Latest / Self-Schooled / Better Sleep for Kids & Teens: What Actually Works with Dr. Melisa Moore
Transcript
- Heather DiNino (she/they): Welcome to Self-Schooled, a podcast where we explore how to understand our children and ourselves more clearly. I'm Heather, parent, educator, and micro school founder. And every week we talk to someone who gives us a different lens for understanding what it means to be human and parent other humans. Because the more we understand, the more connected we feel to the people who matter most. And the more confidently we can parent and find our family's own path. This is the education that actually matters. Let's dive in together. Welcome everyone to Self Schooled. I'm so excited to have Dr. Melissa Moore with us today, talking about something I know we all desperately need more of, which is sleep and quality sleep. So, Dr. Melissa Moore is a clinical psychologist, board certified in behavioral sleep medicine, with over 20 years' experience helping families improve their sleep. She maintains a private practice in the Los Angeles area and works virtually with families across the United States. Dr. Moore regularly speaks about children's sleep at hospitals, universities, schools, and parent organizations around the world. She is the author of The Good Sleep Guide for Neurodivergent Kids. Which, if you have not read it yet, you need to read it immediately. It's also on audiobooks, so you can listen to it or read it in whatever way works for you. it is a compassionate evidence-based guide to helping neurodivergent children and teens get their best sleep. So welcome, Melissa. I'm so glad you're here. Melisa Moore: Thank you. I'm so happy to be here with you. Heather DiNino (she/they): It is so good to have you on the podcast. It's so good to chat with you. I think I'd love to get started by just hearing a little bit about what brought you to sleep medicine. Like what how'd you end up being like, yes, I need to spend my life studying sleep? Melisa Moore: I know. It seemed people think it's like how how did that even happen? So when I was in graduate school, getting my doctorate in psychology, I just I really loved working with adolescents in particular. And I started looking into the leading causes of death. This sounds very morbid, but at that point I was super idealistic and I wanted to make a big impact. So and they were the same as they are today, actually. Suicide, homicide, and car accidents or accidents. And those change places here and there, but they're pretty they've been the same for for a long time. And then I started looking into threads that kind of run through all three of those things. And believe it or not, sleep is a big one. So then I started working clinically with families, trying to help families improve their sleep. And once I saw the difference that that made, I was hooked. I was really just hooked. It was so incredible. And after I graduated, I was at the Children's Hospital of Philadelphia and I was working with families for about 10 years before I had my first yeah. All of it. Heather DiNino (she/they): Personal, professional, all the things. I mean, there's so much I love about your work. And two of the things that I have not really seen elsewhere, one is that most sleep people I have found are babies or babies and toddlers. Melisa Moore: Mm-hmm. Heather DiNino (she/they): And even the sleep folks who say school age, it's usually like preschool or like very, Melisa Moore: Yeah. Heather DiNino (she/they): very young school age. So I love that you Have this work into like adolescents, adults, families, right? And then also, I we've talked offline about this, but the neurodivergent piece is very personal and professional to me as well. Like I know it is to you. So Melisa Moore: Yeah. Heather DiNino (she/they): let's just like break those down a little bit. You talked about your work with adolescence. what is sleep in like what What changes in sleep in adolescence? Is it the same as baby sleep? Like what what is that difference? Melisa Moore: So one of the main things that happens, and this happens to teenagers everywhere, all across the world, it's been studied, is that our circadian rhythm, which is the clock in our brain that kind of tells us when to be awake and when to be asleep, it shifts later by about two hours during adolescence. And so, you know, your eleven year old that used to fall asleep at nine with no problem might be still up. Close to 10, having trouble falling asleep, and then having trouble waking up for school. And then that becomes a vicious cycle because then they're so tired after school or during school they're falling asleep. And compounded onto that is that neurodiverse people can have different circadian rhythms. So for example, Kids with ADHD or people with ADHD, it's been shown that their circadian rhythm also can be later. And people on the spectrum, their circadian rhythm could be inconsistent. So one night it your circadian rhythm at 2 a.m. might say, time to be asleep. And then the next night your circadian rhythm might say, time to wake up. So I think especially for teenagers, and even more, you know, important is teenagers. That are neurodiverse, they really have some significant risk factors. Heather DiNino (she/they): Yeah, so if we if we know this information, which first of all, clearly traditional school systems have not consulted sleep professionals because Melisa Moore: Mm-mm. Heather DiNino (she/they): the older the kids get, the earlier they go to school. Okay, so that doesn't Melisa Moore: Yeah. Heather DiNino (she/they): line up. Okay. but if we know this, like there's their circadian rhythm shifts in if we know this, right? Like, is there anything we can do to better support them or Or ourselves, like how do we get more sleep? Melisa Moore: Yeah, it's a good question. I mean, I always want to say this first, even though I know this is more of like a big picture item, but just however you can advocate for later school to start times for middle school and high school. but getting more local and you know, a little bit more close to home, I would say there are a few things. Number one, don't let your teenagers sleep in until the afternoon on the weekends. So you know. There are two things that help us to fall asleep at night. One is that circadian rhythm I mentioned, and then the other is something called sleep pressure. And that is just like it sounds pressure. So when you wake up in the morning, you really shouldn't need sleep. Your need for sleep builds and builds and builds and builds throughout the day. It reaches a certain threshold, and then you can fall asleep. And it's not just the night before. So If your child gets really sleep deprived during the week and then they sleep in until 1 or 2 p.m. on the weekends, they're not going to have enough sleep pressure during the week to be able to fall asleep. The other thing related to sleep pressure is falling asleep at school and daytime naps. You definitely don't want to have any daytime sleep if possible. So those are two things. The other thing, and I know we are all balancing this so much, like our Helping our kids get more independent, be more independent, but also staying involved. When you look at the science, really parental involvement in b in the schedule, not necessarily you don't need to like be in the room while your teenager's trying to fall asleep, but just having input into the schedule is really helpful. And one other thing I want to mention, sometimes it's better to go to bed later and fall asleep more quickly than it is to be in bed for a long period of time awake. When you're just lying there and you can't sleep for hours, you're teaching your brain that the bed is not just for sleeping. And so, Heather DiNino (she/they): Mm-hmm. Melisa Moore: you know, we all should take between 10 and 30 or 40 minutes to fall asleep. That's normal. So don't be worried about that. But if it gets into the hours, a good first step might be, even though it's kind of not what you want to think about, might be moving bedtime temporarily at least a little later. Heather DiNino (she/they): Okay. And what about if you're in that moment and your kid has been struggling to go to sleep for a while and you are getting close to that hour? Do you I I remember hearing years ago, I think it was before I had kids, so this goes back like way, way back, but to like walk around the house or do something to like get up and like Melisa Moore: So Yeah. Heather DiNino (she/they): reset. Melisa Moore: Exactly. So you're really always wanting to train your brain that the bed is only for sleeping. So when you're when you see your bed, your brain should think sleep, bed, sleep, bed, sleep, bed, sleep. But when you're lying there for a long period of time awake, it starts to not not get that message. And so the way that we retrain the brain that the bed is only for sleeping is that if you can't sleep and You don't want to watch the clock. That's an that can be something that also leads to more trouble. Then you just get out of bed. And I usually say do something boring. Sometimes for especially for teenagers and and kids, boring equals frustrating. So you don't want to go down that path either. You're always trying to keep the temperature down when it comes to sleep. But things like, you know, sometimes I've had kids who just fold and unfold their socks or read a magazine, which nobody does anymore, but something that they've already read before. You wanna try to avoid electronics if possible, but if there's something that's calming for your child, it's a good idea to get out of bed and try to do something else. Heather DiNino (she/they): Okay. Now, can we talk about electronics for a moment? Melisa Moore: you know, electronics, we're learning more and more that the impact of electronics on sleep is more nuanced than we originally thought. So when you really look at How much sleep difference there is if you use electronics before bed or not? It really the answer is it depends. So if your child with ADHD, for example, watches a video and then can't sleep for hours, obviously you're not gonna do it. And I typically don't recommend electronics. But if your child is using it to relax, so if I I talk to parents of little kids who might have like Bluey or Daniel Tiger on while they're brushing their teeth, and that's how they get them through the bedtime routine. Or they're watching something and it's a movie or a show that's not very activating, we don't really see a huge impact on sleep there. So even though there's a lot of information out there about the impact of blue light on the brain, for example, that's only been shown to move the needle a couple of minutes. It's more the problem happens and this happens to all of us where we start watching something or doing something or scrolling and then we look up and it's two hours later. So the problem is when it moves the bedtime. If the bedtime is the same Heather DiNino (she/they): Yes. Yes. Melisa Moore: every night, the falling asleep is the same every night. There's nothing that we know now about electronics that says that it inherently is bad for sleep. Heather DiNino (she/they): Okay. So could it be s like if it if it ain't broke, don't fix it kind of thing? Like if yeah. Melisa Moore: Yes. I I that's how my approach is to a lot of things, honestly. you know, there's so much misinformation out there, especially right now. And also when it comes to sleep, people feel really, really strongly about what you should or shouldn't do. But when you really look at what the science is, you don't have to do fifty thousand things to have good sleep. And especially Heather DiNino (she/they): Yeah. Melisa Moore: as parents of neurodivergent kids, we have a lot. on our plates that we are already trying to deal with. We're trying Heather DiNino (she/they): Yeah. Melisa Moore: to deal with, you know, picky eating and exercise and homework and reading and social skills and hygiene. So I would say, like you said, if it's not broke, don't worry about it so much. Heather DiNino (she/they): Yeah. Melisa Moore: I totally agree. And the other place where I see that it's kind of helpful, you know, I'm I also see kids for anxiety and depression and mood issues. If that time that you are waiting for sleep to arrive is filled with anxious or really upsetting thoughts. What we see is that electronics for some people actually make it so that you can fall asleep faster because you're not stuck in those thoughts. So I'm not saying I'm pro electronics when it comes to sleep, but Heather DiNino (she/they): Right. Melisa Moore: I'm pro whatever works for someone's family. Heather DiNino (she/they): Well, I mean, like a parent of a neurodivergent kid, you are individualizing your recommendations. Like we Melisa Moore: Yeah. Heather DiNino (she/they): that is how we have to think about life is through a Melisa Moore: Yeah. Heather DiNino (she/they): lens of like what works for this child and what works for this family, right? So that's what I hear you Melisa Moore: Exactly. Exactly. Heather DiNino (she/they): saying is it's not pro or anti. It is a more holistic view, an individualized view. Melisa Moore: Yes, that's exactly right. That's exactly Heather DiNino (she/they): Yeah. Melisa Moore: how I think about it. And honestly, I learned this about electronics from my own son when he was little. And he like accidentally snuck the iPad in and then he was asleep in ten minutes and it had been taking him like an hour. And the research has just caught up with that. But, you know, it always feels good to have whatever you're doing validated. And and so Heather DiNino (she/they): yeah, I love when the science backs up what we're doing, right? When we're doing the parenting thing that that we feel like, you know, this is what works. It's so great to get that validation. Like, look at that research backing up what we what we knew. Melisa Moore: Yeah. Yeah. Yeah, it is. I know. I know. And I could be like I've been doing this for the last ten years. Heather DiNino (she/they): Yeah. Melisa Moore: but yeah. Heather DiNino (she/they): Can we talk a little more about the the mental health stuff and the mood stuff? Because that is definitely the world I'm living in personally and professionally. Is that you know, kids I work with and probably families that are listening to this, their kids have a hard time shutting off their brain. They're having a lot of thoughts and a lot of feelings, and nighttime comes and that can feel really overwhelming. So whether it's anxiety or depression or highly sensitive kids or just any number of things can really impact that. Do you have any like tips or strategies to support that? Melisa Moore: Yeah, you know, there's a few things. Number one, there's literally nothing that you can do to force yourself to fall asleep. So when we're saying to our kids, just try, just try your best to fall asleep, that's kind of added pressure and it's more accurate that you're just waiting for sleep. And so if you start talking about it that way, I feel like that's been helpful for me. The other thing is that during that waiting time is a lot of times when things do go off the rails. And something that I've learned from families that I've worked with is that the right level of distraction, and again, this is going to be individual, the right level of distraction so that you're engaged enough, but not blasting off and you know, inventing a new method of communication or way to go to Mars. you gotta find that in between, and it really depends. For some kids that I've worked with, it's just been ripping pieces of paper or flipping through a like a soft photo album. Other kids are counting backwards from a hundred by threes or by sevens or something like that. There's also, I think I saw it actually in the New York Times this week. They were talking about something we've known about for a long time, which is the cognitive shuffle where you pick a word like bedtime and you go through each of the letters and picture everything you can that starts with that letter. So you would go B basketball. baloney, blueberry, bear, bus. And then when you can't think of anything else, you go on to the next letter. And a lot of times for people that are more verbal, that might be something. So again, it really depends on what your child is into. But I think we've all probably had the experience and we know that counting sheep It's not working. You can count Heather DiNino (she/they): gosh. Melisa Moore: sheep. You can think about what you're having for dinner tomorrow. You can review your to-do list. You know, it has to be something that's really engaging enough. Heather DiNino (she/they): Okay. I like that idea. And I'm also thinking for for younger kids or for kids with, you know, dyslexia or maybe different abilities there, like, could they do like think of go through the rainbow. Think of all the things you can think of that are red or think of Okay. Melisa Moore: That's what I do. Yeah. That's what I do with little kids. Yeah. Or yeah. And like I said, you know, the paper ripping example was for someone that was non speaking, but they really were engaged by that, flipping through Heather DiNino (she/they): Yeah. Melisa Moore: a deck of cards. It doesn't matter what it is. It just has to be the right thing, which takes a little bit of time to figure out. But again, I think in this world of neurodiversity, we think of distraction. as such a bad thing. But here's one case where it can be really great and really helpful not only to wind down, but to help keep those upsetting thoughts away. And also to just take up the time while you're waiting for sleep to arrive. Heather DiNino (she/they): I mean waiting for sleep makes it sound so magical. Right. And I'm and I'm just picturing that, you know, you're just laying there peacefully and and sleep arrives. Are there Melisa Moore: Yep. Heather DiNino (she/they): certain conditions that we can set up? Like I'm all about the environment. Are there things Melisa Moore: Yeah. Heather DiNino (she/they): that we know are helpful? Obviously, don't put white noise on if your kid is driven crazy by it. But are there things that we know are helpful that can help sleep to come? So that when we're waiting Melisa Moore: Yeah. I mean Heather DiNino (she/they): it feels better. Melisa Moore: There are two things. One is like the actual physical environment. We want it to be dark. We want it to actually be cool. So in adults, believe it or not, it's been studied in very specific detail. Sixty-eight degrees is the magic temperature. In kids, it might be around seventy. but it should be dark, cool, quiet. You don't need a fancy sound machine. if you have like a noisy fan or air purifier or something like that, that's fine too. Whatever you have to fall asleep though, you want it to be the same all night long. So you don't want something that turns off after like 45 minutes. The second thing that gets the brain ready and helps wind down, believe it or not, is a bedtime routine. So you want to try to have three or four things that you do pretty much the same every night or every night that you can. Heather DiNino (she/they): Okay. Now is those three or four things you you that seems like a magic number, three or four and it's not a hundred. You're not doing you know, you're not having like a two hour long bedtime. Melisa Moore: Right. No. A bedtime routine should be short. So thirty minutes, maybe like forty if there's a bath or a shower, but it can be five minutes. But you don't want once it gets longer than thirty or forty minutes, you're really not talking about a bedtime routine. You're talking about a extra activities, other activities. Heather DiNino (she/they): Right. Now what about the negotiator or like the delayer that that it's like but but I'm hungry and I'm tired Melisa Moore: Yeah. Heather DiNino (she/they): and I'm I and thirsty and yeah, what do we do with that? Yeah. Melisa Moore: Yep. The curtain calls. So I would say, first of all, try to include everything that your child normally asks for or asks for, you know, often into the bedtime routine. So, you know, maybe you have like a bath, PJs, you know, teeth. If your kid is always asking for a snack, then maybe right after the bath you're giving a snack. Or you're doing a snack while you're reading books and then you're brushing teeth or something like that. water, same thing. I would include that in the bedtime routine if they're asking for it a lot. For kids that delay, sometimes I will set a timer and if they are get to the end of the bedtime routine, then there might be a reward. Rewards with sleep though are are complicated because you don't want to increase the energy and the emotion, whether they get it or don't get it. So it might be Heather DiNino (she/they): Right. Right. Melisa Moore: something like, okay, you get an extra book if you're done with your routine when this timer goes off. They're also, I find that visual schedules are super helpful, even if it's an older kid. I think those things can be pretty helpful. but those are the things that I think about when I think about trying to make things a little bit easier at bedtime. Heather DiNino (she/they): That's really helpful. And you know, I try to explain because rewards, I mean, I'm a recovering behaviorist. I have my own complicated relationship with rewards and consequences. But the way I Melisa Moore: Yeah. Heather DiNino (she/they): try to talk with my kids about it is, well, I can do an extra chapter of this book because we have the time to do so, right? So it's not like Melisa Moore: Yes. Yes. Heather DiNino (she/they): it's not like Yay, gold star, you did the things that be you complied and now I'm going to give you a reward. But it's like, yes, we got everything done. Now we have the time to read an extra chapter. Right. So Melisa Moore: Yeah. Yeah. Heather DiNino (she/they): that there are ways that you can do it without it being like, you know, you're gonna get a reward and now you're all hyped up and you're supposed to be relaxing and now you're mad at me that you didn't get it. Like Yeah. Okay. Melisa Moore: Right. Right. Or you didn't get it. Yeah. Yeah. I mean that's a it and we also know that rewards are the most effective when they happen really close to the behavior you want to see. And that's also hard with sleep. What are you gonna do if your child falls asleep? Well, you're gonna wake them up and give them some Skittles, you know. No, that's not gonna happen. so Heather DiNino (she/they): Right, right, right, right. Melisa Moore: it takes a little bit of of flexibility and creativity and also again just knowing what motivates your kid. Heather DiNino (she/they): And I'm thinking about those patterns too, just from like an introsceptive standpoint, because we know with neurodivergent kids often comes not as much of awareness of their hunger or their and Melisa Moore: Yeah. Yep. Heather DiNino (she/they): so they actually it might not be a stalling tactic. It might be Melisa Moore: Yes. Heather DiNino (she/they): they are hungry and they didn't Melisa Moore: I agree. Heather DiNino (she/they): realize it until things calm down in their world. So I think yes. Melisa Moore: Yes. And that's why you just want to include it. I would just include it in the bedtime routine. And again, you're not making it super long. It's just you can combine a couple of things. But I really like the idea of a bedtime snack. maybe it's because I like myself to have a bedtime snack. And I know honestly, when my son has a bedtime snack, I know that I'm getting a better night's sleep that night. Heather DiNino (she/they): Yeah. Yeah, so you love for him to have a bedtime snack 'cause you want a good night's sleep. Melisa Moore: I I do. I do. When he's like, I'll have three grapes, I'm like, no, this is not gonna be a good night. Heather DiNino (she/they): I'm gonna be up in a couple hours. You're like, how about a peanut butter and jelly? You need that that extra protein. Melisa Moore: Exactly. Or a yogurt yeah. Yeah. Heather DiNino (she/they): yeah, because I'm just thinking it's about knowing our kids, right? It's Melisa Moore: Yeah. Heather DiNino (she/they): about knowing like they are actually truly hungry versus their stalling. And then there's part of me too that says, Well, if they're stalling, why? They might be scared, they might not be. Melisa Moore: They might be scared, they might not be tired. Heather DiNino (she/they): Yeah. Melisa Moore: You know, and so it does really I think in general it's a good idea to try to be as consistent as possible, but to maybe add a little flexibility. So for my son, what I've learned over the years, and it took a lot for me to learn this, but when he says he's not tired, he's really not gonna be able to fall asleep. And so he'll tell me that and I'll say, Okay, you can do Legos or you can draw or you can play with your Transformers. But those are the three things you can do. And it has worked out fingers crossed for us that he really knows when he's tired and can fall asleep. I know all kids are not like that and I do have to check back, but if I check back and then he then he might be like, yeah, actually I am tired now. So and I'm not talking about hours and hours of difference. I'm talking about maybe forty five minutes difference, thirty minutes difference. Heather DiNino (she/they): Yeah. Well, and don't we all do that? I mean, like, let's give Melisa Moore: Yeah. Heather DiNino (she/they): our kids some grace that we naturally give ourselves. You know, if we're Melisa Moore: Right. Heather DiNino (she/they): having a harder time winding down after a certain type of day, we might Melisa Moore: Yeah. Heather DiNino (she/they): we might need that time. So yeah, I think n allowing kids and it's it's one of my life missions to just be more of an advocate too for neurodivergent kids who aren't always taught how to listen to themselves because there's so many Melisa Moore: Yes. Heather DiNino (she/they): people in their lives often telling them like what to do and how to do it and like like let's help them figure that out for themselves. So I love that your son can say, I'm not tired and that is like that is true to him and it is true to you. Melisa Moore: Well, you know, I think for so many of us, we're taught as parents, like that's just a scam, you know. And Heather DiNino (she/they): Yeah. Melisa Moore: I just wanna be honest, I thought that too until I really realized like he actually is telling me. He's not trying to pull one over on me. When he's tired, he's gonna go to sleep. but giving that flexibility, it also kind of took the pressure off me. I think, you know. like many parents, I have that little voice in the back of my head too, saying that I'm not doing it right or if I found the right thing it would be better. And so I think just getting to that point helped me not to feel guilty also. Heather DiNino (she/they): Now you're saying that you are wondering if you did the right thing and you've spent your career studying sleep. Melisa Moore: I know, I know. yeah. It's Heather DiNino (she/they): So this is just human? Melisa Moore: human. It's human. I mean, I do this for a living. And I have done this for a living for a long time. And it's still really hard. Which to me says it must be a million times harder for other people. But I also see it like I know how I feel, like I said, about nutrition and you know, behavior and education and the future and independence and I know how worried I am about those things and I imagine that that's how everyone else feels about sleep too. But I'm here to tell you I I've done this for twenty years and it's still hard, so it's not you. Heather DiNino (she/they): well I had two thoughts and one of them you might not specialize in, so let's get that out of the way. Melisa Moore: Okay. Heather DiNino (she/they): Do you do anything with dreams? Do you talk about like is has that been part of your studies at all? Dreams or nightmares? Melisa Moore: Nightmares, yes. Dreams not as much. so with nightmares, sometimes kids, sometimes people will have repetitive nightmares and they start to get afraid of being able to fall asleep because they might have a nightmare. And a lot of times that is associated with a trauma, a traumatic event. Sometimes here and there it's not, but then I work really directly with the child either to practice adding a helper into the dream or changing the dream a little bit, but we'll work on it quite a bit together to to change how the dream goes. And believe it or not, it's very effective. And again, science has shown us that it does work. So While I don't know that much about lucid dreaming and being able to control your dreams and that kind of thing, n nightmares can get better for sure. Heather DiNino (she/they): That is really, really cool. I love that idea of adding a helper. so Melisa Moore: Mm-hmm. Yeah, yeah, yeah. Heather DiNino (she/they): so thank goodness. I mean, all of your information will be in the show notes and so people can connect with you for more help because, like, this is just not enough. I want like more of you. Melisa Moore: Great. Heather DiNino (she/they): My other question before we have to wrap up soon is about you know. We set these routines and we are as consistent as we can be and we might have like a good thing going. And then Melisa Moore: Mm-hmm. Heather DiNino (she/they): maybe we travel and we're in Melisa Moore: Yeah. Heather DiNino (she/they): a hotel or a time change or a Melisa Moore: Yep. Heather DiNino (she/they): sleepover. Like any any little disruption is like for pr for Melisa Moore: Absolutely. Heather DiNino (she/they): maybe all people, but for especially neurodivergent kids, youth, and adults. really throws a a wrinkle into the plants. Do you have Melisa Moore: It does. Heather DiNino (she/they): any tips for that? Melisa Moore: Well, although you're right, it does throw a wrinkle in things. Kids also at very young ages learn that there are different rules for different situations. So for example, if you're on vacation, my recommendation is just do whatever it takes to have a good time. If that means temporarily sleeping with your child or, you know, being in the same room until they fall asleep. When you get back home, I would try to go as quickly as possible right back into the new situation or the the the usual situation at home. When it comes to things like changing time or for a lot of people, the start of school, you always want to start with the wake up time. So you want to move the wake up time earlier before you move the bedtime earlier. Because as I said in the beginning, this idea of sleep pressure, we need it in order to fall asleep. So if you are on a different time zone, start by moving the wake time earlier before you move the bedtime. before you move the bedtime earlier. But again, I'm maybe more flexible than other people. I say when things are unusual, just do what you can to get through it. And then when you get back home and when things get back to their normal. Conditions go right back to their sleep routines. Heather DiNino (she/they): Yep. And maybe just having a buffer zone to expect that things are gonna be off a little bit. Yeah. Melisa Moore: Absolutely. Absolutely. Absolutely. That definitely happens. And you know, our kids get sick. They things happen. Heather DiNino (she/they): Just one of the things yes. Yeah, I mean, my son has had like a paint. He keeps saying he thought he bit his cheek. and I kept looking and not seeing it, 'cause he always feels better when he can see like the Melisa Moore: Yeah. Heather DiNino (she/they): thing. And and finally the molar, it was like a the twelve year molar poked through. And I was like, Yes, that's it. Like, that's the thing. But Melisa Moore: Right. Heather DiNino (she/they): but he was been really nervous about it and he had had like kind of a traumatic experience at a dentist a couple years ago. And so he was really, you know, that one feeling, like painful, discomfort, whatever, really triggered a lot of stuff for him. And really like he Melisa Moore: Yeah. Heather DiNino (she/they): was waking up in the middle of the night and not able to go back to sleep. Melisa Moore: Right. Heather DiNino (she/they): Right. So there's falling asleep and then there's also like, what about those middle of the night wakings? Like, Melisa Moore: Right. Right. Heather DiNino (she/they): what do we do when they're just up in the middle of the night? Melisa Moore: So I think we try to keep things dark and quiet no matter what. this is a time where I would try to avoid electronics if you can. And just remember this whatever you need to fall asleep in the first place is what you need through the whole night. And the reason for that is that, you know, we all go through sleep stages. We have light sleep, then we go into deep sleep, then we go into dreaming sleep or rem sleep, and then our brains wake up. So a wake up is at the end of every sleep cycle. That is happening all night long. You need, or I'll say it's easier to connect those sleep cycles to go from one to the next if your environment is the same. So Heather DiNino (she/they): Yeah. Melisa Moore: if you fall asleep with a parent or with the TV on or with I don't know what, and it's not there during those night wakings, you're gonna see that kid wake up more. you'll know more that they're awake. And so that is the first thing. And then the second thing is I think try not to make big accommodations if your kid doesn't sleep well. What I mean by that is don't have them stay home from school and sleep all day. I mean, if they're sick, that's a different story. But because then what you're looking at is trouble falling asleep the next night. So try it you really need it. Heather DiNino (she/they): 'Cause of that sleep pressure you talked about, right? Then the sleep pressure is not building. Melisa Moore: Yep. You cannot fall asleep without it. Even with medication, with melatonin, with anything, nothing is gonna take the place of sleep pressure. Heather DiNino (she/they): That's so fast. So that is the most powerful thing that we could be thinking about really is this sleep pressure. Melisa Moore: I think sleep pressure, your circadian rhythm, and then the environment and keeping it consistent. So I would think about those three things. Heather DiNino (she/they): Yep. Okay. Melisa Moore: Well, when one person in the family isn't sleeping well, it affects everybody. It affects the whole family. Heather DiNino (she/they): Oof. It sure does. Melisa Moore: So yeah. Heather DiNino (she/they): It sure does. Cause even if that one person, the adult that gets to sleep that night, then you're just building resentment that like well you got to sleep last Melisa Moore: I yeah. Heather DiNino (she/they): night, so you're doing all the chores today. Melisa Moore: I know, I know. I mean, like I said, I'm living it. I'm loving all this all the things. So but I also Heather DiNino (she/they): Yeah. Melisa Moore: think I also want to say this. I truly believe that there is always hope that sleep can improve. And I think I said this to you before, that I've been doing this for 20 years and I've never reached a point where I was like, all right, there's nothing left to do. So I Heather DiNino (she/they): Yeah. Melisa Moore: think there's always a reason to have hope when it comes to sleep.