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Dreaming of Sleep?

Courtney Hill, 28, of Fort Washington, Maryland, is doing it all. All except sleeping, that is. Hill, mother of Zoe, 7 months, and Denver, 5 years, commutes 2 hours a day to Washington, D.C., to work as an office manager and gets up twice a night with Zoe, whose teething keeps both Mom and baby awake. Since her partner, Aaron, 33, an officer in the Navy, is stationed three hours away and preparing to ship out to Kuwait, "Mom isn't getting much sleep," says Hill.

Hill is hardly alone. A new mother loses 200 hours of sleep in the first year of her child's life, according to a recent poll by The National Sleep Foundation (NSF). The irony is that newborns can keep Mom awake while still getting 16 to 20 hours of shut-eye themselves. That's because infants rarely sleep more than a few hours at a time and don't differentiate between night and day, according to NSF research. This cycle of interrupted, insufficient sleep can leave women irritable, lethargic, and more prone to depression. What's more, it can affect a woman's ability to think through and perform even simple tasks. These are the months when the prospect of taking a shower seems akin to scaling Everest, the drama of "Barney" can produce tears, and folded laundry ends up in the refrigerator.

The fact that new moms are sleep-deprived is hardly news. "Every woman with a newborn goes through several months where sleep is terrible," says Meir H. Kryger, M.D., past president of the American Academy of Sleep Medicine and author of the new book A Woman's Guide to Sleep Disorders.

But parental lifestyles have changed recently in ways that make getting a good night's rest even more challenging. For instance, 54 percent of women with children under age 1 now work outside the home. Increasing rates of breastfeeding mean that dads can't necessarily take a night shift during those early pre-bottle weeks. About a third of babies are born to single mothers, so there may not be someone else to take over when things get rough. Plus, work hours and commutes are longer than ever, leaving at-home moms with less help on hand.

While a new mom's sleep-deprivation can be extremely stressful, it's usually temporary. By 6 or 7 weeks, babies begin to spend more time sleeping at night than during the day; by 4 months they may sleep between five and eight hours at a stretch; and by 6 months they should settle into a pattern of a solid five to eight hours each night that, when not interrupted by teething, earaches, or other illnesses and discomforts, allows parents to get something resembling a normal night's sleep.

To keep you going until that point, BabyTalk interviewed some top sleep researchers and a few well-rested moms. Their proven and innovative approaches will surely help you get better sleep -- and more of it.

Making it through the night

Tara Kron, 27, of Mantua, New Jersey, not only gets up every two to three hours with son Zachary, 3 ½ months, but like many of her peers, started out motherhood exhausted. "I really couldn't sleep well during pregnancy. Towards the end I was very uncomfortable," Kron recalls. About 78 percent of moms-to-be report increased sleep disturbances, according to the NSF. This leaves moms with a "sleep debt" that only increases after childbirth.

So how can exhausted new moms catch up on sleep before it catches up with them? For parents who aren't single, experts say the first line of defense should be Dad. "Most couples today accept that there needs to be a sharing of responsibilities," says Dr. Kryger. Popular advice suggests letting Dad give one feeding at night so that Mom can get a few extra hours' sleep, which works well for some families.

But researcher Kathryn A. Lee, Ph.D., who studies sleep in pregnant and postpartum women, urges new moms not to lock themselves into a "one size fits all" strategy. "Sometimes it's more sane to have at least one person functioning on all four cylinders," adds Lee. If Dad isn't on the night shift, he can help by coming home early from work and giving Mom a chance to do something for herself.

This strategy worked for Cozette Carlisle, 39, of Alton, Illinois, whose son Johnny refused to take bottles as a newborn. "It was insanity" at first, remembers Carlisle, who often overslept, making her daughter late for school. Finally Carlisle set up a bed in Johnny's nursery and slept there. "All I had to do was stand up, walk four or five steps, pick him up, and nurse him," she says. Husband John got a good night's sleep, and pitched in with baby care when he got home from work each evening.

Dads who have rested are more likely to enjoy positive quality time with their babies, says Lee, and Dad can also take responsibility for dinner -- which doesn't mean he has to be Emeril. Picking up and heating a frozen lasagna or bringing home take-out chicken counts, too.

Breastfeeding at night like Carlisle also may increase the quality of maternal sleep. Lee's research has shown that nursing mothers may be awake longer, yet they get the same total amount of sleep as bottle-feeding mothers. Not only that, but a 2002 Australian study found that breastfeeding mothers got more deep sleep, probably due to increased production of the relaxing hormone prolactin.And what if Dad isn't around, as in Courtney Hill's case? Hill has a few trusted friends who will take the kids on weekends and let her catch up on much-needed rest. "When things are tough, there needs to be someone to give the new mother respite to sleep undisturbed for a night or two," says Dr. Kryger. He suggests that if a close friend wants to know what baby gift you'd really like, ask for one overnight stay a week during the baby's first month.

Routines for rest

Once Hill settles Zoe and Denver down for the night, she grabs a glass of wine and catches up on her favorite TV shows or household chores, meaning she may end up doing the wash at 11 p.m. Experts say many moms, like Hill, set up soothing bedtime routines for their babies but never consider the benefits of doing the same for themselves.

"It's a common assumption: 'It's only 9 p.m., now I can make my phone calls, respond to my e-mails, and fold laundry,'" says Amy Wolfson, Ph.D., a sleep researcher and author of The Woman's Book of Sleep. "It would be better if she started getting ready to go to bed."

An effective adult version of a bath, lullaby, and Goodnight Moon might include a warm bath or shower, stretching, and a light snack. Tara Kron has found that showering at night not only relaxes her, it means she can get an extra 15 minutes of sleep each morning before work. Denise Austin, a fitness expert and mother of two, recommends yoga and stretching because breastfeeding, bending over to change diapers, and hoisting a baby carrier can stress even fit bodies, and because unlike aerobic exercise, it won't raise your heart rate and make you wakeful.

And if, like Hill, you indulge in wine to relax, replace it with a glass of milk or light snack. "Using alcohol at bedtime is a huge mistake," says Dr. Kryger, because alcohol can cause night waking. Wolfson adds that going to bed either hungry or stuffed makes sleeping more difficult. Austin prefers a snack of low-fat yogurt, which boosts calcium (especially important while breastfeeding). And while research is not conclusive, some feel that dairy products can make you sleepy thanks to the amino acid tryptophan.

So when should your sleep routine start? "Earlier!" says Lee. "No late-night TV. Tune into the 10 p.m. news instead of the 11 p.m." Of course, this depends on how early your baby goes to sleep, and Wolfson adds that early bedtimes may leave moms who are lifelong night owls staring at the ceiling. "Everyone is different," says Wolfson, who suggests gradually adjusting your bedtime by 15 minutes a night.

If television is part of your nighttime routine it should not be watched in the bedroom, which Dr. Kryger says should be a quiet, soothing sanctuary reserved for sleep and sex (light reading and soft music are also permitted). If a total ban on bedroom TV feels like too much, banish the box until your baby is sleeping more during the night.

Getting a good start

A morning routine can help rouse you as effectively as one at night can help you sleep. Experts say a small amount of caffeine (check with your pediatrician if you're nursing), a dose of natural morning light, and moderate exercise can give you the boost you need to start your day.

An eight-ounce cup of coffee is the equivalent of a 20- to 30-minute nap, says Wolfson. But she cautions moms not to fall into a caffeine trap, like Tara Kron, who now depends on several caffeinated beverages a day to keep going. More than 200 milligrams of caffeine can cause sleeplessness -- a regular cup of coffee has between 110 and 250 milligrams, while a diet soda has around 30.

Because new mothers have a chaotic sleep schedule, their natural "clocks" (circadian rhythms, which program when we're sleepy and alert) are disrupted and must be reset each morning. One of the best ways to set your clock for the day, according to Wolfson, is a dose of natural or bright artificial light. Research has shown that 30 minutes to an hour of light therapy can postpone exhaustion in shift workers.

A short 10- to 15-minute morning walk with your baby in the stroller or jogger is a great way to combine "light therapy," quality time with baby, and exercise. "Walking with the baby really helps with the stress of work and seems to give me more energy," says Kron, but adds, "It seems like we start it one week and then don't follow it up the next week." The problem is Kron and her husband, both fitness buffs, immediately attempted long daily walks. Denise Austin says 10 minutes of walking is all it takes to get the oxygen flowing through muscles and adds that more than an hour of exercise a day will leave even the fittest new mother exhausted. It's also easier for new moms to stick with a routine when it's manageable.

Wolfson adds that new mothers should never choose exercise over sleep: If you are too tired, if your husband offers to go in to work late, or your baby chooses to "sleep in," take advantage of the opportunity. "There isn't really a substitution for sleeping," says Wolfson.

Getting more rest

Courtney Hill drops her children off at daycare and arrives at work around 7:45 a.m., giving her time for a catnap in the office before coworkers arrive. "And since I work in a leafy neighborhood near a university, at lunch, I sit in the shade and catch a little nap." (Women, of course, should always use caution when napping in public places.)

Sleeping on the job? It may sound unconventional, but it's a great way for working moms to catch up on badly needed rest. "Some women are in a job situation where instead of going out to lunch they may be able to put their head down and take a twenty-minute nap," says Wolfson. She points out that the workplace has become more flexible, and jogging or pumping breast milk at lunchtime are now accepted, so why not sleeping? She urges employers to "rethink the space of work" creatively to find napping nooks where overtired employees can recharge. Hill's office offers a "quiet room" for this purpose.

The latest sleep research from Japan also indicates that there are ways for daytime nappers to maximize their energy boost. Young adults in a Japanese study felt less sleepy if, after a 20-minute nap, they drank a caffeinated beverage, were exposed to bright light, and/or washed their faces. Wolfson suggests that working mothers limit themselves to 20- to 30-minute "power naps," since research shows that longer naps can leave you groggy.

For at-home mothers, Wolfson cautions against napping in the same room with your baby. Adults naturally have trouble with daytime sleep and need a darkened, quiet environment that resembles night as much as possible. A baby, on the other hand, needs to learn to differentiate between night and day, and spending hours in a darkened room could lead to more nighttime waking.

The bottom line, says Lee, is that new mothers are going to be tired. And in her studies she has found that, while they plan everything from the nursery border to their maternity leave, moms-to-be seldom plan for how they are going to get more rest. "It requires accepting that you cannot keep burning the candle at both ends," she says. "You need to know it's normal to feel tired because your sleep patterns have changed. You need to plan and take breaks so you have more energy."