Sleeping Angels

How children's sleep affects their health and well being.

Dennis Rosen, M.D. is a pediatric sleep specialist who practices at Children's Hospital Boston. See full bio

March 22, 2009, Sleep

Little footsteps in the night

Children sleeping with their parents: normal or not?

"Is it normal for a 7 year old to climb into bed with his parents in the middle of the night, every night?", with the age and gender of the child varying according to who is asking and at whom they are glancing pointedly while doing so, is a question I am asked at least once a month, whether in clinic, or at talks that I give. It always gives me pause, and I try to answer it as best I can while realizing that the issue is much more complex than simply defining this as normal or abnormal behavior.

For what does "normal" mean, anyways? Physiologically normal? Psychologically normal? Culturally normal? Normal within the narrow definitions of what our society has grown accustomed to, or what the larger family of humankind does and has done for generations?

A child climbing into her or his parents' bed is seeking the warmth and comfort of their physical proximity and companionship. This can be because she is feeling physically ill (has a toothache, for example), or after he has awoken from an especially scary nightmare and is soothed by their closeness. Most would agree that this is not a problem. Where it becomes more complicated is with children for whom sleeping next to a parent is something they've grown accustomed to and can't do without, in the same way that other children find that snuggling up to a stuffed doll or holding a special "blankie" allows them to relax and fall asleep. Many of these children associate falling asleep with direct physical contact with a parent, and are simply unable to do so without it. They are able to fall asleep in the evening only if a parent is lying down next to them, or holding or stroking them. As they cycle through sleep at night, they stir and discover that their "sleep object" is missing. This leads them to awaken fully, seek it out, and only once they have found it are they able to return to sleep. This is seen in many infants and toddlers, and also in some school aged children, and is known as "sleep association disorder", one of the main causes of behavioral insomnia in children. The younger children will signal for their parents, crying until they are rocked back to sleep again, or brought into the parents' bed. Older children are able to solve the problem themselves, and pick up and migrate to their parents' bed on their own.

Can this persistent pattern of sharing the parents' bed at night cause friction? Absolutely. It can detract from the parents' privacy and intimacy, and breed resentment towards the child and/or between the parents, especially if they hold different ideas on whether or not to allow the child into their bed in the first place. If the child is an "active sleeper", squirming and kicking and thrashing about, one or both parents can find exile to the living room couch, or the child's now abandoned bed, the only way to get a good night's sleep.

But framing something as normal or abnormal implies that there is a right way versus a wrong way of doing it. And I'm not sure, in the bigger, human picture, that one can break it down so neatly. While we have grown accustomed in this country to our children sleeping apart from their parents, often alone in unshared bedrooms, this is a relatively recent development (from an evolutionary perspective), and even today, in much of the world, entire families sleep together in the same room.

A better way of framing the question, then, is "is this working for our family", rather than "is this normal". People, especially children, are very adaptive, and able to adopt new patterns and ways of doing things. If the family's sleeping arrangements aren't working for all involved, one should, in my mind, feel comfortable (and NOT guilty) about working to re-define them in a way which does. Depending upon the age of the child, engaging her or him in making the transition to the new way of doing things is helpful, and cooperation can often be enlisted with positive reinforcement, such as sticker charts and small rewards for milestones reached on the way to the hoped-for resolution. Consistency in messages from both parents to the child is also very important, as nothing undermines behavior modification in children more than mixed or contradictory messages, and having all parties (both parents and the child) work with someone trained in pediatric sleep disorders can often make the transition a smoother one.