One of the most common questions voiced by parents of infants and toddlers is how to get their young children to sleep. Bedtime can start early in the evening and stretch on for hours as parents try everything to get their children to fall asleep and stay asleep. Persistently crying infants or toddlers requesting "one more drink of water" cause increasing frustration to already exhausted parents.So what's a parent to do?

The researchers provided the mothers with a simple three−part bedtime routine.

A recent study published in the May 2009 issue of Sleep, offers one solution: develop a bedtime routine. Knowing that well−established routines improved many problematic daytime behaviors in infants and toddlers, the researchers studied a bedtime routine as a solution to the nighttime woes. They enlisted about 200 infants (7−18 months) and 200 toddlers (18−36) months whose mothers had reported that they had mild to moderate difficulty going to sleep. The researchers provided the mothers with a simple three−part bedtime routine. But they did not change the way that the children were actually put to sleep. Mothers who put their children down while still awake, who rocked them until they were asleep, or who remained in the room until the child fell asleep continued to do so. The researchers monitored how fast the children fell asleep, how much they cried or called out to their parents, and how many times they awakened during the night. They also monitored the the mother's perception of their children's bedtime behavior and the mother's own mood.

The bedtime routine began with a bath, followed by a massage with lotion for the infants, or gentle application of lotion to the toddlers, and ended with quiet activities such as reading. Lights out occurred 30 minutes after the bath. Both the infant and the toddler groups responded to this routine by falling asleep more quickly and awakening fewer times during the night. The mothers reported an improvement in their children's sleep behavior, and showed a significant decrease in their own feelings of tension, depression, anger, and fatigue. The researchers concluded that instituting a nighttime routine, even without changing the actual method of putting the children in bed, significantly improved children's sleep and their mothers' moods. There were no changes in the daytime napping schedule.

Why did the routine work? The researchers suggested that the bedtime routine might have replaced activities that were more arousing to the child such as active playing or viewing stimulating TV. The decreased arousal achieved by the quieter routine may have persisted through the night, leading to fewer nighttime awakenings. They also noted that the nighttime bath, which changes the body's core temperature, might have had a soothing and sleep promoting effect. The mothers' mood may have helped, too. In addition to being more rested, mothers may have felt happier because they were more in control of the bedtime experience.

Should parents try this at home? When a young child sleeps poorly, the whole family is affected. Exhausted parents have difficulty coping with the child's constant needs. Tired children are cranky and difficult to enjoy. Parents should discuss sleep issues with their child's doctor and should think carefully about their own bedtime practices and how they might be contributing to sleep problems. Developing a simple routine, similar to the one in this study that is aimed at relaxation, soothing touch, and quiet interactions with the child can be a useful first step in relieving the stress of bedtime.