As if the bedtime battles, the midnight feedings, the let-them-cry-or-not dilemmas weren't enough: Researchers say that children's sleep problems carry greater consequences than many doctors and parents realize.
Lack of sleep is linked to a whole host of problems, from attention deficit disorder to weighing too much, researchers say in several studies published Monday in a special issue of the journal Archives of Pediatrics & Adolescent Medicine.
Not only are such problems more serious, but they're also more widespread than Americans realize, said Dr. William C. Kohler, director of pediatric sleep services at University Community Hospital in Tampa.
"Most children are not getting enough sleep," he said. "They're getting an hour or two less than they really need."
Monday's studies stretched from Australia to Canada, from Harvard Medical School to the University of London. Taken together, the studies show that when children have problems sleeping, those problems spill over into their waking hours. The findings include:
• By age 3, children are more likely to be overweight if they slept less than 12 hours per day as babies.
• Most children with attention-deficit/hyperactivity disorder have sleep problems, such as difficulty sleeping, nightmares and tiredness when they wake.
• Children who sleep less are more likely to report feeling anxious, depressed or aggressive as adults.
• Young children's sleep problems can spin into a vicious cycle. Babies have trouble sleeping, so parents try to soothe them with habits from co-sleeping to late feedings that make the sleeping problems worse.
Serious sleep problems often aren't recognized, Tampa Bay area doctors said. Parents might not see that their son's snoring is actually a sign of sleep apnea. Up to 40 percent of the children she sees for behavior problems have sleep disorders, said Dr. Carol Lilly, division chief of child development at the University of South Florida.
When it comes to everyday sleep troubles, doctors have seen it all. There's the MacGyver child transfer: feeding or nursing the baby to sleep and then carefully, carefully lowering her into the crib.
"It's like that show where you've got a bomb, and do you cut the green wire or the red," said Dr. Jeffrey Ewig, medical director of the sleep lab at All Children's Hospital in St. Petersburg. "Because if the baby wakes up, the parents have to go through it for three more hours."
It's enough to make every new parent want to give up and take a nap. They know firsthand how important sleep is — because they aren't getting any.
"I know if I don't get enough, I'm delirious," said Emily Wright, 28, of Tampa.
But finding the right way to get her first child, 3-month-old Abigail, to sleep has been a learning experience.
"Everything the doctors seem to tell me hasn't been true," Wright said. "They don't have that many suggestions."
Abigail just started sleeping through the night last week. Wright's not sure why, so she's nervously following the same routine each night: 4-ounce bottle; bath; 4 ounces more; bed.
Such routines are the first step to sleep success, doctors said. Slowing down activities, regular bedtimes and teaching children to soothe themselves to sleep are among doctors' suggestions.
"Everybody likes to give advice — their grandmas, aunts, uncles, pediatricians. & There's a lot that's conflicting and confusing," Lilly said. "The earlier we set routine schedules, the more likely they are to have" healthy sleep patterns.
But following such advice can be easier said than done.
"Changing sleep patterns is not easy," Kohler said. "It's very important to keep the routine, but it's very easy to break from the routine."
And from there, it's just one long sleepless night.
Maybe the number of sleep-deprived children isn't really surprising in a society where adults take a perverse pride in their exhaustion level.
"Sleep in our society is an underrated thing," Ewig said. "It's almost like a little mantra: I can get away with six hours. I can get away with four or five hours. But very few people can do that on a regular basis."
Sometimes, parents say, getting some sleep and following the rules don't go together. St. Pete Beach resident Ashley Brown, 30, said her 3-year-old son, Kyle, gets a good night's rest, but it's not always in the same place.
"He still crawls in our bed sometimes," she said. "I'm very lenient about where they sleep."
Still, Brown admitted she doesn't get much rest when her youngest child wants to sleep with her. But at 6 weeks old, Savannah only sleeps a few hours at a time.
When Kathryn Wright wanted to get 15-month-old Evan to sleep through the night, she couldn't handle crying it out. Her mother came in to help, comforting Evan but not picking him up.
"You've got to do what works for your kid and what you can live with," said Wright, who was at a Tampa park Monday with Emily Wright, her sister-in-law, and their children.
In the end, Ewig said, parents need to keep the same standards night and day, rather than giving in to the demands of problem sleepers.
"The same behaviors you would not put up with at 4 in the afternoon, you put up with at 4 a.m.," he said. "Because you just want to get to sleep."
Lisa Greene can be reached at firstname.lastname@example.org or (813) 226-3322.