In last week’s post, I talk about reasons why you might want to avoid co-sleeping, because of SIDS risk in infancy, and the fact that it can be associated with poor sleep as children get older. Now, I wanted to offer some advice on how to stop cosleeping. [Note: as in the previous post, I use “co-sleeping” to mean “bedsharing”; although this is a bit imprecise, I do think that it reflects the common usage of the term.]

When is co-sleeping OK?
After putting up my post I got some great feedback from around the web from readers, friends, and colleagues. People I know and respect have chosen to co-sleep with their children and have been happy to do so. One great example is Dr. Claire McCarthy, who wrote about co-sleeping with her children on the Huffington Post.
This made me reflect on what would make me OK with ongoing co-sleeping if a family asked my opinion. My goal for families is good enough sleep, which in this case means:

• Your child is older than a year and thus the risk of SIDS is minimal.
• Everyone is sleeping well
  • Enough space in the family bed (Thanks to Olli Orajärvi from Finland for this one)
  • Parents are not being disturbed during the night.
  • Parents and children feel well rested in the morning and are not sleepy during the day.

If all of these circumstances are not met, then I think you should stop cosleeping.

How to stop co-sleeping

There is no magic bullet for fixing sleep problems. How you address this issue depends on how and why you are cosleeping with your child. But no matter your circumstance, there are some important elements to a successful transition. For more on why people fail to fix sleep issues, please read my post on Sleep Training Mistakes and Pitfalls.

General Recommendations:

• Be consistent: The number one reason I see families fail at extricating their child from their bed is that they are inconsistent. Either your child is sleeping in your bed or he or she is not. If you relent even once in a while during the process of establishing a new sleeping pattern, you will reinforce the behavior you are trying to extinguish. Remember that intermittent reinforcement is a powerful mechanism for encouraging undesirable behavior. (Again— if your kid comes into your bed once a while, and you do not regard this as a problem, you don’t need to proceed with any of this).
• Have a plan: To be consistent, you have to know exactly what you are going to do. It is hard to come up with good plans on the fly in the middle of the night. Make sure that all caregivers are on board with the plan.
• Have a “quit date”: I highly recommend that you mindfully chose a time for a change and do not, say, start a change the day before a vacation, or before your mother in law comes to visit
• Make your child’s room special: Some children may be apprehensive about spending time alone in their room. Spending fun and special one on one time. Take him to pick out some new pajamas and sheets. Pick out a new stuffed animal to use as a transitional object.
• Move into your child’s room first: It’s not fair to expect your child to start sleeping by herself in an unfamiliar place. I advocate moving with your child in her room for a week or so before starting to withdraw your presence.

Based on type of co-sleeping

• Reactive cosleeping: Your child comes into your bed at night but in theory they are supposed to sleep in their room.
  • Addressing sleep onset associations:(): This is the most important thing to do: How your child falls asleep is the key to successful sleep. Sleep onset association are when your child falls asleep under circumstances absent during the night: usually this involves you being present when he falls asleep. These sleep onset associations may be subtle. Do you turn out the lights and then have to go back in to settle your child? Does he come out of the room multiple times at bedtime until you lay down with him.
  • One of the most challenging forms of reactive cosleeping is due to  early morning awakenings. Although it is really tempting to just relent at 4 or 5 in the AM, if you want your child to stop this behavior, they will not do it on their own. In this scenario, I recommend the OK to wake clock. The correct way to use this is to set the “OK to wake” alarm to 10 minutes after their usual wake time, and then move it 10 minutes later a day.
  • Sleeping bag on floor: For children who come into your bedroom on his or her own, I highly recommend that you provide them an option for sleeping in your room without disturbing you. A sleeping bag and pillow on the floor is a great solution for a transition. Many children will stop using this of her own accord with time, especially once they realize that it is not as comfortable as her own bed.
  • Bringing you child back to her room every time: If your child does not want to sleep on your floor and insists on disturbing you every night, you need to walk him back to their own room. Every time. Most kids will not pitch a huge fit in the middle of the night. If they do, you can employ the door closing strategy. This means bringing your child back to bed with the expectation that he will stay in bed. If he gets up and leaves the bed you close the door for one minute and hold it shut. If you open the door and he is not in bed you close it for two minutes, and increase as needed. This is a nuclear option, but sometimes it needs to be employed.
• Intentional cosleeping: Your child sleeps in your bed every night for the whole night, and this is a long-standing pattern. In this scenario, many families want to stop once they are expecting another child, or their child hits a milestone such as kindergarten. In this scenario, you need to go gradually. Why is this different? Often your child does not know another way to sleep.
  • Discuss with your child at an age appropriate level. Often this transition may happen at an older age. Be honest. Tell her that she is a big girl now and is almost ready to spend the night in her own bed. Tell her that Mommy and Daddy (or Mommy, or Daddy, or Daddy and Daddy, or Mommy and Mommy) need some time by themselves.
  • Start moving bedtime into your child’s room: If your child spends the whole night in your room, start doing all of bedtime in his room and then moving him into your bed for a few days, as a dress rehearsal for spending the night in his own bed.
  • Napping in her bed first:If your child is still napping, this may be a good time for your child to practice sleeping on her own.
  • Bedtime fading (moving bedtime later) can be a big help with this transition.
  • Consider camping out If (you or) your child is very apprehensive about this, consider a “camping out” approach where you temporarily move to an air mattress on the floor of your child’s room. I would recommend NOT bed-sharing at this point to smooth the transition.

Other questions that may come up:

• How long will this take? It is somewhat hard to predict. It may go really smoothly if your child is ready for this change and take a day or two. In other children, who may be more reluctant, you may need to go more slowly. I would expect this to take no more than two weeks. If you try to stop cosleeping and it is a disaster, I recommend discussing it with your pediatrician or a sleep specialist. However, remember the extinction burst: your child’s sleep will typically worsen before it improves, and such difficulties may occur 2–3 days in.
• What if my child gets sick/has a nightmare, etc?I would encourage you to try to follow your plan as strictly as you are comfortable. A quick cuddle in the middle of the night in their room is OK; bringing him into your bed for the rest of the night may undo weeks of hard work. I would say that if you are not ready to be firm on this topic for a month, I would hold off for a bit. After your child is successfully sleeping in his bed for a month or so, I think that it may be OK to bring them into your bed if you really have to (e.g. if he is running a high fever) with the understanding that you may need to be a bit firm afterwards.
• What if I’m not sure if I am doing the right thing? If you are ambivalent and telegraph that to your child, you are setting you both up for failure. Perhaps you should wait for a bit. However, if you have come up with a plan and started executing, I encourage you to follow through in spite of middle of the night misgivings. Give it a week. If you stop too soon, you and your child have suffered for nothing, and possibly made it more difficult for yourselves in the future. I think you can do it.

So this has turned into an epic post. Let me know if you have other thoughts on this topic, or questions I have not answered. Also, if you have successfully navigated this transition, please let me know what worked for you.