讓寶寶有更好睡眠的 ABC

ABC of Better Baby Sleep

資料來源網站 http://www.appsasleep.org/node/17/download/6abb82a1e983768dfda93404633d58e0

周醫師的點評: 個人曾參與APPSA運作十年以上, 此一專家團體對兒童睡眠投入許多努力, 以下小冊希望對想要幫助嬰幼兒有更理想睡眠的照顧者有所幫助

Asia Pacific Paediatric Sleep Alliance in partnership with JNJ 亞太兒科睡眠專家聯盟 與嬌生公司為合作夥伴

In recognition of the importance of quality sleep in infants and toddlers, this educational leaflet aims to provide information and advice to parents and caregivers to help their babies have better quality sleep. In recognition of the importance of quality sleep in infants and toddlers, this educational leaflet aims to provide information and advice to parents and caregivers to help their babies have better quality sleep. 由於認知到良好品質的睡眠對嬰兒與學步兒的重要性，我們特別編寫了此一教育性小冊，目的在於提供父母與照顧者符合醫學學理與臨床有用的資訊與建議，以幫助孩子養成良好的睡眠品質。

1. Effects of Disturbed or Inadequate Sleep –On Both You and Your Baby 受干擾或不足的睡眠導致的效應- 對您以及您的孩子

Adequate and restful sleep is essential for a child’s social, cognitive and physical development. Sleep, learning, mood, performance and health are closely related.

足夠而平穩的睡眠對於孩子的社會、認知以及身體發展是必要的。睡眠與學習、情緒以及日常表現與健康都有密切的關係。

Insufficient nighttime sleep in a baby can lead to -• Daytime sleepiness • Irritability • Developmental problems in learning and memory • Behavioral changes such as aggressiveness and hyperactivity • Accidental injuries • Disturbance in immune and metabolic functions

不充足的夜間睡眠可能使孩子產生以下情形: • 白天想睡覺 • 躁動不安 • 學習與記憶上的發展問題 • 行為上的改變例如攻擊性與過動 • 意外傷害 • 免疫與代謝功能上的干擾

Insufficient sleep in babies can also cause adverse effects in parents such as - • Parental frustration and distress • Maternal depression • Disrupted family functioning

不充足的睡眠也可能對嬰兒的父母親造成不利的影響如下: • 父母親的挫折感與焦慮 • 母親的憂鬱 • 家庭的正常功能受損

2. Is My Baby Getting Enough Sleep? 我的寶寶是否有得到足夠睡眠?

Since infants and toddlers have very different sleep patterns compared with adults, parents may wonder if their babies’ sleep patterns are normal and healthy. The chart below offers a general guideline on what to expect: 由於嬰兒與學步兒相較於成人有相當不同的睡眠型式，父母親常會擔心寶寶是否有正常而健康的睡眠型式。

以下表格提供一個一般性的嬰幼兒睡眠指引:

(1) 新生兒-2個月嬰兒 10.5-18小時 沒有規律而可定義的睡眠型式

(2) 2個月嬰兒-12個月 14-14.5小時 轉變為較長的夜間睡眠；明確的白天小睡

(3) 12個月嬰兒-36個月 13-14小時 持續在夜間有長時間睡眠；白天需要小睡的需求逐漸減少

3. The Global Sleep Survey 全球性的嬰幼兒睡眠調查 APPSA in partnership with Johnson & Johnson captured the cross-cultural sleeping habits of almost 30,000 babies aged 0-36 months across 17 countries, including most countries in Asia. This is the largest survey of baby sleep habits ever conducted. Using the Sleep Survey data, we have identified three parent interventions, which can significantly improve the amount and quality of sleep in babies.

亞太兒科睡眠專家聯盟與嬌生公司共同合作進行了一項跨國性及不同文化背景的0-3歲嬰幼兒睡眠調查，涵蓋了17個國家，也包括了大部分亞洲國家。致是迄今最大型的嬰幼兒睡眠調查。藉由此一調查，我們已經找出三種父母親的介入方式，可以有效的改善嬰幼兒的睡眠時數以及品質。

#A regular bedtime routine 建立一個規律的入睡前例行習慣

#Bed before 9pm 夜間上床時間應在九點以前

#Children learn to fall asleep on their own 嬰幼兒要學習自行入睡

 

#A regular bedtime routine 建立一個規律的入睡前例行習慣

The Global Sleep Survey showed that: 全球性的0-3歲嬰幼兒睡眠調查顯示:

• With a bedtime routine 86% of babies fell asleep within 30 minutes. ．若有建立規律的入睡前例行習慣的嬰兒有86%在上床後30分鐘內可以入睡 

• Parents with a regular bedtime routine reported less bedtime problems with their babies like fussing, crying or protesting. 父母親若有規律的入睡前例行習慣常陳述他們的嬰兒較少有睡前問題例如吵鬧、哭泣以及抗議 

• Babies with a regular bedtime routine had earlier bedtime, longer nighttime sleep and less night wakings. 嬰兒若有規律的入睡前例行習慣會有較早的入睡時間，較長的夜間睡眠以及較少的夜間甦醒次數

 

What you can do 您能幫助孩子做甚麼?

Establish a regular bedtime routine to help your baby fall asleep faster. 建立規律的睡前例行習慣可以幫助孩子更快入睡

It will also benefit the family with a more pleasant bedtime experience. Refer to the section on “3-Step Before-Bed Routine” for a clinically proven routine. 此一做法能使家庭獲得更為愉快的睡前經驗。請參考”睡前例行習慣三步驟”章節，它是一個經過臨床證實的例行習慣做法。

When to start a bedtime routine? 何時應該開始訓練寶寶的睡前例行習慣

While it may be best to start a routine when you first bring your baby home, it may be difficult for some parents to settle into a routine immediately, since having a newborn requires major adjustments in the household. A good time to start would be when the baby is 1-2 months old. This is when most babies shift toward longer nighttime sleep and families are past the initial adjustment phase of having a baby in the home.

雖然開始訓練睡前例行習慣的最佳時間，是在將寶寶從醫院帶回家之後，但是對於某些家長而言，要立即將寶寶帶入此一習慣可能相當困難，因為家庭有了寶寶後可能需要做很大的調整。因此，開始建立睡前例行習慣的較好時間可能是在孩子1-2個月大時。此時大部分寶寶已經出現較長的夜間睡眠，而且家庭也度過了最初有新生嬰兒進入家中的調整期。

#B ed before 9pm 夜間上床時間應在九點以前

Results from the Global Sleep Survey suggest that: 全球性的0-3歲嬰幼兒睡眠調查顯示:

• Babies who go to bed before 9pm sleep an hour more (9.9 hours) than those who go bed after 9pm. 在夜間九點以前入睡的孩子比九點以後入睡者會多睡一小時之久(9.9小時) 

• The babies who slept less at night did not tend to make up the “lost” time during the day through napping. •在夜間睡得較少的孩子無法在日間小睡中補充失去的睡眠 

What you can do 您能幫助孩子做甚麼?

Put your baby to bed early (before 9pm) on a regular basis. 儘量每天規律地將寶寶早些(在晚上九點以前)放在嬰兒床上

This may require some adjustment of the family’s lifestyle, but the results are worth it! 此一動作可能會導致家庭的生活型態需要做些調整，但是依照獲得的結果而言是值得的

When to start a bedtime before 9pm? 何時應該開始規律地將寶寶在晚上九點以前放在嬰兒床上?

Start in conjuction with beginning a bedtime routine when the baby is 1-2months old. 當孩子已經1-2個月大時就可以開始協助建立晚上九點以前上床的規律習慣

#Children learn to fall asleep on their own 嬰幼兒要學習自行入睡

Feeding or rocking the baby to sleep or simply being in the room or bed when the baby falls asleep develops a sleep association, such that the baby needs the parent to be around every time he/she wakes up at night. A baby who is rocked to sleep at bedtime will need to be rocked back to sleep when he/she wakes up!

如果藉由餵食或者搖晃使孩子進入睡眠，或者只有在孩子已經睡著了之後才抱他進入嬰兒房或者床上，都會形成一種與睡眠的不當連結，此後只要孩子在夜間醒來，父母親就都要出現在身邊才行。更甚者，平時需要被搖晃身體才能入睡的寶寶在半夜醒來時，也需要再次地搖晃身體才能再度入睡。

What you can do 您能幫助孩子做甚麼?

Let your baby learn to fall asleep on his/her own. 讓孩子能夠依賴自己進入睡眠

You can still do quiet activities (e.g. feed, rock, sing, etc) as the last activity before your baby sleeps, however your baby should be put down drowsy but awake so he/she can fall asleep on his/her own. 在孩子入睡以前，您仍可以給予較靜態的活動(如餵食、輕輕搖晃、唱兒歌等)，但是您應該在孩子有睡意而沒有睡著以前，就把他放在床上，以便他能自己入睡。

When should your baby learn to fall asleep on his/her own? 您的孩子何時應該學會自己進入睡眠？

3-6 months of age is a good time to start. By 6 months, your baby is able to settle and soothe himself/herself to sleep and since habits are not too engrained, they are not difficult to change. 3-6個月大左右是一個好的時機。到了六個月大之後，孩子就能自我安靜下來並安撫自己進入睡眠，並且由於此時的習慣還沒有過於根深蒂固，而不會太難以改變。

What if my baby sleeps in the same bed or room as me? 如果孩子是跟我一起共床或共房呢?

Even in these circumstances you can still let your baby fall asleep on his/her own (instead of rocking or feeding to sleep) without leaving the room. 即使在這種情形下，妳仍能在不離開房間的情形下，讓孩子能夠依賴自己進入睡眠，而非以搖晃或者邊吃邊睡方式

@The 3-Step Bedtime Routine 三步驟的床邊睡眠例行習慣

The 3-step bedtime routine consists of a warm bath, gentle massage and quiet activities before sleep.

The 3-Step Bedtime Routine is clinically proven to: 三步驟的床邊睡眠例行習慣包括溫水澡，溫柔的按摩以及靜態的床邊活動。

它已經被研究證實有以下效果:

• Help infants fall asleep faster 幫助嬰兒進入睡眠的時間快一些

• Decrease the number and duration of night wakings 減少夜間醒來的次數與期間

• Increase the duration of consolidated sleep • 增加穩定而深度睡眠的期間

#Step 1: Warm Bath 第一步驟:溫水澡 A warm bath (or towel bath) and your comforting touch will help your baby relax and let go of the excitement of the day.

一項溫水澡(或毛巾浴)以及您對孩子安撫性的撫摸，都可以幫助孩子放鬆以及將一整天以來的興奮情緒驅離。

#Step 2: Gentle Massage 第二步驟:溫柔的按摩 Massage is a great way to relax your baby. It’s also a wonderful way to bond with your baby. After drying your baby and before you dress him/her for bed, apply a small amount of baby lotion or oil into the palms of your hands and try giving a gentle massage.

嬰兒按摩是讓您的寶寶放鬆的最佳方式。它也是連結您與寶寶有正向依附的很好的方式。在幫孩子洗澡後擦乾身體，還沒有穿上衣服放上床之前，可以將少量嬰兒乳液或嬰兒油放在您的手上，嘗試為孩子做輕柔的身體按摩。

What you can do 您能幫助孩子做甚麼? There’s no one way to massage your baby – provided you know how to do it safely. Remember to take your baby’s cue on what is best for him/her. 假如您知道安全的進行按摩，它並沒有單一或固定的按摩方法。要記得掌握孩子最喜歡的方式，而調整按摩的做法。

#Step 3: Quiet bedtime activities 第三步驟:靜態的床邊活動 Ease your baby off to sleep with quiet time together; speak softly, sing lullabies, read him/her a story – whatever you do, your quiet time is about the warm, cozy feeling your baby gets from sharing this special moment with you.

讓您的寶寶輕鬆地經由一些靜態活動進入睡眠，例如輕聲講話、唱兒歌、講故事等，不管您做些甚麼，這些靜態活動是讓寶寶感受到有一種溫暖、舒適的感覺，並且是由他與媽媽共同分享的特別時刻。

What you can do 您能幫助孩子做甚麼? To ensure a good night’s sleep, your quiet time should not exceed 20 minutes. 為了確保良好的夜間睡眠，您的靜態活動時間不要超過20分鐘。