Meanwhile, the majority of studies rely on "parent report", such as questionnaire responses or sleep diaries kept by the parents, rather than using an objective measure to determine when a baby is awake or asleep. Many trials often have high drop-out rates, meaning parents who found sleep training especially difficult may not have their experiences reflected in the results. And, of course, the difficulty of studying something like sleep training is that even in a randomised trial, parents assigned a controlled crying method may decide against it – so a "perfect" study is impossible to set up. Alternately, it could be parents whose babies really struggle to fall asleep by themselves that are more drawn to the method, making it look less effective than it is. For example, parents who have reason to think their babies will only cry for a short while (or not at all), then fall asleep, may be more open to trying out controlled crying to begin with – which could skew results to make it seem more effective than it is. This makes it hard to prove cause and effect. However, research is never perfect, and many of those prior studies had attracted some criticism – which Hall was hoping to address.įor one, relatively few studies on sleep training have met the gold standard of scientific research: trials where participants are randomly allocated to receiving the intervention, that have a control group that did not receive the intervention (especially important with sleep research, since most babies naturally sleep in longer stretches over time), and that have enough participants to detect effects.Ī number of studies, for example, have been non-randomised, with parents deciding on the method of treatment themselves. Dozens of studies say they have found sleep interventions effective paediatricians routinely recommend sleep training in countries like the United States and Australia (although infant mental health professionals often do not). This would be in line with existing findings. In their study, Hall and her team predicted that the babies whose parents were given instructions for sleep training along with advice would sleep better after six weeks than those who were not, with "significantly longer longest sleep periods and significantly fewer night wakes". Around the world, an entire industry is devoted to helping parents sleep train. Half of parents who responded to questionnaires in Canada and Australia and one-third of parents surveyed in Switzerland and Germany said they've tried it (although the surveys are not necessarily representative of parents as a whole in these countries, due to the way they were conducted). In the US, more than six in 10 parenting advice books endorse some form of "cry-it-out". Parents can be especially willing to give it a shot when broken nights begin to affect the entire family's wellbeing – poor baby sleep is associated with maternal depression and poor maternal health, for example. But in North America, Australia and parts of Europe, many families swear by some form of the technique. Modern Mayan mothers, for example, expressed shock when they heard that in the US, babies were put to sleep in a separate room. In global terms, the idea of "training" babies to sleep alone and unaided is uncommon. (Read part one of this two-part series: the biggest myths of baby sleep). Any of these approaches often mean letting the baby cry – hence the common, if increasingly unpopular, moniker "cry-it-out". Or, in the cold-turkey approach, it may mean leaving the baby and shutting the door. It can involve set time intervals where a baby is left alone, punctuated by parent check-ins. This may mean a parent is present, but refrains from picking up or nursing the baby to physically soothe them. So was a strategy that has become commonly associated with "sleep training" and tends to be far more divisive: encouraging babies to put themselves to sleep without their parents' help, including when they wake up at night, by limiting or changing a parent's response to their child.
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