The Sleep Edit – Details, episodes & analysis

In this episode of the Sleep Edit podcast, we welcome Dr. Shelby Harris, a leading expert in behavioral sleep medicine. Often, parents are struggling even after their kid's sleep problems are addressed. We talk about the common sleep challenges faced by parents focusing on the impact of stress, hormonal changes, and modern technology on sleep quality. Dr. Harris provides insights into the diagnosis and treatment of insomnia, emphasizing cognitive behavioral therapy for insomnia (CBTI) and its effectiveness over medication for long-term improvement. The conversation also explores the practicalities of sleep hygiene, sleep restriction, and the influence of consumer sleep tracking technologies.

• Dr. Harris’ website
• Dr. Harris' on Instagram
• The Women's Guide to Overcoming Insomnia: Get a Good Night's Sleep Without Relying on Medication (affilate link)
• Room sharing recommendation in 2024
• Directory of providers at the Society of Behavioral Sleep Medicine
• University of Pennsylvania CBT-i Provider Directory
• Orthosomnia

In this episode of the Sleep Edit, Craig and Arielle are thrilled to welcome Dr. Sujay Kansagra of Duke University to discuss the weird and wonderful world of parasomnias, restless leg syndrome, and restless sleep disorder in children. Parasomnias include NREM parasomnias (sleep walking, hypnic jerks, night terrors) and REM parasomnias (sleep paralysis and nightmares).

• 00:00 Introduction and Disclaimer
• 01:09 Parenting Anecdotes and Guest Introduction
• 02:22 Journey into Medical Social Media
• 05:21 The Importance of Engaging Content
• 10:50 Understanding Parasomnias
• 15:25 Non-REM vs REM Parasomnias
• 24:26 Night Terrors and Sleepwalking
• 28:17 Fever Dreams and Sleep Disruptions
• 28:58 Genetic Predispositions and Sleep Studies
• 29:21 Scheduled Awakenings and Melatonin
• 30:23 Nightmares vs. Night Terrors
• 31:39 Sleepwalking Safety Tips
• 37:43 Understanding Restless Leg Syndrome
• 48:58 Restless Sleep Disorder
• 53:38 Final Thoughts and Parenting Advice

• Dr. Sujay Kansagra at Duke Health
• Sujay’s Instagram profile 
• Sujay's time zone video
• “I am the research”
• His excellent sleep book
• The rest of his links
• Night terrors, sleep walking, and sleep talking in children by Dr. Canapari
• Restless leg syndrome in children by Dr. Canapari

Today, Craig and Arielle unpack the often mystifying world of newborn sleep—those crucial first three months. The inspiration for this episode was Craig's new niece, who was 2 weeks old at the time of recording. Whether you're navigating the unpredictable waters of infant sleep or just curious about what's normal, this episode promises to arm you with the insights you need to feel a bit more in control—or at least to understand that sometimes, chaos is just part of the parenting package.

• [00:00:00] Introduction and disclaimer
• [00:01:09] Welcoming listeners back and introducing the episode's focus on newborn sleep
• [00:02:12] Discussion on the erratic nature of newborn sleep
• [00:03:22] Personal story about sleep expectations with a newborn
• [00:08:21] Explanation of active sleep in newborns and advice for parents
• [00:10:41] Impact of external factors like maternity and paternity leave on sleep
• [00:14:26] Transition to detailed discussion on sleep cues and signs of tiredness in newborns
• [00:21:08] Exploring the science of sleep cycles and the development of circadian rhythms
• [00:26:35] Discussion on the "witching hour" and strategies to cope with it
• [00:32:23] Month-by-month sleep development and expectations
• [00:37:38] Review of sleep tools and technologies affecting newborn sleep
• [00:42:35] Closing remarks and where to find more resources

Notable Quotes:

• Craig Canapari MD: "Things will get better with time, even if you're really struggling. It's funny, my older son was one of those babies that we took him home from the hospital. My wife had a c-section the first night. And he slept six hours overnight."
• Arielle Greenleaf: "I think one of the biggest things I wish I had known back in the day was I didn't know really about active sleep. And so I think when she was coming, she's going through that, what did you call it?"
• Arielle Greenleaf: "I always tell newborn parents, don't rush. They will tell you if they need you. They will, they have lungs and they can scream."
• Craig Canapari MD: "A newborn, that could be anywhere from 13 to 14 hours per or 20 hours within a 24 hour period. So if you have a baby who's natural sleep needs at that point is 20 hours a day, you are gonna feel like a parenting genius."

Links and Resources:

• Sleep and Wakefulness by Nathaniel Kleitman
• Why room sharing is important for safe sleep
• AAP Safe Sleep Guidelines
• Period of purple crying
• How many wet diapers per day
• Happiest Baby on the Block
• Bringing up Bebe- and Le Pause
• Wirecutter article on the SNOO

Connect with Us! Send us an email about questions, feedback, or ideas for future topics.

In our first mailbag episode, Arielle and I take a deep dive into your most pressing sleep-related questions, from the perfect setup for your toddler's room to managing sleep challenges in children with autism. We took YOUR questions from email and Instagram.

Timestamps:

• [00:02:00] "What should the light setup be in a toddler's room?"
• [00:03:23] "Can you immediately stop using a pacifier when sleep training?"
• [00:05:39] "How to introduce room sharing?"
• [00:08:31] "Tips for jet lag when flying overseas with kids?"
• [00:11:30] "How much movement during sleep is typical in an elementary schooler?"
• [00:15:05] "Is it okay to use melatonin for sleep issues in kids?"
• [00:22:44] "How to manage bedtime for children with autism?"
• [00:28:47] "Dealing with night nursing and weaning issues."
• [00:36:00] "How do we break the cycle of bottle feeding and rocking to sleep for a 2-year-old?"
• [00:39:00] "Will removing a nighttime sleep crutch result in split nights?"
• [00:51:27] "Should weekend naps match daycare schedule for a 6-month-old?"
• [00:53:10] "Recommendations for a 3-year-old inconsistent in taking naps."
• [00:55:00] "How to handle a baby's strong preference for one parent at bedtime."
• [00:57:16] "Helping a 6-year-old with congenital heart disease to sleep better."

• "It should be dark enough in your kid's room that you can't read a book by the light." - Dr. Craig Canapari
• "The sooner you can eliminate the pacifier, the better." - Arielle Greenleaf
• "Kids adjust more quickly to new time zones than adults do." - Dr. Craig Canapari
• "Melatonin is not a magic bullet. It's part of a broader strategy." - Dr. Craig Canapari
• "Natural light is very helpful for adjusting to new time zones." - Arielle Greenleaf
• "Being a little bit careful with screens before bedtime can help with jet lag." - Dr. Craig Canapari
• "Restless leg syndrome in kids is typically associated with both sensory and sleep issues." - Dr. Craig Canapari
• "Swap your child's fear of not having the pacifier with germophobia and you're all set." - Dr. Craig Canapari, humorously suggesting a strategy for weaning off pacifiers.

• Sleep edit episode with Dr. Garay
• Room sharing links: Dr Canapari article in the NYT ; Dr Canapari article on his website
• Melatonin for Children: A Guide for Parents
• Melatonin overdoses are on the rise: why parents should worry
• Solving Sleep Problems in Children With Autism Spectrum Disorders: A Guide for Frazzled Families
• How to stop night feeds
• AAP Safe Sleep Guideline 2022
• Want to stop cosleeping? Here’s how
• List of sleep training methods
• Early morning awakenings: what to do about them

In this episode, Dr. Canapari and Arielle welcome their first guest, pediatric psychologist Dr. Danielle Garay from the Yale Pediatric Sleep Program to discuss the role of psychology in treating children's sleep difficulties, focusing on anxiety, nighttime fears, tantrums, and separation anxiety. 

• [00:03:09] The role of a psychologist in the care of children with sleep difficulties
• [00:07:47] Discussion on temperament and its relevance to sleep difficulties
• [00:10:12] Advice for dealing with nighttime fears in children
• [00:17:56] Managing nighttime tantrums in toddlers and preschoolers
• [00:39:49] Explanation of separation anxiety and its manifestation at night
• [00:44:58] Understanding accommodations and their role in managing anxiety
• [00:52:55] Using reward structures and incentives for behavior change in children

"It is such a powerful intervention to be able to help people with their sleep." - Dr. Danielle Garay

"Tantrum has such a negative connotation, and it's not like a child is choosing to have a tantrum, and I feel like sometimes parents see it as the child choosing to have that tantrum and cause chaos at bedtime. And it's really just not the case." - Arielle Greenleaf

"True boundaries should require the other person to do nothing. It's you setting the boundary for yourself." - Dr. Danielle Garay

"Small changes in parental behavior can lead to significant improvements in a child's sleep." – Dr. Craig Canapari

• How to stop cosleeping including an evidence based plan for children with separation anxiety
• Huggy puppy treatment for night time fears
• How to help an anxious child sleep better
• Breaking Free of Child Anxiety and OCD: A Scientifically Proven Program for Parents By Eli Lebowitz PhD
• Treating Childhood and Adolescent Anxiety: A Guide for Caregivers by Eli Lebowitz PhD and Haim Omer PhD
• Psychology Today - find a therapist, screening for your insurance type and specialty of provider
• https://www.spacetreatment.net/space-providers - Find SPACE treatment providers (excellent parent training for treating anxiety in children
• The Sleep Edit CIO episode
• Books on dealing with fears of the dark:
• Uncle Lightfoot Flip That Switch: Overcoming Fear of the Dark
• Orion and the Dark
• The Rabbit, the Dark and the Cookie Tin.

(Note that we use Amazon Affiliate links to support the podcast).

Today, we're cutting through the noise to bring clarity to some common pediatric sleep myths that frequently confuse tired parents. Dr. Canapari and Arielle are tackling:

• Wake windows
• Sleep regressions
• Nap strikes
• Whether you should or should not wake a sleeping baby
• Teenage sleep myths

Notable Quotes:

• "Children are as unique in their sleep needs as they are in their personalities. It's our job to guide, not dictate, their path to better sleep." - Dr. Craig Canapari
• "The concept of wake windows has become a maze for parents. Let's simplify and tailor sleep strategies to fit the child, not the other way around." - Ariel Greenleaf
• "Initiating a bedtime routine early is key, but adjusting strategies as your child grows is equally important." - Dr. Craig Canapari on establishing and evolving sleep routines.
• "Addressing sleep is not just about tonight's rest; it's about setting a foundation for healthy sleep habits that last a lifetime." - Arielle Greenleaf

Time Stamps:

• 00:00 Introduction and Discussion on Naps
• 00:15 Debunking Sleep Myths and Discussing Wake Windows
• 08:44 Understanding Sleep Regressions
• 17:17 The Controversy of Nap Strikes
• 23:05 The Impact of Napping on Nighttime Sleep
• 23:39 The Role of Daycare in Children's Sleep Patterns
• 25:35 Debunking Sleep Myths: Late Bedtimes and Desired Wake Times
• 38:22 The Controversy of Sleep Training
• 42:38 The Struggle of Teenagers with Early School Start Times
• 45:33 Closing Thoughts and Future Advocacy

• Do wake windows really help babies and kids nap better?
• How to deal with a sleep regression
• Are sleep regressions real?
• Dealing with a nap strike
• FAQ and Tips for Sleep Regressions
• Sleep regressions in the NYT:
• Iglowstein article– on sleep needs and nap timing
• Study on driving in sleep deprived mothers: 
• Understanding sleep drive and the circadian clock in children
• Facebook groups raise cortisol in moms
• More help on napping

In this episode, we talk about the controversial method of 'Cry It Out' (CIO) or Extinction Sleep Training. This approach, often misunderstood and feared, can be a quick and efficient method to improve a child's sleep. We go deep on the criteria for its successful implementation, discussing age-appropriateness, parental consistency, and prioritizing safety and health. We also cover that the method is not suitable for all children or families, and alternative methods like bedtime fading and pick up/put down are also considered. Finally, we cover importance of sleep training for both children and parents to improve the overall family dynamic. (Full transcript and a video are available here).

Be open to trying different sleep training methods - What works well for one child's temperament may not work for another. Give a new method 3-5 nights before deciding if it's effective.

"Gentle" is not always better - Sitting in the room while ignoring crying (camping out) can actually prolong upset in some young babies. More separation may help them learn to self-soothe faster.

Cry it out is generally safe when done responsively - Research shows no long term emotional harm. But if excessive crying persists beyond expectations, reevaluate and adjust. Be responsive to your baby's needs.

• 00:00 Introduction to the Sleep Edit
• 00:03 Discussing Cry It Out (CIO) Method
• 00:09 Introducing Arielle Greenleaf
• 01:08 The Controversy Around Sleep Training
• 02:56 Understanding Different Sleep Training Techniques
• 03:43 The Importance of Sleep for Children and Parents
• 04:02 Defining Sleep Training Terms
• 09:21 The Impact of Parenting Styles on Sleep Training
• 09:27 The Role of Attachment Theory in Sleep Training
• 17:03 The Effectiveness of Extinction Sleep Training
• 24:46 Sleep Training in the Era of Room Sharing
• 28:14 The Power of Parental Presence
• 29:12 Understanding the Importance of Age-Appropriate Schedules
• 29:56 The Role of Routine in Sleep Training
• 30:58 The Challenges of Nap Time
• 31:40 Who is Extinction Sleep Training For?
• 33:35 The Importance of Consistency in Sleep Training
• 36:54 The First Year of Life: Sleep Expectations and Realities
• 39:22 The Pitfalls of Sleep Training Methods
• 42:59 The Role of Feeding in Sleep Training
• 45:56 Alternatives to Extinction Sleep Training

• How long will your baby cry during sleep training?
• How to CIO Sleep Train Your Baby
• Article in Time on why Dr. Sears’ contention about the dangers of crying are false
• Two articles on why sleep training doesn’t hurt your child
• Why you should room share but not bed share in infancy
• Modern family sleep training scene

Assistant producer: Theodore Canapari

In part two of our discussion on helping kids sleep through the night, pediatric sleep expert Dr. Craig Canapari and sleep consultant Arielle Greenleaf tackle night wakings and feedings.  (You can find part 1 here, including a video of both episodes). They provide guidance on when night feeds may or may not be necessary, how to handle night nursing for comfort vs nutrition, and tips for transitioning toddlers away from nighttime calories.

- Only a small percentage of sleep issues are caused by medical problems. Most kids need some type of sleep training or behavioral intervention.

- Check with your pediatrician before dropping night feeds - make sure your child is getting enough calories during the day first. 

- Night nursing is about more than nutrition - it also provides comfort. Wean slowly if desired.

- Toddlers generally don't need extra calories at night. But there is little guidance given on transitioning from milk feeds to solids at this age.

"I always like to say I am not, if a sleep consultant starts working with someone and says, without any digging, we're going to eliminate all feedings overnight really fast, we're just gonna take 'em all away, run for your life." - Arielle Greenleaf

"Honestly, a normally growing child over a year of age doesn't really need those calories at night. And if you find that you are meaning to give milk or anything else during the night you, I give you permission to cut it out and you may want to wean it slowly." - Dr. Craig Canapari

Subscribe & Follow:

Don't forget to subscribe to "The Sleep Edit" podcast and follow Dr. Canapari and Arielle Greenleaf on social media for more great sleep advice!

• 00:02 Introduction and Disclaimer
• 01:18 Understanding Sleep Disorders in Children
• 02:03 Medical Problems and Behavioral Interventions
• 05:14 The Role of Bedtime and Nighttime Awakening
• 05:18 Feeding and Sleep Patterns
• 13:44 Adjustment Issues and Sleep Disruptions
• 18:02 Addressing Nighttime Fears
• 20:24 Imagining Bedtime Stories
• 20:41 Addressing Children's Fears
• 21:13 The Huggy Puppy Intervention
• 21:55 Dealing with Trauma and Sleep Difficulties
• 23:18 Environmental Causes of Nighttime Awakening
• 24:44 The Impact of Light and Shadows
• 25:14 The Creepy Doll Story
• 25:53 Technology and Sleep
• 26:40 Sensory Disorders and Sleep
• 27:54 Too Much Time in Bed Syndrome
• 36:14 The Importance of Independent Sleep
• 38:28 Closing Thoughts and Contact Information

• Huggy puppy intervention for night time fears
• Brett Kuhn Ph.D
• Why is your toddler waking up at night
• How much sleep does your child need at night?
• How to address night feedings

Night time awakenings are THE most common reason that parents bring their child to a sleep physician or consultant. Dr. Craig Canapari and expert sleep consultant Arielle Greenleaf join forces to give advice on the most common reasons that kids wake up at night. The first step to getting your child to sleep through the night is understanding why they are waking up. They address the concept of sleep regressions, the impact of medical conditions such as asthma, acid reflux, and ear infections on sleep, and the importance of consulting a professional when these issues arise. Greenleaf discusses her own journey from a sleep-deprived mother to a pediatric sleep consultant, highlighting the valuable role of sleep consultants in helping families achieve better sleep. Canapari reminds listeners that the goal isn’t about achieving “perfect” sleep but about achieving sleep that enables everyone in the family to feel good and function well in the morning. (Note that this is such a big topic we split it in two-- here is part 2).

• 00:00 Introduction and Disclaimer
• 01:06 Meet the Host and Guest
• 01:41 Arielle's Journey into Sleep Consultancy
• 03:15 The Impact of Nighttime Awakenings
• 05:37 Defining 'Sleeping Through the Night'
• 09:34 Understanding Nighttime Awakenings
• 09:49 Addressing Early Evening Awakenings
• 16:06 Understanding Sleep Cycles and Stages
• 18:35 The Importance of Independent Sleep
• 24:07 Understanding Your Child's Sleep Patterns
• 24:27 The Role of Sleep Consultants and Pediatricians
• 25:04 The Importance of Independent Sleep
• 26:21 The Misconceptions Around Sleep Training
• 28:06 The Impact of Developmental Milestones on Sleep
• 30:19 The Effects of Travel and Illness on Sleep
• 31:35 Addressing Nighttime Awakenings
• 37:11 The Role of Medical Issues in Sleep Disruptions
• 40:34 The Importance of Addressing Health Before Behavior
• 42:35 Preview of the Next Episode
• 43:18 Closing Remarks and Contact Information

• Sleep training won't hurt your child
• How much sleep do kids need?
• What to do about sleep regressions
• How to stop night feedings
• Things that go bump in the night: Night terrors, sleep walking, etc.
• Craig's Book: It's Never Too Late To Sleep Train: The Low Stress Way to High Quality Sleep for Babies Kids and Parents
• Why you should ignore annoying things your kids do
• Toddler night wakenings: what causes them, what you can do about them

Parenting is hard-- especially when your child isn't sleeping well. Because that means you aren't sleeping well. I'm excited to launch a new podcast tackling the most common sleep issues that parents are facing these days. Why does my child wake up every night? How do I get him out of my bed? Is melatonin safe. Join us twice a month as Dr Craig Canapari (author, sleep expert, and director of the Yale Pediatric Sleep Center) and Arielle Greenleaf (noted sleep consultant) give you the best, evidence based information you need so EVERYONE in your home can sleep better.