What Does the Research Really Say About Sleep Training?
Few parenting topics are as emotionally charged as sleep training. Decisions about how your family sleeps can feel incredibly personal and emotional. Each family has their own preferences, values and needs when it comes to sleep. There are many ways families choose to sleep – bed sharing, independent sleep spaces, or some combination. There is no one right way.
Introduction
It’s no secret that having a baby often means disrupted sleep for months and sometimes years. If you decide to prioritize sleep in your home and what you are currently doing isn’t working, you deserve evidence-based information and support to help you make an informed decision. You may choose to prioritize sleep for any number of reasons. After all, we can all agree that when we sleep well, we feel better – more energy, less brain fog, and a better mood.
If you choose to prioritize independent sleep and sleep train your child, you shouldn’t feel ashamed for that decision. However, from working many years as a Nurse Practitioner and Pediatric Sleep Consultant, I know that the decision to sleep train is hardly ever easy and almost never guilt-free. There is a lot of misinformation and many opinions out there about sleep training being harmful or neglectful. But, what does the evidence say?
In this article, we’re going to look at what evidence we have around sleep training and whether the data shows benefits and/or harms in the short and long-term. Before we jump into what the data says, I want to discuss why parents feel guilty about sleep training first.
Guilt Around Sleep Training
Many parents feel guilty and selfish for choosing to sleep train. They feel guilty because of the narrative on social media and within their family/friend circle that sleep training is harmful, neglectful, or traumatizing. I hear over and over that parents worry about harming their attachment to their child.
I firmly believe that choosing to sleep train does not make you a bad parent. A “good parent” should not have to sacrifice their own sleep to maintain a loving, secure, and attached relationship with their child.
Wanting both you and your baby to get more restorative sleep is not selfish. If poor sleep is affecting your mood, your health, or your ability to be the parent, partner, or friend you want to be, choosing to sleep train is a reasonable option supported by current evidence. Current research has not found evidence that sleep training negatively affects attachment, emotional development, or the parent-child relationship in healthy children.
Don’t get me wrong. Sleep training is not the only way to get more restful and longer sleep. Many families bed share as a way to improve sleep. If that works for your family, I support you. Other families want independent sleep spaces for their children and themselves. If that works for your family, I support you.
Stress Versus Trauma In Sleep Training
Many parents worry that sleep training will cause trauma to their child. I would argue that sleep training will be stressful for your child but not traumatizing. Let’s look at the definitions of stress vs. trauma.
Your child will likely experience stress while learning a new way to fall asleep through sleep training. This type of stress is considered a tolerable stress which is different from toxic stress.. Tolerable stress means that the rise in cortisol is temporary, and it occurs in the context of a secure, responsive caregiver relationship. This type of stress is a normal part of a child learning any new skill.
Toxic stress occurs when a child experiences prolonged and severe stress without a secure, responsive caregiver relationship.Toxic stress overwhelms the nervous system and can be traumatizing.
If you choose to sleep train in the context of a loving, secure and responsive child/parent relationship, your child will experience temporary, tolerable stress while learning the new skill.
What The Evidence Shows
Here’s what the current evidence tells us.
Key takeaways:
- Behavioral sleep interventions (sleep training) work, causing meaningful improvements in reducing the time it takes to fall asleep, decreasing resistance to bedtime, and a reduction in night wakings.
- There is no evidence that sleep training causes negative impacts on attachment, emotional development, child behavior, or parent-child relationships in healthy children.
- There is more than one approach to sleep training that has evidence supporting its effectiveness. You can choose a method that aligns with your parenting style. Most studies look at extinction (Cry It Out), graduated extinction (Ferber style methods with check-ins).
Limitations in these studies:
- Many studies relied on parent-reported information rather than objective information.
- Participants in these studies only included healthy, typically developing children.
- Families who enrol in these studies may differ from the general population as far as motivation, resources or willingness to use behavioral interventions.
- Many studies have relatively small numbers of participants.
TLDR
Current research has not found evidence that sleep training is harmful to attachment, emotional development, or parent-child relationships in healthy children. Sleep training may involve short-term stress while a child learns a new sleep skill, but this is different from the toxic stress associated with abuse or neglect.
Studies looking at the impact of sleep training are still relatively limited, but the data we do have shows no difference in development or attachment between sleep trained and non-sleep trained babies, even up to 5 years later.
If you decide to sleep train, I believe you can do so confidently. Confident that the stress your child will experience is short term and confident that the end result will help improve your child’s sleep but also your own sleep and well-being.
It’s also important to remember that sleep training isn’t necessary for every family. Many children learn to sleep independently over time without formal sleep training. The decision ultimately comes down to your family’s needs, values, and goals.
Studies I reviewed and used to write this article:
- Michael Gradisar, Kate Jackson, Nicola J. Spurrier, Joyce Gibson, Justine Whitham, Anne Sved Williams, Robyn Dolby, David J. Kennaway; Behavioral Interventions for Infant Sleep Problems: A Randomized Controlled Trial. Pediatrics June 2016; 137 (6): e20151486. 10.1542/peds.2015-1486
- Price AM, Wake M, Ukoumunne OC, Hiscock H. Five-year follow-up of harms and benefits of behavioral infant sleep intervention: randomized trial. Pediatrics. 2012 Oct;130(4):643-51. doi: 10.1542/peds.2011-3467. Epub 2012 Sep 10. PMID: 22966034.
- Mindell JA, Kuhn B, Lewin DS, Meltzer LJ, Sadeh A; American Academy of Sleep Medicine. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 2006 Oct;29(10):1263-76. Erratum in: Sleep. 2006 Nov 1;29(11):1380. PMID: 17068979.
If you’d like to have a 1:1 conversation about whether sleep training is right for your family, you’re welcome to schedule a no-cost consultation.
