Q&A: going insane from lack of sleep

Stacy writes:

"Please help.  I am going crazy from lack of sleep. 

The baby is 7.5 months old.  He's never been a good sleeper.  Every once in a while, he'll sleep in nice 4 hour chunks.  My heart soars with joy!  I could do that until he's 18, if I had to.  But much more often, he's up every hour.  Which is why I feel like I'm going to die.

He's a big boy, strong and healthy.  He breastfeeds plenty during the day, and gets some solids, too.  I don't think he's hungry all night long.  I don't even think he NEEDS the breast to fall asleep; he's fallen asleep in the Ergo, in the car, in the stroller, in his grandfather's arms, on a futon with his aunt, and even on the floor while playing.  But he likes to nurse to sleep, and if he knows I'm in the house and it's bedtime, he demands it.  For a long time, I handled this by co-sleeping.  It was okay, but I didn't sleep as much as I hoped, because I was always worried about rolling over him.  And, now that he's mobile, co-sleeping has become absolutely impossible.  He's kicking and squirming all night.  We've recently transitioned him to the crib, and he's actually okay with that.  He's been napping in his room for a long time, so he knows the drill.  But being away from us doesn't seem to be decreasing his night wakings at all.  The only difference is, now I have to walk down the hall to feed him.

We've tried early bedtimes and late bedtimes.  We've tried scheduled naps and random naps.  We do have a good, consistent bedtime routine.  Nothing ever seems to change.  Yes, there are probably teething issues/growth spurts and such going on, but since he's been doing this hourly wakeup thing for most of his life, I don't want to say it's just that, either.

I think it's time to do some sort of "sleep training," but I'm stuck as to what.  I like your idea of letting Daddy take a night shift or three, and my husband is game.  However, the kid is a drama queen. He goes from zero to screaming-gasping-choking--hysterical in two seconds flat.  And I can't shake that stupid first-time Mom feeling that I'm doing something *wrong* if he cries that hard, even if I know my husband is there taking care of him.  I feel like it goes against my instincts - but my stupid instincts haven't gotten me any sleep for almost 8 months, so I'm starting to doubt those, too.

Plus, and here's the real sticking point, I feel like I just don't know how much my son needs to cry.  He almost always breaks down before bed, usually when we are putting his pajamas on.  There's nothing physically wrong, no need unmet...he just knows bed is coming and he has to let off steam before he can sleep.  So part of me thinks, maybe I should just let him go for 10 minutes and see what happens. But another part of me - the part that has to drive down the road while he's sobbing in the car seat and just will. not. stop. crying and is getting louder and louder and louder as the minutes pass - that part of me thinks the only thing those 10 minutes will do is make him upset and less likely to ever sleep.

I feel like I don't even know my own son.  Everyone tells me to trust my instincts, but my instincts tell me a hundred contrary things.  Meanwhile, I'm getting less coherent as the days pass.  I have bags under my eyes.  So does my son.  An infant with bags under his eyes!  I'm nauseated and so, so tired.  All the time.  I just don't know what to do."

This is a big bucket of hurt for you.

First of all, if he really has dark circles under his eyes, it could be a sign of environmental allergies, which could explain some of the constant waking. If it's dark circles, get a referral to a pediatric allergist, who can tell you for sure if it is or isn't.

Now, it seems like you've got a bunch of different issues and you're going to have to tease them apart.

Before we start with the specific issues, though, does crying help your son shut down to be able to sleep? Knowing this is going to help you figure out what to do even once you solve the immediate problems, so it's a good thing to spend time figuring out. I think you're going to just have to bite the bullet and see what happens. You know crying doesn't help him fall asleep in the car seat, but the crying during pajama time might mean that he's crying as a way of kind of creating some white noise in his brain and letting himself disconnect from everything to shut down at night. Or it might not. The only way to know is to find out what happens if you let him cry for 5 or 10 minutes. After around 5 minutes you should be able to tell if he's increasing in upsetness or starting to lose steam, and another 5 minutes will really tell you whether he's escalating or not.

If he increases tension by crying, letting him cry for 10 minutes means you're going to have to spend even more time soothing him down to sleep (I've been there), so you probably want to do the "What Kind of Cryer?" Project on a Friday night so no one has to be up early for work the next morning.

Here's my hunch: I think that some kids melt down at bedtime because their bedtimes are a little too late, so they're already super-tired. If you've already messed around with that and it doesn't seem to be the case, then my suspicion is that he's melting down for the other reason I suspect causes bedtime crying--because he's starting the process of shutting himself down for the night by crying. If that's it, then he may be a person who needs to cry/fuss to shut himself down and tap off the tension before sleep.

Now, you're looking at the night nursing as one big problem, when in reality it's at least two different problems. I'd attack one at a time and let it stabilize before you move on to the next one. As I see it, Problem 1* is how he falls asleep "for the night" at bedtime, and another problem entirely (Problem 2) is how he wakes up and then won't go down without being nursed down again in the middle of the night. Another problem (which could be part of Problem 2, so Problem 2A, or could actually be Problem 3) is how frequently he's waking at night.

Now, which problem you attack first is up to you and what's bothering you the most. If it were me, I'd work on Problem 2A/3 first, because the frequency of waking would bug me waaaay worse than having to nurse back to sleep would. But I know people who find it much easier to deal with frequent wakings as long as they don't have to nurse the kid back down. Figure out what's making you most stressed and go for that first.

Unfortunately, Problem 1 is probably the easiest one to attack. If he must nurse down to sleep as long as your home, just don't be home for bedtime for a week or two. (Obviously your husband is going to have to agree to participate in this plan.) Head out--to book club, to a bar, to a movie, to the gym, or just for a walk--at bedtime and be gone for a reasonable amount of time or until your husband texts you the all-clear. How your husband gets your son to sleep is up to them--you're out of the loop.

Don't think that two nights of easy bedtimes for your husband means you're off the hook. It'll really take a week at least until you're off the hook while you're there.

On to Problem 2. If you have a partner who has volunteered willingly to take a night shift, you must take advantage of it. I know you feel like you can't stand to hear the baby cry (or your husband cry because the baby's crying, for that matter), but while your husband's on duty, he's on duty and you're not. You are not.

Now, two things about that. 1) Good luck hearing the baby cry and not jerking awake with that drop in the pit of your stomach. But you can train yourself to go back to sleep when your husband's on the case. It might also help if you take a calcium-magnesium supplement right before you go to bed, since that can sometimes take the edge off that kind of jittery worried half-sleep that doesn't even have the dignity to qualify as insomnia that lots of us suffer from periodically. 2) Don't berate yourself and give yourself any of this "nervous new mother" belittling just because it's hard to detach from nighttime duty. Think of how many babies lives have been saved throughout the millennia because of "nervous new mother" instincts. You're doing an amazing job. But all this waking up is essentially torture, and it's breaking down your system physically. Of course your judgment isn't what you'd like it to be.

So, bearing both those things in mind, if you have enough space that you can sleep in a completely different part of the house where you won't hear anything, do it. If you can't, make a policy decision before you go to sleep about how long you'll wait before you intervene, and then stick to it so you don't get frazzled in the heat of the moment.

(Think of what a gift you're giving your husband by letting him solve the problem on his own. Instead of owning your son's sleep all by yourself, you're letting him step in and be an equal parent. That's going to pay off for the rest of your lives.)

My guess is that once your husband has been the one going in to get your son for a few nights (OK, it'll probably take more than just a few nights), your son might stop waking up so much in the first place. Some of these frequent-wakers just seem to have gotten into a loop of waking up, and once something changes (like they're forced to deal with dad instead of mom and her amazing milk jugs) they just stop waking up as often. But don't count on it, because it might not happen that way, or it could and you'd have a few good weeks until he hits the 8-9 month sleep regression and he's waking up all night again for another few weeks.

I think the takeaway from this should not be "There's a Foolproof Way To Fix His Sleep" but instead coming up with a few ways to ease things up so you can get out from under some of the nursing and get one good stretch a night, then you'll be able to regain some health and get your confidence back to figure out how to weather the next sleep regression and make the longer stretches a permanent thing.

Sympathy for Stacy? I can still remember that nausea from sleep deprivation.

* Names of problems have been changed to protect the innocent problems.