Sleep regression. It’s a phrase you probably didn’t know existed before you had a baby, but now? Now that your baby is waking every 20 minutes, and you are exhausted beyond all reason? Now that your toddler is waging a fierce anti-nap campaign?
Sleep regressions: what they are
A sleep regression describes a period of time (anywhere from 1 – 4 weeks) when a baby or toddler who has been sleeping well suddenly starts waking at night, and/or skipping naps (or waking early from naps) for no apparent reason. Parents often describe being caught totally off guard: you think your have conquered all your little one’s sleep challenges, when suddenly, out of nowhere, you’re back to constant night wakings and nonexistent naps.
Sleep Regressions: When and why they happen
Remember, every baby is different, so what is true for your friends’ babies may not necessarily be true for yours. That is, your baby or toddler may show true regression signs at some of these month markers, but not others.
That said, there are some seasons during which most babies or toddler go through at least a mild sleep regression:
4 Month Sleep Regression
This one’s permanent, folks! That is to say that the changes that happen with the 4 month sleep regression are permanent changes. By 4 months, your baby has ditched her babyish sleeping patterns and is sleeping more like an adult – and that translates into frequent night waking (and lots of fussing) along with shortened naps.
8 Month Sleep Regression
This one is all thanks to the developmental milestones that are happening around 8 months, 9 months, and 10 months. At this stage, most babies are making great strides physically – learning to crawl, to pull up, to cruise, etc. There’s also a lot of brain development happening at this stage. Your baby is absorbing language like crazy! Finally, most babies are cutting at least a few teeth during this season. Add it all up, and you get more night waking, shorter (or even skipped) naps, and one cranky baby on your hands.
11 Month Sleep Regression
This one doesn’t seem to affect as many of our clients as the other regressions do – maybe it’s a less common one? At any rate, this regression has a lot to do with naps – specifically, you might find that your baby suddenly starts refusing his or her second nap, and tries to get by with just one nap. Lots of parents assume that this is a normal nap transition, and that it means their little one is ready for just one nap a day. However, we urge parents to treat this one as a regression instead, since most toddlers really aren’t ready to transition to just one nap a day until about 15 months.
18 Month Sleep Regression
Oh, parents – this one is a doozie. Why? Because now your baby is a toddler – a walking, talking (well, babbling at least), tantrum-throwing toddler. This regression has a lot to do with your toddler’s new-found independence. Separation anxiety also comes into play here; your toddler may genuinely be distressed when you leave at nap time, or when you walk out of the room at bedtime. Finally, teething is still a factor at 18 months – toddlers are often cutting molars (those big, painful teeth!) around this time.
2 Year Sleep Regression
To be honest, the 2 year sleep regression is a little less straightforward than the others. That’s because there are a variety of factors that can cause it. For one thing, your 2 year old’s awake time is growing longer, but as he makes that transition, it can disrupt sleep. Your 2 year old is likely also going through some big life transitions, like potty training and transitioning to a big-kid bed (and maybe even getting a new sibling!) And around 2 years of age, lots of toddlers begin having very real nightmares (or even night terrors). All of this can lead to a very real, very exhausting sleep regression around 2 years old.
Sleep Regressions: How To Move Past Them
You know the what, the why, and the when behind common baby and toddler sleep regression – now how about the ‘how to’?
Well, for starters, remember that the 4 month sleep regression is a permanent change – there is no going back to the way things were. Once you are through the worst of the 4 month sleep regression you will want to focus on helping your baby break her sleep associations, and on heaping her learn to fall asleep without help from you. Once she can do that, she will be well on her way to sleeping through the night, and establishing a more predictable daytime schedule.
As for the other sleep regressions, here are a few tips to help you cope WITHOUT undoing all the sleep coaching progress you’ve made up to this point:
• Don’t be afraid to offer extra feedings. Growth spurts can be a component of sleep regressions, so don’t worry about offering an extra nighttime feeding (or even daytime feeding) here and there. Remember – this is temporary! You will eventually return to your normal schedule.
• Offer comfort as needed, but avoid making new (or reinstating old) bad habits. You will definitely need to offer your baby or toddler plenty of extra kisses and cuddles during the sleep regression, and this is okay! But avoid creating new sleep associations – avoid rocking your baby to sleep regularly, or nursing her to sleep. Avoid reinstating old bad habits, too – if you have weaned your toddler off the pacifier, for example, don’t revert to offering the pacifier during a sleep regression.
• Solicit help, and lean hard on your partner. Sleep regressions last for awhile (up to 4-6 weeks, in some cases!) And if you are doing your due diligence, and trying to cope while not creating new sleep associations, you are bound to get tired. This is the time to ask for help from anyone who will offer it! Have friends or family members help you (either with your little one, or with the household management).
• Offer an earlier bedtime if necessary. Sleep regressions can lead to missed sleep, which can lead to overtiredness, which can quickly spiral into more missed sleep. Yikes! So to ward off exhaustion, offer an earlier bedtime if necessary.
-babysleepsite.com
Minimally invasive spine surgery in Abuja, By Dr. Biodun Ogungbo
Spine surgery is an individual thing. Operations are designed specifically for each patient and what Joe had may not be suitable for Adamu. Operations are often designed to achieve one of two results: remove pain or to free the nerve from compression. The pain may be coming because of instability of the bones or pressure on the nerve.
So, operations may be designed to free the nerves or to fix the bone or both. More often than not, the surgery will involve cutting of the skin to get to the bones or nerves. You can do that through a tiny hole (minimally invasive: using a microscope or by using special tubes and cameras) or through a hole wide enough for a surgeon and his assistant to climb into (conventional open surgery). What do you care, so long as the job is done and you are free of pain!
However, lets explain the issues related to the type of operation we do for spine diseases.
Conventional Open Surgery
Conventional operations on the spine entails opening the skin widely and dissecting the muscles to get to the bone and nerves to perform the operation. For example, a patient complaining of back pain and leg pains may require surgery that will remove pressure on the nerves and then fixation as shown in the picture above.
The operation is usually performed under general anesthesia and could last for upwards of 4 hours. The open operation can be complicated by bleeding and pain from the muscle dissection. This interferes with recovery with some patients requiring blood transfusions and massive amounts of pain killers. There is sometimes difficulty with wound healing and scar tissue formation.
So, these issues led to the development of minimally invasive spine surgery.
Minimally Invasive Spine Surgery
This technology allows spine surgery to meet its objectives through minimally invasive techniques that offer some benefits over traditional open back surgery. These benefits also include: minimal scarring and better cosmetic results. One must not forget reduced risk of infection due to small surgical incisions.
The idea is to be able to perform the same operation through small skin incisions, limited muscle dissection leading to almost no significant blood loss and less post-operative pain. These may then lead to better recovery and even at times earlier discharge home.
Endoscopic surgery
Some operations are also performed through small special tubes with cameras called endoscopes. Of course, a small number of patients have had laser spine surgery for back pain.
This is however not suitable for everyone and careful selection is very important.
Word of caution
Some patients come into the clinic asking specifically for a type of operation, they may have heard or read about on the internet. Minimally invasive spine surgery or laser spine surgery does not automatically mean no risk. There are still risks associated with such operations both in the short term and longer term. Also, note that all operations are designed to solve the problems presented with at that specific point in time.
However, arthritis (cervical and lumbar spondylosis) is a progressive disease. We cannot stop the ageing process.
Case report
We recently admitted a middle-aged woman of 58 years. She presented with a history of severe low back pain and pain in the right leg associated with numbness in the toes. She described difficulty walking long distances. The pain started in 2010 but worsened in 2014 and has been progressing in severity since then.
We performed x-rays and an MRI scan of her spine in the lower back which showed ‘kissing vertebra’. This means that the shock absorber between two bones in her back had worn out completely hence the bones were rubbing together causing severe back pain.
She was examined and felt suitable for surgical intervention. We opted for a minimally invasive procedure for her and the operation was performed uneventfully. She recovered very well and was in hospital for only 5 days before discharge home.
In Abuja
Patients with spine disease can be operated safely and successfully in Nigeria. Specifically, patients with lumbar and cervical spondylosis can be reassured that such operations are safe in Abuja. Patients should no longer have to travel abroad on medical tourism to manage these conditions. They can be treated successfully with comparable outcomes in Abuja. The operations are also at times significantly cheaper than the cost of a plane ticket. Nigerians also need to know that the odds of getting a successful surgery are great.
The choices of operation as discussed above are all available except laser spine surgery. We can perform conventional open operations or the minimally invasive spine surgery for patients who deserve either. We help the patient choose the best operation to deliver the best outcomes.