In some good news for parents who wage bedtime struggles with their children, a new study shows that various forms of "sleep training" can put kids' sleep difficulties to rest.
In a review of 52 previous studies, a panel gathered by the American Academy of Sleep Medicine found that a number of behavioural approaches can help children learn to fall asleep, and stay asleep, without a fuss.
These include methods like teaching children how to "self-soothe" themselves back to sleep when they wake at night, and creating quiet bedtime rituals that children enjoy.
Across the studies the panel reviewed, more than 80 percent of children who received sleep training showed significant improvements in their bedtime behaviour, according to findings published in the journal Sleep.
"We know that sleep training works," said the study's lead author, Dr. Jodi A. Mindell of St. Joseph's University in Philadelphia.
And parents should know there are plenty of resources out there to help them, she told Reuters Health.
With young children, "bedtime refusal" is often the issue; they may cry, cling to their parents or "stall" by repeatedly asking for food, a drink or a story. With babies, it's frequent night-time wakings that last past the first few months of life.
But the exact definition of a "problem" behaviour is personal, Mindell said. Parents have to decide if their children's bedtime habits are affecting daytime behaviour -- making them irritable or inattentive, for instance -- or affecting the rest of the family.
Then they can find a form of sleep training that suits them.
In their review, Mindell and her colleagues found that a technique called "extinction" had particularly strong evidence to back it up. In its most stringent form, extinction has parents putting their children to bed at a particular time each night, then ignoring their crying and tantrums until a set time in the morning.
A variant of this is the "controlled crying" technique popularised by Dr. Richard Ferber, where parents gradually let their child's crying go on for increasingly longer stretches before checking in on them. When they do check in, the visit should be uneventful -- no lights, no playing.
But an important finding from the review, Mindell said, was that preventive measures -- educating new parents on how to instil good bedtime -- were highly effective.
"You really can prevent these problems from happening," she said.
She suggested that expectant parents ask their doctor about ways to form healthy sleep habits early on. There are also many books and other resources on the subject.
A key first step, Mindell said, is that parents let go of the idea that they are "selfish" for wanting bedtime to go smoothly; their children may benefit even more than they do from a good night's sleep.