminate the pacifier, the better." - Arielle Greenleaf
"Kids adjust more quickly to new time zones than adults do." - Dr. Craig Canapari
"Melatonin is not a magic bullet. It's part of a broader strategy." - Dr. Craig Canapari
"Natural light is very helpful for adjusting to new time zones." - Arielle Greenleaf
"Being a little bit careful with screens before bedtime can help with jet lag." - Dr. Craig Canapari
"Restless leg syndrome in kids is typically associated with both sensory and sleep issues." - Dr. Craig Canapari
"Swap your child's fear of not having the pacifier with germophobia and you're all set." - Dr. Craig Canapari, humorously suggesting a strategy for weaning off pacifiers.

Got sleep questions? Drop us a line for a future episode

Tackling Anxiety and Sleep Issues in Children: A Psychologist’s Perspective Mar 18, 2024

In this episode, Dr. Canapari and Arielle welcome their first guest, pediatric psychologist Dr. Danielle Garay from the Yale Pediatric Sleep Program to discuss the role of psychology in treating children's sleep difficulties, focusing on anxiety, nighttime fears, tantrums, and separation anxiety.

Important Sections:

[00:03:09] The role of a psychologist in the care of children with sleep difficulties
[00:07:47] Discussion on temperament and its relevance to sleep difficulties
[00:10:12] Advice for dealing with nighttime fears in children
[00:17:56] Managing nighttime tantrums in toddlers and preschoolers
[00:39:49] Explanation of separation anxiety and its manifestation at night
[00:44:58] Understanding accommodations and their role in managing anxiety
[00:52:55] Using reward structures and incentives for behavior change in children

Highlighted Quotes:

"It is such a powerful intervention to be able to help people with their sleep." - Dr. Danielle Garay

"Tantrum has such a negative connotation, and it's not like a child is choosing to have a tantrum, and I feel like sometimes parents see it as the child choosing to have that tantrum and cause chaos at bedtime. And it's really just not the case." - Arielle Greenleaf

"True boundaries should require the other person to do nothing. It's you setting the boundary for yourself." - Dr. Danielle Garay

"Small changes in parental behavior can lead to significant improvements in a child's sleep." – Dr. Craig Canapari

Show notes

Questions or feedback? Email us here. We are collecting questions for future Q&A shows!

To CIO and Beyond! Making good decisions about extinction sleep training Feb 07, 2024

In this episode, we talk about the controversial method of 'Cry It Out' (CIO) or Extinction Sleep Training. This approach, often misunderstood and feared, can be a quick and efficient method to improve a child's sleep. We go deep on the criteria for its successful implementation, discussing age-appropriateness, parental consistency, and prioritizing safety and health. We also cover that the method is not suitable for all children or families, and alternative methods like bedtime fading and pick up/put down are also considered. Finally, we cover importance of sleep training for both children and parents to improve the overall family dynamic. (Full transcript and a video are available here).

Here are the three key take-aways from the episode:

Be open to trying different sleep training methods - What works well for one child's temperament may not work for another. Give a new method 3-5 nights before deciding if it's effective.

"Gentle" is not always better - Sitting in the room while ignoring crying (camping out) can actually prolong upset in some young babies. More separation may help them learn to self-soothe faster.

Cry it out is generally safe when done responsively - Research shows no long term emotional harm. But if excessive crying persists beyond expectations, reevaluate and adjust. Be responsive to your baby's needs.

00:00 Introduction to the Sleep Edit
00:03 Discussing Cry It Out (CIO) Method
00:09 Introducing Arielle Greenleaf
01:08 The Controversy Around Sleep Training
02:56 Understanding Different Sleep Training Techniques
03:43 The Importance of Sleep for Children and Parents
04:02 Defining Sleep Training Terms
09:21 The Impact of Parenting Styles on Sleep Training
09:27 The Role of Attachment Theory in Sleep Training
17:03 The Effectiveness of Extinction Sleep Training
24:46 Sleep Training in the Era of Room Sharing
28:14 The Power of Parental Presence
29:12 Understanding the Importance of Age-Appropriate Schedules
29:56 The Role of Routine in Sleep Training
30:58 The Challenges of Nap Time
31:40 Who is Extinction Sleep Training For?
33:35 The Importance of Consistency in Sleep Training
36:54 The First Year of Life: Sleep Expectations and Realities
39:22 The Pitfalls of Sleep Training Methods
42:59 The Role of Feeding in Sleep Training
45:56 Alternatives to Extinction Sleep Training

Links:

Questions or feedback? Email us here. We are collecting questions for future Q&A shows!

Assistant producer: Theodore Canapari

Ep 2: Sleeping through the night (part 2) Feb 06, 2024

In part two of our discussion on helping kids sleep through the night, pediatric sleep expert Dr. Craig Canapari and sleep consultant Arielle Greenleaf tackle night wakings and feedings. (You can find part 1 here, including a video of both episodes). They provide guidance on when night feeds may or may not be necessary, how to handle night nursing for comfort vs nutrition, and tips for transitioning toddlers away from nighttime calories.

Key Takeaways:

- Only a small percentage of sleep issues are caused by medical problems. Most kids need some type of sleep training or behavioral intervention.

- Check with your pediatrician before dropping night feeds - make sure your child is getting enough calories during the day first.

- Night nursing is about more than nutrition - it also provides comfort. Wean slowly if desired.

- Toddlers generally don't need extra calories at night. But there is little guidance given on transitioning from milk feeds to solids at this age.

Notable Quotes:

"I always like to say I am not, if a sleep consultant starts working with someone and says, without any digging, we're going to eliminate all feedings overnight really fast, we're just gonna take 'em all away, run for your life." - Arielle Greenleaf

"Honestly, a normally growing child over a year of age doesn't really need those calories at night. And if you find that you are meaning to give milk or anything else during the night you, I give you permission to cut it out and you may want to wean it slowly." - Dr. Craig Canapari

Subscribe & Follow:

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00:02 Introduction and Disclaimer
01:18 Understanding Sleep Disorders in Children
02:03 Medical Problems and Behavioral Interventions
05:14 The Role of Bedtime and Nighttime Awakening
05:18 Feeding and Sleep Patterns
13:44 Adjustment Issues and Sleep Disruptions
18:02 Addressing Nighttime Fears
20:24 Imagining Bedtime Stories
20:41 Addressing Children's Fears
21:13 The Huggy Puppy Intervention
21:55 Dealing with Trauma and Sleep Difficulties
23:18 Environmental Causes of Nighttime Awakening
24:44 The Impact of Light and Shadows
25:14 The Creepy Doll Story
25:53 Technology and Sleep
26:40 Sensory Disorders and Sleep
27:54 Too Much Time in Bed Syndrome
36:14 The Importance of Independent Sleep
38:28 Closing Thoughts and Contact Information

Questions or feedback? Email us here. We are collecting questions for future Q&A shows!

Links:

Ep 1: Sleeping Through The Night (part 1) Jan 24, 2024

Night time awakenings are THE most common reason that parents bring their child to a sleep physician or consultant. Dr. Craig Canapari and expert sleep consultant Arielle Greenleaf join forces to give advice on the most common reasons that kids wake up at night. The first step to getting your child to sleep through the night is understanding why they are waking up. They address the concept of sleep regressions, the impact of medical conditions such as asthma, acid reflux, and ear infections on sleep, and the importance of consulting a professional when these issues arise. Greenleaf discusses her own journey from a sleep-deprived mother to a pediatric sleep consultant, highlighting the valuable role of sleep consultants in helping families achieve better sleep. Canapari reminds listeners that the goal isn’t about achieving “perfect” sleep but about achieving sleep that enables everyone in the family to feel good and function well in the morning. (Note that this is such a big topic we split it in two-- here is part 2).