Does sleep training have any long-term effects? Does it affect attachment?
How will sleep training affect my child?
If you’re even asking yourself the question, “Will sleep training damage my child’s attachment?” or “How does sleep training affect attachment?” or even, “Does sleep training have any long-term effects?” You are a great parent!
These are common questions I get asked on my discovery calls, so I figured it’s time to get into it and give you all the research you need to know about sleep training and how it may - or may not - affect your child.
Does sleep training have any long-term effects?
In a five-year follow-up of a randomized trial of the harms and benefits of behavioral infant sleep intervention (aka sleep training), researchers Price, et al, found that “behavioral sleep techniques have no marked long-lasting effects (positive or negative). Parents and health professionals can confidently use these techniques to reduce the short- to medium-term burden of infant sleep problems and maternal depression.”
They looked at various factors including (1) children’s emotional and conduct behavior scores, sleep problems, sleep habits score, parent- and child-reported psychosocial functioning, and chronic stress; (2) child-parent closeness and conflict, global relationship, and disinhibited attachment); and (3) parent depression, anxiety, and stress scores.
Since there was no difference between the group of children when behavioral sleep interventions were used and those when none were used, we can conclude that there are no long-term effects and that sleep training may improve the sleep quality of a household if used as a strategy for helping a child or children sleep better.
It’s both humorous and logical that there aren’t many more studies on this out there. In a recent (2022) study on the implementation of behavioral sleep interventions (sleep training), researchers Kahn, et al, found that “implementation of BSIs (behavioral sleep interventions) outside clinical settings is pervasive and occurs earlier than generally recommended. Unmodified and Modified Extinction were associated with longer and more consolidated infant sleep. Despite concerns regarding the potential harm of BSIs, implementation of these approaches was not linked with negative outcomes, providing additional evidence for their safety and effectiveness.”
Universally, over the last few decades, researchers have continued to find the same thing - sleep training has no long-term effects and seems to be a valid choice for families to use to improve their child’s sleep skills.
What about crying and stress levels during sleep training?
Let’s reframe our thinking around crying. Crying does not necessarily mean something is wrong. It can mean a variety of things: hunger, frustration, something is actually wrong (illness, fever, pain), your baby doesn’t like something, etc. Young children, and especially babies who are not yet verbal, communicate by crying. It’s okay for babies to have feelings - they are people after all! Crying = communication. If you know all your baby’s needs are met, you can probably assume that your baby is just having some feelings about something. That’s okay!
There are three types of stress to consider when we’re talking about it in the context of child development that may cause a child to cry or have some negative feelings - positive stress, tolerable stress, and toxic stress. The stress a child experiences in their early years will affect how their brain develops. As one might guess, we want to avoid our child experiencing toxic stress, especially in the early years of critical brain development.
As defined in her research, Hillary A. Franke states that toxic stress “results in prolonged activation of the stress response, with a failure of the body to recover fully. It differs from a normal stress response in that there is a lack of caregiver support, reassurance, or emotional attachments.”
The key words here are “prolonged activation” and “lack of caregiver support, reassurance, or emotional attachments” - neither of which are present with sleep training. In opposition, she writes that “A positive stress response is a normal stress response and is essential for the growth and development of a child. Positive stress responses are infrequent, short-lived, and mild. The child is supported through this stressful event with strong social and emotional buffers such as reassurance and parental protection. The child gains motivation and resilience from every positive stress response, and the biochemical reactions that occur with such a stressful event return to baseline [5]. Examples include meeting new people or learning a new task.”
Believe it or not, learning a new task - like learning how to sleep independently - is a positive stressor. Regardless of the sleep training method chosen, the child is supported through the stressful event (really, a positive stress event), whether it’s with contextual factors like an age-appropriate daytime schedule, quality bedtime routines, and an environment that is conducive to sleep, or emotional and/or physical support with the method itself
You might compare sleep training, or teaching independent sleep skills, to any other learned skill: riding a bike, learning to read, mastery of a musical instrument, etc.
Here’s some food for thought: If you’re not focusing on sleep training, I’m guessing your child may be crying a lot now as it is. They may be difficult to settle because they’re tired, yet they don’t know how to go to sleep on their own. Or maybe you’re not sure what they need. Are they hungry? Are they tired? What now? After teaching your child the skill of independent sleep, you may notice that there is actually a lot less crying and fussing in the long run because it’s a skill set they now have; you don’t have to guess if they’re tired or not. You’ll know. And you’ll know how to respond. And that means fewer tears for everyone!
If you’re confident that this is something you’d like to do for your child, I say go for it! And if you’re confident this is something you want to do but don’t know how to do, that’s where I come in. I help families teach their children to sleep independently to promote healthy brain development and to ensure the whole family is getting the sleep they need to be happy, healthy, and well-rested. You can view my services or get in touch if you’re interested in learning more about working together
Sources
Price, A. M., Wake, M., Ukoumunne, O. C., & Hiscock, H. (2012). Five-year follow-up of harms and benefits of behavioral infant sleep intervention: randomized trial. Pediatrics, 130(4), 643-651.
Kahn, M., Barnett, N., & Gradisar, M. (2022). Implementation of Behavioral Interventions for Infant Sleep Problems in Real-world Settings. The Journal of Pediatrics.
Franke H. A. (2014). Toxic Stress: Effects, Prevention and Treatment. Children (Basel, Switzerland), 1(3), 390–402. https://doi.org/10.3390/children1030390
