NOTE: When I publish these question and answer sessions it is with the permission of the families. I am not using cases where I have a doctor patient relationship. Details have been changed to protect privacy.
A old friend recently contact me via email with the following question. She is a retired supermodel turned astrophysicist.*
OK. D has a mild cold and a cough. When this happens, she sleeps poorly. In general, she can get to sleep and stays asleep for about 2-3 hours, then has a coughing spell and cries and can’t get back to sleep. Someone (usually her dad) generally has to sleep in her bed to get her to rest again. It sucks for all kinds of reasons. We’re anxious about any change in routine as we just got out of a long period of early morning awakenings which was challenging for us to address.
She’s been diagnosed with asthma and is on fluticasone twice a day. We are using albuterol when she is sick. He does not have a fever. We’re new to the asthma diagnosis (which came in the aftermath of a recent bout with pneumonia) so it’s hard to know if we’re doing the right things. I definitely don’t want her miserable and alone at night when she’s sick–I just also don’t want to be that parent with the poor boundaries/not seeing the forest for the trees.
Basically, I just want to know if I should try to train a kid who’s a little sick to self-soothe a little more effectively. “Crying it out” feels lousy when your kid is snotty and miserable, but I worry that we will lose the progress we’ve made in having a good night of sleep.
This is a challenging situation for family’s who are working on sleep issues or who have struggled with them in the past. I think that all bets are off when your kid is sick. If your child is sick with fevers, cough, vomiting, etc., I encourage you to do what feels right, even if it may have some consequences in terms of your sleep quality. You can always return to the rules that worked before once your little one is feeling better. I know it’s hard to compromise if your good night’s sleep has been hard won.
There is an important corollary here. Many medical problems have night-time symptoms, specifically asthma (cough), gastroesophageal reflux (vomiting, belly pain), and allergies (nasal congestion and post nasal drip), and, of course, obstructive sleep apnea. Your sleep training is likely to fail if you have not addressed these issues. It’s a good idea to talk about any of these problems with your pediatrician as they may actually be the cause of nightwakings.
*Note that some details may have been changed to protect the innocent. Also, I was told that I needed to include this detail if I wanted to run this story.
