5.5mo waking tons, feeling pressure to bring in sleep specialist.

[okinawamama]

For some reason, it took having my mom out visiting me to realize just how completely terrible our nights are. I mean, I knew, but having someone a little more removed from the situation see/tell me, really opened my eyes. So, here I am. I need help with these ridiculous NW!

My son has never been a good sleeper at night, but when he hit about 3.5 months we went from 2-3NW, to where we are now with 2-10NW and often a 2hr NW thrown in.

Here's the pertinent info
*Ds is 5.5mo old
*he has a paci, and I don't *think* it's an issue (however, he's woken at the 45minute mark twice this week and went back with the plug of the paci ). He sometimes stirs at the 45min mark but goes back on his own.
* he is not swaddled during the day, but has one arm swaddled at night (tried going unswaddled many times at night and he's harder to settle). We are going slowly on the wean.
* He is BF
*he sleeps with white noise
* We are working on independent sleep. I'd say 95% of sleeps during the day he falls asleep in his crib and I shh/pat the least ammount I can get away with. BT however, Id' say we're 50-50 on whether or not he falls asleep in the crib. If he won't settle in his crib I walk him around the room until I see his eyes close for about 30 seconds and then lay him down. He often cries out but settles quickly with shh/pat.
*We just started solids this week and haven't seen a change in NW's
Here is a typical day

A:7ish (varries by 30ish minutes)
E: BF 730
A:
E: solids 830
A:
s: 9:30-1045/11
E:1100ish BF
A:
E:130 BF
A: just a diaper change
S:145/2 -4
E: 430ish BF
A:
E: 530ish
A:
E: 645BF
S: 715

*this is where it gets hairy
A: 745
A:  805
A: 905-9:30 *tried settling but wouldn't so I fed around 930 and laid him down asleep, he woke about 5 minutes later, but settled easily
E:1am fed him and laid down asleep
A: 110
A: 330
A: 515 laid down next to him and fed him to sleep, it took about 25 minutes to get him to sleep
A: for the day at 700ish

Unless noted that I fed him, I try and settle in his crib, if he doesn't settle after a little while I pick him up and walk him around the room for a bit. This night we didn't have a loong NW, but those happen pretty frequently as well. There are nights where he randomly sleeps great, 1NW and goes right back down, some nights he sleeps ok, 2 NW and easy to settle, but those nights happen about 3 nights a month. 

so, what do you think? My mom would like to see me bring in an outside sleep specialist but  I told her I'd feel more comfortable asking you ladies

[mmom]

((HUGS)) Wakings that close to bt are normally OT for us.  Do you think that last A is too long and causing those NWs?  Normally at this age, there is a CN in there.

Is teething a possibility?

Any signs of discomfort during the waking hours?

[~Sara~]

Wakings that close to bt are normally OT for us.  Do you think that last A is too long and causing those NWs?  Normally at this age, there is a CN in there.

That's what I was thinking, too.  It's okay if his days get a little bit longer if you have to add in a catnap (right now he's doing a 12h day, but some LOs can do more until the catnap is dropped).

[okinawamama]

I do try and do one if he takes a short nap in the day but do you think there's time to squeeze in a CN after 4?  He'd need at least 2.15min A time before he'd go back down, and the only APOP we have is the sling ( he doesn't falla sleep in a swing, carseat, stroller....) and even that is hit or miss.

I have tried medicating him just in case teeth were at play, but it didn't make a difference.

We did have an interesting day yesterday, for some reason he took 45 minute naps all day, but we went on to have one of our best nights in ages. He woke at 10pm (after an 8pm bedtime) and then not again until 3:30 (but wouldn't settle again until 5...ugh). For us, that stretch is amazing! We've had a similar day today because we were out at an airshow for a large chunk of the day so naps were short and hard to come by ( napping with jets roaring by is just about imppossibl ).

[Tweakster]

Like Kara, I was going to ask if he's teething Steph.  Is his reflux still controlled?  There;'s usually a flare during teething and as their tummies get bigger.

Agree those are some high A times there, I think he's accumulating OT.

[C&B&E]

Is his reflux still controlled? 

I was going to ask the same thing.  I would really be questioning whether it is - it sounds like he has always struggled and perhaps this is actually the issue  .  I remember for months and months with DS thinking he was OT or teething...we had 8-10 night wakings most nights..and it was only when we changed his reflux meds that he slept through the night *immediately*  .  Worth seeing your GP for a trial of something stronger than ranitidine?  Two weeks on a ppi would tell you whether it is reflux.

x

[okinawamama]

I really feel that the reflux is under control, he doesn't have any other symptoms other than night sleep issues. I could talk to the doc about it, but all I have to "justify" a med increase is bad nights.

His A times are on the high side but about a month ago we started having some short afternoon naps, which I thought were OT, so I cut A times, but short naps persisted. One day someone on a birthboard suggested an A time increase, so I tried it and the naps began to lengthen, so we went with it.

So, after the air show and bad naps, we had a semi decent night.
A: 7ish
e: 7:30
A:
E: 9 am solids
A:
s:940-1020
E: 1130
A:
E: 1230 solids
A:
S: 130-150
A:
s: 235-320
E: BF
A:
E: 500
A:
E: 615
S: 645
*NW*
745 easily resettled
1230: BF and went down pretty easy
330 BF
400
420
600-700 would cry out occasionally but resettle on his own

I think I need to go over and post on the naps board. In a 24hr period  he's gone from sleeping 3-4hrs a day, to 1.5ish hrs. He wakes from every nap happy and looking around, so you'd think an A time increase, but his A times are already so high it seems like any more is recipe for disaster. Today we stayed home to try and get him to go back to his decent day sleeps, but again, 45 min naps every time

so, that brings me to my next ?. The past three days we've had the lease ammount of day sleep we've had in a while, but we're getting some decent (for us anyway ) nights. Is it just a fluke or do you think that he was getting too much day sleep (which who knows, maybe I don't even need to worry about that now with our short naps....sheesh!).

[mmom]

I really don't think it is too much sleep.   That last A is probably too long, especially on that short nap, which is why you are having NWs so close to BT.

[okinawamama]

yesterday we had more short naps...grr.

I dont have my log with me but I know the day ended like this
S: 4:15-4:55
E: 530
A
E: 615 solids
A
S: 750 tried at 7 and he just looked around the room, played with his paci and sang, I stayed in the room to try and get him tto sleep and he finally fell asleep at 750
A: 11bf
A: 3 bf
A: 515
A: 8 up for the day

Yay for no OT wake up

I guess the part I dont understand is that when I was gettingg a long afternoon nap (2+ hrs)  we'd shoot for a 3hr A time before bed and get a NW close to BT and then about 4-5 additional ones. Then last night he has a 40min nap and a 2hr45min A time to bed and doesnt give me an OT wake up and goes on to havea decent night. gah, baby is awake, another day of short naps around here. what is up with this...i'll be back

[mmom]

When you get a chance, can you post the rest of the day please?

[okinawamama]

Here was yesterday
A: 7
E:730
A:
E:9
A:
S: 945-1045
E: 11
A:
E: 1210
A:
E: one side
A:
S: 135-205
E: 230
A:
S: 415-455
E:
A:
E:
s: 750

what do you think?

[Khalam's Mama]

A  lot of ladies have said to me recently that often the only sign they had for reflux needing meds increase was bad nights and fine in the day esp at this age when they are more upright in the day. I forget are you eliminating anything from your diet? I also wonder if some nights are worse if it is something you ate if he has intolerance (can't remember if he has?)

I always bear in mind that when we get an awful day followed by a good night that sometimes they just crash and it seems like they need less sleep by do it for more than 2 days in a row and they get really OT.

Have you tried a slightly earlier BT rather than a CN if you feel that makes the day too long? The fact he settles worse at BT than in the day says OT to me. With naps he seemed to do better on the shorter A time the 1st day you posted where they were 2.25-2.5hrs rather than >2.5hrs.

What do you think? Hope you had a better day. I know it is hard to be sleep deprived all the time. (not sure why I am offering advice when we have bad NW ourselves!)

[okinawamama]

KM: thanks for popping on. I agree, I need to shorten some of those A times and see what happens. I'm not sure why they were working so well for a while, but for now, I think they're too high. Once we get caught up maybe we can go back. In the beginnning I thougt he had some intolerances, but I'm not sure anymore. I thought we might have some MPSI issues, and I cut out all dairy and soy (even trace ammounts) and didn't every really see a difference. I still try and limit them, but no longer cut them out completely. Things were completely off track before I reintroduced things back in my diet and i haven't noticed any bad affects. I was actually prepared to ask for  ameds wean at our next appointment, I really felt his reflux was under control. I still haven't noticed any other symptoms, but I might bring it up at our 6month well baby and see what the doc thinks.

So last night was a complete disaster, which I expected because he short napped all day and refused a CN, and then, as life goes, we had a birthday party to go to and an early BT wasn't an option. Ugh. So I was up about 7 times.

So, here's today.
A: 8
E: 830
A:
E: 930
S: 10:10-1055, went in a resettled and he woke again at 1105, went in a resettled and he slept until 1150, so about 1.45 min total
E: 1215
A:
E:130
A:
S: 230-315 woke happy and wouldn't resettle
E: 330
A:
E: 430
A:
S: 515-545
A:
E: 715
S: 815 tried starting at 745 and he wouldn't go down until 815

so, I know he didn't go to bed OT, so here's to hoping for a better night.

[Khalam's Mama]

Ok let us know.

[okinawamama]

we didn't have an early NW last night, so that's a positive, unfortunately it's the only one...

Here was last night
S: 815
A/E: 1130
A: 110
A: 130
AE: 215 fed him because I wasn't sure weather or not the frequent wakings were due to hunger
A: 3 and he was up until 5...awful!
A: 730 ( restless from 645-730)

So, it looks like we avoided the early OT wakings, but what do wakings that occur late at night/early morning?

I'm headed to the doc today, I'm not really sure what I'm going to say, but I'm going to ask about a med increase and see what he thinks.