What controls the circadian rhythm in babies and when is it developed?

At 6 week old baby has no idea about day or night, and has no 24 hour rhythm. By 60 days, to 3 months (12 weeks) this rhythm is developed or developing.  Hormones are beginning to shape your baby’s day and night. This internal biological clock is controlled by a part of the brain called the hypothalamus – in a small section known as the SCN. The SCN receives information from the eyes, from temperature, social cues and food availability.

Natural dawn light is white/blue light which encourages us to wake up by cueing the release of Cortisol, the wake up hormone. As the day passes to night natural light becomes orange/red light, encouraging the brain’s release of Melatonin, the hormone of sleep. Using electric white/blue light when attending to your child at night, is stimulating the release of “wake up” hormone. Using a low level red/orange light is going to naturally be less disturbing,

If food is always available from 7pm to 7am, you are training your baby to regularly be awake at night expecting food.  Again, this disrupts the body clock. Few children, from 9 months old, physically require feeding at night. These late night milk feeds have other physiological effects on babies. When babies consume milk, their bodies produce insulin in response to this. Insulin secretion has actually been shown to block the production of melatonin the sleep hormone.

These lowered levels of melatonin are what then create a fitful night’s sleep for your baby, who then struggles to get into a nice deep sleep cycle without enough of this hormone. This is why, if you resisted that feed after midnight, your baby would eventually settle until morning – even if you heard them wake and re-settle a few times.

Night time feeding also delays the production of another hormone called ghrelin, this hormone helps control appetite. Studies show as the number of hours of sleep increase, ghrelin concentrations decreases, thereby reducing appetite. This reduced appetite allows your baby to sleep for longer period without waking hungry.

So not only are there hormones disrupting his sleep, an excessive fluid intake can cause him/her to wake up wet and uncomfortable, and the milk in the digestive tract is sending information to tiny little biological clock controls, to tell baby to wake up, as food available = day time!

Each time your baby sees your beautiful face at night contributes to disruption by sending messages to that SCN in the brain that this is a social time of day and not a time to be sleeping. This further confuses your baby’s circadian rhythm. This is the  truth behind the strict “no eye contact no smiles at night” that parents are encouraged to follow. Eye contact and using a name is encouraging the possibility of a prolonged interaction, play or negotiation. Night time is sleep time and this should not be negotiable.

If you would like help and support to alter your child's sleep behaviour;-
Contact us at  info@dream-angus.com

Normal infant sleep patterns

Understanding how infants sleep patterns develop, and what parents should expect from their newborn, are the first steps which should be taken to determine how well an infant sleeps, and getting a realistic view of what is, and is not possible for a little one.

In the first week of life the longest sleep period possible for a healthy newborn is about four hours. By the sixteenth week this has extended to over eight hours. Newborns do not have their own internal circadian rhythms. The production of Melatonin, the hormone which regulates sleep, makes you feel sleepy, and Cortisol the hormone assists in the creation of a natural circadian rhythm and keeps you alert, does not happen until infants are several months old. The initial wake sleep pattern is influenced by hunger, feeding, digestion and becoming hungry again. This happens every two to three hours. Most babies do not develop an internal circadian rhythm before they are twelve weeks old, and some take much longer.

Circadian rhythms help determine human sleep patterns and are directly affected by light and darkness in the environment. Light affects waking, rest, activity, hunger, eating, hormone release and fluctuations in body temperature.

Parents can influence waking and sleep patterns in the following ways;-

1. Reduce the light, noise, and social interaction at night time. This will create a difference between night and day which will help regulate baby's body clock.
2. Involve baby in the daily routine of the household so that social cues will help baby acclimatise to a 12 hour day.
3. Once baby is two months old, healthy and gaining weight, start to slightly delay responding to cries at night. This is not a prolonged thing, waiting two or three minutes by the clock, means waking is not immediately rewarded by feeding.
4. When baby is four months old and cries, wait a few minutes longer before responding. This avoids baby becoming distressed and allows a short time for baby to decide if they really need you, or if they can resettle without you.
5. Avoid feeding, cuddling or rocking baby to sleep once they are three or more months old because this leads to baby believing that sleep is impossible without this "help".
6. Put baby down in a safe sleeping place when they are drowsy, but aware that this is happening. This demonstrates that you recognise they are sleepy, and that you are confident that they will be comfortable and safe in this place.
7. Unless the sun is shining directly on baby's face do not darken a room for baby's daytime sleep. Naps should be taken in normal ambient daylight with normal household noise in the background.

 If you would like help with your child's sleep contact Dream-Angus.com
email;- Info@Dream-Angus.com

The Golden Rules

These are the "golden rules" which, if observed, will help ensure a good night's sleep.

1. Make sure your child's room is quiet and dark.
2. Keep environmental noise to a minimum, no loud TVs.
3. If your child still needs a nap, schedule that nap for early afternoon, before 3pm.
4. Wake your child at a regular time every morning. This will strengthen the circadian rhythm.
5. Avoid drinks of tea, cola and drinks containing caffeine before bedtime.
6. Quiet play in the hour before bed is better than stimulating, exciting play.
7. Keep the room at a comfortable temperature. If the room is too warm sleep may be disturbed.
8. Use a short pre bed routine that your child will recognise and stick to it.
9. Make sure that your child does not go to bed hungry, but do not give children over 6 months feeds or drinks through the night.
10. Help your child to fall asleep without your presence. Use a favourite toy or blanket and put your child to bed while he/she is drowsy but still awake.

You may find you are already doing some of these things, or all of them. If your child is still having difficulty getting to sleep or staying asleep contact Dream-Angus.com we can help you to help your child.

Circadian Rhythm Disturbances

Circadian Rhythm is the internal body clock and it is responsible for ensuring we sleep at night and wake in the day. Within this rythm, there are two well recognised disturbances, which can dramatically affect sleep patterns.

Delayed Sleep Phase Syndrome (DSPS) - This is a disorder that causes the sleep wake cycle to be delayed by 2 or more hours. This means that instead of falling asleep at 10pm and waking at 7am, an affected person will not fall asleep until 12 midnight and then has great difficulty waking at 7am for school or work. Approximately 7% of adolescents are known to have this problem. The cause is unknown but it is definitely not a deliberate behaviour. This syndrome causes other additional problems e.g. school absences and all the known problems associated with sleep deficit.

Early Sleep Phase Syndrome (ESPS) - This is the opposite of DSPS. Children with ESPS wake inappropriately early, e.g. 4am is not unusual. They cannot get back to sleep despite being able to self sooth and settle at a reasonable bedtime.

Both DSPS and ESPS are very difficult to treat because the whole family is affected by the disorders. Therefore the affected individual, and the whole family, have to be involved in, and make considerable effort to follow, a remedial behavioural treatment plan. The treatment plan to remedy these disorders is lengthy.

Duration of Treatment
Having worked to correct the circadian rhythm to a more acceptable state, the patient and family must continue to follow the prescribed course, even after positive results have been established. This means that the family must continue with the plan for the same length of time that it took to establish a positive outcome. e.g. is it took 3 months to correct the problem, it will take a further 3+ months to ensure that the "new" revised circadian rhythm becomes accepted by the body as "normal" for that person.

Setbacks
Deviations from the plan e.g. one late night, or one early morning, during the treatment can cause the body clock and therefore the plan, to require restarting from the beginning. Some children and adolescents who experience these problems are also affected by depression, which may co-exist with behavioural problems and excessive daytime sleepiness.

Detection
There is no definitive test for these disorders. They occur in children and adolescents and rarely occur after 30 years of age. They are recognised from clear history taking and in particularly complex situations may require overnight sleep studies to rule out other disorders.

If you think your child has a problem with circadian rhythm disturbance, contact Dream-Angus.com for advice and support.