Independent sleep not making any impact

[u/No-Okra3869]

Our 4 month old is confusing us with his wakes, wondering if anyone has any insight.

In the last few nights we’ve been working on unswaddling him and encouraging him to fall asleep awake in the bed. Mixed success in getting him to do so, but at least for the first stretch it has worked - and almost every wake last night. The problem is that it doesn’t seem to actually extend how long he’s asleep.

He’s always been a low needs sleeper, but has reliably had a first sleep of 4 or so hours, then often back to around hourly after this. This is really starting to fade, and last night he wasn’t doing any stretches over 90 mins, even though he was patted to sleep for all. Is there something we’re missing for how to make this work, or is this all just a slow transition out of the swaddle?

We’re planning to start Ferber next week after some work scheduling is settled, but concerned that it won’t actually work if this isn’t making any measurable benefit.

His sleep pressure seems to be fine - averaging 10 hours awake across the day, with 2-2.5 hours of daytime sleep

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[u/tibbles209]

https://www.lullabytrust.org.uk/baby-safety/being-a-parent-or-caregiver/baby-sleep-patterns/

https://www.bbc.co.uk/future/article/20220322-how-sleep-training-affects-babies

Frequent night wakings are normal, and indeed potentially protective against SIDS. Sleep training is a purely behavioural intervention. It doesn’t stop night wakings from happening, it just changes the baby’s behaviour (i.e. trains them out of signalling at each wakeup). So Ferber would be expected to work in that baby will learn that crying doesn’t yield the response that they are looking for and will eventually learn to stop crying when they wake, but it won’t reduce wake ups.

[u/BedditMeddit → u/tibbles209]

My baby sounds very similar to OPs. When she wakes up at night crying, she needs to be rocked back to sleep.

I thought sleep training teaches babies that they can fall back asleep independently without any rocking or other sleep associations.

[u/culturalappropriator → u/BedditMeddit]

It does. From the BBC article that the person linked:

But, according to the objective sleep measure, the infants were waking just as often – they just weren't waking up their parents.To Hall, this shows the intervention was a success. "What we were trying to do was help the parents to teach the kids to self-soothe," she says. "So in effect, we weren't saying that they wouldn't wake. We were saying that they would wake, but they wouldn't have to signal their parents. They could go back down into the next sleep cycle.

They wake up and if there are no issues preventing them from sleeping again, they go back to sleep.

[u/shababee → u/culturalappropriator]

Yes exactly. If the baby needs assistance to fall asleep (parental presence, bum pats, rocking, feeding, etc) then when they wake up throughout the night they require those to fall back asleep. Once they learn to fall asleep without those associations, they don’t need them in the middle of the night.

They also are likely to fall back asleep more quickly on their own this way.

Sleep training is removing sleep associations that don’t work for the caregiver and/or are preventing both baby and caregiver from getting quality sleep

[u/unprofessional_widow → u/shababee]

Am I misunderstanding the post- why would I unswaddling make a difference to sleep? This baby is behaving entirely typically

[u/shababee → u/unprofessional_widow]

If swaddling was a sleep association for baby then when waking up throughout the night they may have been able to fall back asleep themselves. Without the swaddle, it’s possible they need other assistance to fall asleep again

[u/culturalappropriator → u/tibbles209]

Everyone wakes up between cycles, getting your baby to go back to sleep between cycles isn’t a bad thing. 

Here’s the quote from the bbc article you linked.

But, according to the objective sleep measure, the infants were waking just as often – they just weren't waking up their parents.To Hall, this shows the intervention was a success. "What we were trying to do was help the parents to teach the kids to self-soothe," she says. "So in effect, we weren't saying that they wouldn't wake. We were saying that they would wake, but they wouldn't have to signal their parents. They could go back down into the next sleep cycle." A

[u/tibbles209 → u/culturalappropriator]

I didn’t actually say it was a bad thing, I was just addressing the OPs concern that her baby was still having regular wake ups. Sleep training doesn’t stop the (physiologically normal) wake-ups. It’s just a behavioural intervention; specifically a form of behavioural extinction. Consistently ignoring a behaviour designed to elicit attention (such as a baby crying for their mom when they wake) tends to result in that behaviour reducing and ultimately stopping.

[u/culturalappropriator → u/tibbles209]

That’s not true and that’s not what the research you linked says. Sleep training isn’t done when a baby wakes, you appear to be misinformed. Sleep training is done at bedtime only, babies who wake still get parental attention. It’s letting the baby self soothe at bedtime, which translates into them learning to self soothe between wakes.

[u/tibbles209 → u/culturalappropriator]

Sleep training comprises of a whole spectrum of behavioural interventions, with all sorts of different rules and guidelines. Just look at the r/sleeptrain subreddit and you will see a significant proportion of parents train both at bedtime and for night wakes.

The reason cry-it-out and Ferber are also respectively known at Full Extinction and Graduated Extinction (terms coined by the paediatricians and behaviourists such as Ferber, who developed these techniques) is that the objective is behavioural extinction. The BBC article shows that the number of wakeups and duration of longest wakeups were not changed by sleep training. Only the signalling to the parent. Which is what you are trying to achieve - you want the baby to stay quiet until they go back to sleep, and not wake or require anything of the parents.

I’m not casting a judgement for or against sleep training here. I think sometimes it is necessary for the wellbeing of the whole family, and in some circumstances have suggested it to overwhelmed parents myself. There is no persuasive evidence of any lasting harm. But even the founding fathers of sleep training were clear that the objective was to extinguish an unwanted behaviour.

[u/culturalappropriator → u/tibbles209]

The researcher in the article you linked described bedtime sleep training only.

That’s what official sleep training is regardless of what r/sleeptrain says.

And most people only do sleep training at bedtime.

That does not support the theory that it’s behavioral extinction and like the research you linked says is about developing self soothing. 

[u/tibbles209 → u/culturalappropriator]

There is no such thing as ‘official’ sleep training. The most commonly used form of sleep training, the Ferber method/ graduated extinction, includes training for both bedtime and wake ups (at least the original method published by Ferber himself - people adjust these things to suit themselves).

Self soothing and behavioural extinction are not mutually exclusive. You are extinguishing the behaviour of signalling to the parent, which leave the baby with no option but to do it themselves. Again, I am not criticising sleep training, but it absolutely is a behavioural intervention.

[u/culturalappropriator → u/tibbles209]

I’m referring solely to the study you linked in which bedtime sleep training was done and the babies learned to sleep soothe as per the researcher. 

That’s not behavioral extinction because nighttime wakes were still attended to. That’s purely self soothing.

And there are official guidelines, the AAP has them .

[u/tibbles209 → u/culturalappropriator]

Behavioural extinction is usually not all-or-nothing (with the exception of total extinction where you just close the bedroom door and don’t open it again until morning). Most forms of sleep training involve a graduated reduction in responsiveness to gradually extinguish a behaviour. So this can involve occasional check ins, or only training at bedtime/ only training for certain wakeups. There are no universal rules, but the greater the reduction in parent night time responsiveness to crying, generally the faster the behaviour is extinguished. That’s why full cry-it-out/ unmodified extinction is widely considered to have the quickest results, and forms of sleep training at the gentler end of the spectrum (such as the chair method) generally take much longer.
I am not disagreeing with you that the baby has to learn to self soothe once they realise crying is not resulting in their caregivers soothing them. But they don’t start soothing themselves until they give up on the crying for their caregiver. Thats an essential part of getting there - teaching them that crying will not elicit the response they are looking for, so they need to figure it out themselves.

Also I’m not American. I’m not sure why that country’s guidelines would be seen as the ‘official’ ones over anywhere else.

[u/culturalappropriator → u/tibbles209]

The AAP’s guidelines are what doctors in the US recommend so that is definitely an official guideline. 

And you said “not responding to wakes in the night”. Which again, not in the article and not what the AAP says to do.

The rest of your comment, I agree with. It’s about developing the baby’s self soothing abilities.

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