2013年9月10日 星期二

8個父母應該知道的嬰兒睡眠真相


8 Infant Sleep Facts Every Parent Should Know

8個父母應該知道的嬰兒睡眠真相

原文出處:http://www.askdrsears.com/topics/sleep-problems/8-infant-sleep-facts-every-parent-should-know

作者:William Sears, M.D.

In order to better understand the how-to's of getting you and your baby to enjoy going to sleep and staying asleep, here are some important principles of sleep that every new parent needs to understand.

為了瞭解如何讓父母及寶寶樂於睡覺並睡得安穩,在此介紹一些父母需要瞭解的重要睡眠原則。
(譯註:第5、第6點很重要建議要看。)


1. How you sleep. After dressing or undressing for bed, most adults help themselves relax for sleep by performing various bedtime rituals: reading, listening to music, watching TV, or having sex. As you drift into sleep, your higher brain centers begin to rest; enabling you to enter the stage of deep sleep called "non-REM" (non-rapid eye movement -- NREM), or deep sleep (also called quiet sleep). Your mind and body are quietest during this stage of sleep. Your body is still, your breathing is shallow and regular, your muscles are loose, and you're really "zonked." After about an hour and a half in this quiet sleep stage, your brain begins to "wake up" and start working, which brings you out of your deep sleep and into light sleep or active sleep, called rapid eye movement or "REM" sleep. During this stage of sleep your eyes actually move under your eyelids as your brain exercises. You dream and stir, turn over, and may even adjust the covers without fully awakening. It is during this sleep stage that you may fully awaken to go to the bathroom, then return to bed and fall back into a deep sleep. These alternating cycles of light and deep sleep continue every couple hours throughout the night, so that a typical adult may spend an average of six hours in quiet sleep and two hours in active sleep. Thus, you do not sleep deeply all night, even though you may feel as though you do.

1. 你如何睡眠。大部分大人睡覺前有自己的睡前習慣幫助自己放鬆,像是聽音樂、看電視、炒飯等。當你入睡時,腦部的higher brain centers開始休息,讓你進入所謂的"non-REM"(非快速動眼期),或稱作深層睡眠(也叫作安靜睡眠)。你的身心都進入睡眠中最安靜的時期,你的呼吸淺而規律,肌肉放鬆,你真的睡得不醒人事。進入這安靜睡眠期後一小時或半小時,你的腦部開始“起床”並且開始運作,使你脫離深層睡眠進入淺層睡眠=活躍睡眠(active sleep),也叫作快速動眼期睡眠"REM" sleep。在這個睡眠階段你的眼睛真的會隨著你的腦部活動而在眼皮下轉動。你會做夢、翻身、拉棉被而不會完全醒來,也可能你會起床去上廁所,然後回到床上再次進入深層睡眠,這種深層-淺層睡眠每幾小時循環一次,一般成人晚上可能有6小時處於深層睡眠,2小時處於淺層睡眠,或許你可能覺得自己整晚睡得很沉,但並非如此。

2. How babies enter sleep. You're rocking, walking, or nursing your baby and her eyelids droop as she begins to nod off in your arms. Her eyes close completely, but her eyelids continue to flutter and her breathing is still irregular. Her hands and limbs are flexed, and she may startle, twitch, and show fleeting smiles, called "sleep grins." She may even continue a flutter-like sucking. Just as you bend over to deposit your "sleeping" baby in her crib so you can creep quietly away, she awakens and cries. That's because she wasn't fully asleep. She was still in the state of light sleep when you put her down. Now try your proven bedtime ritual again, but continue this ritual longer (about twenty more minutes). You will notice that baby's grimaces and twitches stop; her breathing becomes more regular and shallow, her muscles completely relax. Her fisted hands unfold and her arms and limbs dangle weightlessly. Martha and I call this "limp-limb" sign of deep sleep. Baby is now in a deeper sleep, allowing you to put her down and sneak away, breathing a satisfying sigh of relief that baby is finally resting comfortably.


2. 寶寶如何睡眠。你輕搖、抱著走、或餵奶,讓寶寶在你懷中睡著,她的眼睛閉上了,但眼皮還會跳動,呼吸也還不規律,她的手和四肢還是緊張的,他可能會突然驚嚇、抽動、或是短暫微笑,稱做睡眠微笑,她可能會持續有吸吮動作。當你彎身準備被她放到小床準備開溜時,她醒了而且哭了,這是因為她沒有完全睡著,當你放下她時她仍處於淺層睡眠期。再來試試你常做的寶寶睡眠慣例,但做的久一點,大約20分鐘,你會注意寶寶的臉部及身體抽動停止了,呼吸變得規律而淺,肌肉完全放鬆,手和四肢無力地放下。瑪莎和我稱這為軟綿綿的四肢”,是深層睡眠跡象,寶寶睡得較沉讓你可以把她放上床開溜,寶寶終於舒服睡著,可以喘口氣了。

NIGHTTIME PARENTING LESSON #1:
Babies need to be parented to sleep, not just put to sleep. Some babies can be put down while drowsy yet still awake and drift others need parental help by being rocked or nursed to sleep.

The reason is that while adults can usually go directly into the state of deep sleep, infants in the early months enter sleep through an initial period of light sleep. After twenty minutes or more they gradually enter deep sleep, from which they are not so easily aroused. As you probably know from experience, if you try to rush your baby to bed while she is still in the initial light sleep period, she will usually awaken. Many parents tell me: "My baby has to be fully asleep before I can put her down." In later months, some babies can enter deep sleep more quickly, bypassing the lengthy light sleep stage. Learn to recognize your baby's sleep stages. Wait until your baby is in a deep sleep stage before transitioning her from one sleeping place to another, such as from your bed to a crib or from carseat to bed or crib.

夜間育兒教學 1
寶寶需要安撫入睡,而非只要放著就會睡著有些寶寶可以在想睡覺但還醒著時就躺著自己睡著,但有些寶寶需要抱著輕搖或喝奶睡著

這是因為月齡小的嬰兒睡眠會先由淺層睡眠開始,不像成人可以直接進入深層睡眠。睡著20分鐘或更久之後才可以轉為深層睡眠,這時才不會輕易醒來。月齡數增加後,有些寶寶可以更快速進入深層睡眠。學著識別你的寶寶的睡眠階段,要移動寶寶時先等寶寶進入深層睡眠。


3. Babies have shorter sleep cycles than you do. Stand adoringly next to your sleeping baby and watch him sleep. About an hour after he goes to sleep, he begins to squirm, he tosses a bit, his eyelids flutter, his face muscles grimace, he breathes irregularly, and his muscles tighten. He is reentering the phase of light sleep. The time of moving from deep to light sleep is a vulnerable period during which many babies will awaken if any upsetting or uncomfortable stimulus, such as hunger, occurs. If the baby does not awaken, he will drift through this light sleep period over the next ten minutes, and descend back into deep sleep. Adult sleep cycles (going from light to deep sleep, and then back to light sleep) lasts an average of 90 minutes. Infants' sleep cycles are shorter, lasting 50 to 60 minutes, so they experience a vulnerable period for nightwaking around every hour or even less. As your baby enters this light sleep, if you lay a comforting hand on your baby's back, sing a soothing lullaby, or just be there next to baby if he is in your bed; you can help him get through this light sleep period without waking.

3. 寶寶的睡眠周期比成人短。觀察他入睡後約一小時,他開始蠕動,眼皮微動,臉部抽動,呼吸不規律,肌肉緊張,他進入了淺層睡眠。從深層進入淺層睡眠的期間寶寶只要有點不舒服的刺激很容易醒來,例如飢餓感。如果寶寶沒醒來,他將渡過約十分鐘的淺眠期,再次進入深層睡眠。成人的睡眠周期(從淺眠到深眠,再回到淺眠)平均時間為90分鐘,嬰兒的周期較短,只有50~60分鐘,所以他們大約1小時或更短時間,就會經歷一次容易醒來的淺眠期。當你的寶寶進入淺眠時,你可以用手安撫他、唱安眠曲、或光是待在他旁邊如果他睡你床上,都能幫助他渡過淺眠期而不醒來。

NIGHTTIME PARENTING LESSON #2:
Some babies need help getting back to sleep.

Some "resettlers" or "self-soothers" can go through this vulnerable period without completely awakening, and if they do wake up, they can ease themselves back into a deep sleep. Other babies need a helping hand, voice, or breast to resettle back into deep sleep. From these unique differences in sleep cycle design, we learn that one of the goals of nighttime parenting is to create a sleeping environment that helps baby go through this vulnerable period of nightwaking and reenter deep sleep without waking up.

夜間育兒教學 2
一些較能自行安定的寶寶可以渡過淺眠期而不會完全醒來,或是如果醒來了,能放鬆再次進入深層睡眠。其他寶寶則需要幫助他的手、聲音、或喝奶來安撫他再進入深層睡眠。這些睡眠周期特徵的差異,讓我們知道夜間育兒的目標之一,是創造睡眠環境來幫助寶寶渡過容易睡醒的淺眠期。


4. Babies don't sleep as deeply as you do. Not only do babies take longer to go to sleep and have more frequent vulnerable periods for nightwaking; they have twice as much active, or lighter, sleep as adults. At first glance, this hardly seems fair to parents tired from daylong baby care. Yet, if you consider the developmental principle that babies sleep the way they do -- or don't -- for a vital reason, it may be easier for you to understand your baby's nighttime needs and develop a nighttime parenting style that helps rather than harms your baby's natural sleep rhythms. Here's where I'm at odds with modern sleep trainers who advise a variety of gadgets and techniques designed to help baby sleep more deeply through the night -- for a price, and perhaps at a risk.

4. 寶寶不像我們成人一樣睡得熟。除了要花更久時間入睡而且有更多易醒來的淺睡期,他們比成人睡得更活躍、更淺眠。乍看之下這對忙於整天照顧寶寶的父母不公平,但是,如果考慮寶寶睡眠的發展原則,他的睡眠方式是有生存上的理由,這點能幫助你瞭解寶寶的夜間需求,發展夜間育兒風格而不去傷害寶寶自然的睡眠節奏。我不認同現代睡眠訓練提倡者發展各種技巧或道具,來幫助寶寶睡得更深沉並睡過夜,這是有代價且可能有風險的


5. Nightwaking has survival benefits. In the first few months, babies' needs are the highest, but their ability to communicate their needs is the lowest. Suppose a baby slept deeply most of the night. Some basic needs would go unfulfilled. Tiny babies have tiny tummies, and mother's milk is digested very rapidly. If a baby's stimulus for hunger could not easily arouse her, this would not be good for baby's survival. If baby's nose was stuffed and she could not breathe, or was cold and needed warmth, and her sleep state was so deep that she could not communicate her needs, her survival would be jeopardized.

One thing we have learned during our years in pediatrics is that babies do what they do because they're designed that way. In the case of infant sleep, research suggests that active sleep protects babies. Suppose your baby sleeps like an adult, meaning predominantly deep sleep. Sounds wonderful! For you, perhaps, but not for baby. Suppose baby had a need for warmth, food, or even unobstructed air, but because he was sleeping so deeply he couldn't arouse to recognize and act on these needs. Baby's well being could be threatened. It appears that babies come wired with sleep patterns that enable them to awaken in response to circumstances that threaten their well being. We believe, and research supports, that frequent stages of active (REM) sleep serve the best physiologic interest of babies during the early months, when their well being is most threatened.

5. 夜間睡醒是有生存優點的。在最小的幾個月時,寶寶的需求是最多的,但能夠表達他的需求的能力是最弱的。假寶寶能幾乎整夜睡得很熟,一些基本需求變得無法滿足。小寶寶的胃很小,母乳是能很快消化的,如果寶寶對於飢餓感的刺激不能輕易讓她醒來,這對於寶寶的生存不是好事如果寶寶的鼻子被塞住而不能呼吸,或是太冷需要溫暖,而她睡得太熟而不能表達她的需求,這對她的生存有害。

我們從多年的小兒科行醫經驗中學到,寶寶的行為是有其天生的理由,以嬰兒睡眠來說,研究者建議活躍睡眠(淺眠)可以保護寶寶。如果你的寶寶睡得像大人睡的很熟,聽起來多棒,對你來說很棒,對寶寶來說不是,如果寶寶需要溫暖、喝奶、或是遇到呼吸受阻礙,但因為他睡得太熟而不能醒來發現問題並表達他的需求,他的生存可能受到威脅。寶寶天生的睡眠模式是可以幫助他對於環境威脅做出反應的,研究指出經常處於快速動眼睡眠,對於月齡小易受威脅的寶寶是最有生理優勢的。

NIGHTTIME PARENTING LESSON #3:

Encouraging a baby to sleep too deeply, too soon, may not be in the best survival or developmental interest of the baby. This is why new parents, vulnerable to sleep trainers' claims of getting their baby to sleep through the night, should not feel pressured to get their baby to sleep too long, too deeply, too soon.

夜間育兒教學 3

助長寶寶睡得太熟、太快,對其生存及成長利益不是最好的,新手父母對於睡眠訓練專家教的讓寶寶睡過夜的睡眠訓練,要特別小心

 

6. Nightwaking has developmental benefits. Sleep researchers believe that babies sleep "smarter" than adults do. They theorize that light sleep helps the brain develop because the brain doesn't rest during REM sleep. In fact, blood flow to the brain nearly doubles during REM sleep. (This increased blood flow is particularly evident in the area of the brain that automatically controls breathing.) During REM sleep the body increases its manufacture of certain nerve proteins, the building blocks of the brain. Learning is also thought to occur during the active stage of sleep. The brain may use this time to process information acquired while awake, storing what is beneficial to the individual and discarding what is not. Some sleep researchers believe that REM sleeps acts to auto-stimulate the developing brain, providing beneficial imagery that promotes mental development. During the light sleep stage, the higher centers of the brain keep operating, yet during deep sleep these higher brain centers shut off and the baby functions on her lower brain centers. It is possible that during this stage of rapid brain growth (babies' brains grow to nearly seventy percent of adult volume during the first two years) the brain needs to continue functioning during sleep in order to develop. It is interesting to note that premature babies spend even more of their sleep time (approximately 90 percent) in REM sleep, perhaps to accelerate their brain growth. As you can see, the period of life when humans sleep the most and the brain is developing the most rapidly is also the time when they have the most active sleep. One day as I was explaining the theory that light sleep helps babies' brains develop, a tired mother of a wakeful infant chuckled and said, "If that's true, my baby's going to be very smart."

6. 夜間醒來是有發展好處的。睡眠研究者相信寶寶睡得比成人聰明,這理論在於淺眠能幫助腦部發展,因為腦部在REM快速動眼睡眠期間沒有休息。事實上,REM睡眠期腦部的血液流量接近平時的兩倍(增加的血流量主要流往腦部控制自動呼吸的區域。)REM睡眠期身體增加製造一些神經蛋白質用來發展腦部,學習也會在這個活躍睡眠期發生,在這段期間腦部會處理睡覺前獲得的資訊,儲存對自己有利的資訊並捨棄沒用的資訊一些睡眠研究者相信REM睡眠會自動刺激發展腦部,提供有益的意像幫助心智發展。在淺眠期,腦部的higher center區持續運作,在深層睡眠時則會停止運作,只剩lower brain centers運作。在淺眠期間寶寶的腦部是能夠快速成長的(寶寶的腦容量在2歲時成長至約成人腦部的70%),腦部需要在睡眠時繼續運作以求發展,值得一提的是早產兒的睡眠有更多時間是處於REM睡眠(90%),可能是為了加速他的腦部成。由此得知,人類睡眠最長且腦部成長最快的嬰兒時期,也正是睡眠最活躍的時期。有一次我向一位因為容易睡醒的寶寶而睡眠不足的媽媽,解釋淺眠可以幫助寶寶腦部發展,她笑著說:果真如此,我的寶寶應該會變得很聰明。

7. As they grow, babies achieve sleep maturity. "Okay," you say, "I understand this developmental design, but when will my baby sleep through the night?" The age at which babies settle – meaning they go to sleep easily and stay asleep varies widely among babies. Some babies go to sleep easily, but don't stay asleep. Others go to sleep with difficulty but will stay asleep. Other exhausting babies neither want to go to sleep nor stay asleep.

In the first three months, tiny babies seldom sleep for more than four-hour stretches without needing a feeding. Tiny babies have tiny tummies. Yet, they usually sleep a total of 14-18 hours a day. From three to six months, most babies begin to settle. They are awake for longer stretches during the day and some may sleep five-hour stretches at night. Between three to six months, expect one or two nightwakings. You will also see the period of deep sleep lengthen. The vulnerable periods for nightwaking decrease and babies are able to enter deep sleep more quickly. This is called sleep maturity.

7. 隨著寶寶的成長,睡眠變得成熟。你說“好,我瞭解了成長機制,但何時我的寶寶會睡過夜?”何時才是寶寶能輕易入睡並維持長時間睡著的年紀,每個寶寶的差異很大。有的寶寶容易入睡,但不會維持長時間睡著,有些寶寶則是難入睡但可以維持長睡,有些寶寶則是入睡和維持長睡都很困難。

最初3個月時,小寶寶較少睡超過4小時而不用喝奶小寶寶胃很小,通常一天睡14~18小時。3~6個月時,大部分寶寶睡眠變穩定,白天醒著的時間變長,有些寶寶晚上能連睡5小時以上,3~6個月的期間,晚上可能會醒來12。深層睡眠時間變長,容易醒來的時段變短,且更容易快速進入深層睡眠,這就叫睡眠變成熟。


NIGHTTIME PARENTING LESSON #4:
An important fact for you to remember is that your baby's sleep habits are more a reflection of your baby's temperament rather than your style of nighttime parenting. And keep in mind that other parents usually exaggerate how long their baby sleeps, as if this were a badge of good parenting, which it isn't. It's not your fault baby wakes up.

夜間育兒教學 4
有一個重要事實你該記住,寶寶的睡眠習慣主要反映出寶寶的個性,而不是你的夜間育兒方式。當別的父母誇口自己的寶寶晚上睡多久,當作自己育兒成功的徽章時,請記得寶寶晚上睡醒並不表示你做錯了什麼。

8. Babies still wake up. When babies mature into these adult-like sleep patterns varies among babies. Yet, even though babies achieve this sleep maturity some time during the last half of the first year, many still wake up. The reason? Painful stimuli, such as colds and teething pain, become more frequent. Major developmental milestones, such as sitting, crawling, and walking, drive babies to "practice" their new developmental skills in their sleep. Then between one and two years of age, when baby begins to sleep through the above-mentioned wake-up stimuli, other causes of nightwaking occur, such as separation anxiety and nightmares.

Even though you understand why babies are prone to nightwaking, you realize it's still important for parents and babies to get a restful night's sleep, otherwise, baby, the parents, and their relationship won't thrive.

8. 寶寶依然會醒來。寶寶何時才能睡眠成熟至如同成人睡眠模式,不同寶寶差別很大。即使寶寶在6個月~1歲時達到睡眠成熟,很多寶寶還是會晚上醒來。為什麼?不舒服的刺激變多了,如寒冷、牙痛;主要的成長里程,如坐、爬、走路等,驅使寶寶在睡眠中練習他們的新技能。在1~2歲時,寶寶開始可以不受上述刺激影響而睡過夜,但別的原因會讓寶寶醒來,如分離焦慮和作惡夢

你知道了寶寶為何容易夜間醒來,你瞭解在晚上獲得充足睡眠對父母和寶寶都是重要的,要不然會影響親子關係。


延伸閱讀

◎Educating the Experts – Lesson One: Crying
教導訓練專家-第一課:哭
http://evolutionaryparenting.com/educating-the-experts-lesson-one-crying/
本文說明寶寶為什麼會哭泣,以及哭泣會停止的原因包含以下幾種:
 1. 寶寶的需求被滿足了,這是最佳的情況。
 2. 哭泣會造成體溫上昇,當體溫過高時寶寶會減少或停止哭泣。
 3.  during baby training that he has given up or learned that he will not be attended to. ...In short, not responding to an infant’s attempt at communication will cause them to give up at the very least and possibly demonstrate long-term learned helplessness.  This type of non-crying is damaging to a baby’s long-term psychological well-being, no matter how beneficial it may be for mom and dad in the present moment.
寶寶因為被訓練而放棄哭,或者他學到了沒有人會來幫助他。 簡而言之,不回應寶寶的溝通嘗試,會使他放棄哭並可能顯現他學到的長期無助感這種類型的停止哭泣會傷害寶寶的長期心理健康,無論它對於父母帶來多棒的立即好處。寶寶不哭了絕對不是因為他學會了訓練專家說的 “自我安撫”。

◎Educating the Experts – Lesson Four: Self-Soothing
教導訓練專家-第四課:自我安撫
http://evolutionaryparenting.com/educating-the-experts-lesson-four-self-soothing/
科學顯示寶寶並不會由哭泣學會自我安撫,這就像是把不會游泳的人丟在水裡而造成滅頂一樣。
Emotion regulation, being a complex and difficult task at the best of times, is something that is most likely far beyond the reach of any young infant.  Children take time to learn how to regulate their own emotions, and this may take place at different time points for different types of regulation.
情緒控制,是複雜而困難的工作,即使是在最好的情況下,完全超出年幼infant(嬰兒)的能力範圍。Children(小孩)需要花時間去學習控制自己的情緒,不同類型的情緒控制可能會在不同的時間點學習。
◎ 7 Benefits of Sleeping Close to Your Baby 
http://www.askdrsears.com/topics/parenting/sleep-problems/7-benefits-sleeping-close-your-baby
靠近寶寶睡覺的7項好處,包含睡得更安穩、方便哺乳、有利於成長等。


◎ Scientific Benefits of Co-Sleeping
與寶寶一起睡之科學上的優點
http://www.askdrsears.com/topics/sleep-problems/scientific-benefits-co-sleeping
有益心理穩定、降低SIDS(嬰兒猝死症)、長期心理健康、比睡小床安全等。


相關文章:

睡眠訓練專家沒有告訴你的事
http://wombat-ch.blogspot.com/2014/03/expertdonttell.html

為什麼Cry It Out及睡眠訓練技術對寶寶有害 (百歲法、費伯法等)
http://wombat-ch.blogspot.tw/2013/08/cry-it-out-1cry-it-out-cry-it-out.html


很多被視為“嬰兒睡眠問題”的問題,其實是正常的嬰兒睡眠模式
http://wombat-ch.blogspot.tw/2013/09/blog-post.html

為什麼非洲寶寶不哭
http://wombat-ch.blogspot.tw/2013/09/blog-post_2.html

安撫哭泣寶寶的簡單方法並擁有更平靜的夜間睡眠
http://wombat-ch.blogspot.com/2013/10/Simple-Ways-to-Calm.html

寶寶夜晚哭泣的可能原因
http://wombat-ch.blogspot.com/2013/10/reasons-babies-cry.html



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