A Few Words On Sleep

October 23, 2019

I went to bed at 7:45 pm last night (!) thanks to a willing husband and a total call hangover (no alcohol involved!). And despite having a sick child wakeup call at 4:30 this morning (poor Annabel), I feel 800000 times better this morning.

SLEEP. It’s such an important thing. I truly feel for those who don’t ever get to catch up — those who have kids with sleep issues or medical issues (type 1 diabetes is an absolute sleep-killer for parents even with today’s better monitoring technologies). After dealing with multiple (completely legit) calls the night prior, I had a busy day yesterday and was absolutely functioning at about 50% efficiency. Everything took twice as long and I was prone to errors, distraction, and generalized grumpiness.

I still marvel at how during my residency training, it was a point of pride to act like getting little sleep was no big deal. Perhaps some people ARE immune to sleep deprivation — chronic or acute — but I have to believe those people are the minority. We have no 24 hour call in our residency program, in part because I have a say in it! There are night shifts (because there is significant learning to be had in overnight care) which can also be difficult, but at least there is time for a reasonable-length sleep period between each one.

I don’t feel like I need an abnormal amount of sleep – 7 hours seems to be pretty sufficient for me unless I’m playing catchup (like last night). I do well with a relatively consistent bedtime around 9:30 and waking up at ~4:45 or so on weekdays (everything shifts later on weekends for me even though I know that academic sleep researchers would probably say that is bad). I just really (REALLY) relish my weekday mornings, and an early wakeup is the only way to preserve that time.

Current sleep routines for the rest of our family:

Annabel (age 7.5) – up ~6:30-7 naturally or we wake her up on school days at around 6:40. Bed between 8:30 – 9 pm most weeknights. If I had my way it would be more like 8 – 8:30, or she could read on her own for that last half hour. Currently, she doesn’t really like to read independently at night (even though she definitely could) and definitely prefers that we stay in the room while she falls asleep. (Old habits die hard and I am ambivalent about how much I care about changing this, because it’s sort of sweet and I know EVENTUALLY she’ll grow out of it.)

Cameron (age 5.5) – up 7:30 or later naturally (ie on weekends or days off from school) but has to be dragged out of bed at 6:40 on school days. Bed at the same time as Annabel because they share a room (bunk beds!). Usually falls asleep between 8:30 – 9 pm. Would love to work on getting this closer to 8.

Genevieve (age 22 months) – up between 5:45 (ugh) and 7. Less predictable and seems to really depend on length of prior day’s nap. Naps vary but usually 2 hours or so. Seems to sleep better at night if nap is not taken too late in day. Bedtime between 7:15 – 7:30 most nights which works out well because I can then eat dinner and give some attention to the big kids.

Josh (age we will leave for you to guess) – honestly, I’m not sure because usually I am asleep long before he is. He does seem to do better with sleep deprivation than I do. BUT he is not as good at getting up in the morning.

I tried out the sleep cycle app in the past and liked it but then just kind of got bored of using it. I don’t typically have trouble waking up to an early alarm, so it didn’t really ‘fix’ anything for me long-term.

Random side note: apparently my iPhone is tracking my sleep without me even asking it to (weird). It is not entirely accurate because some days are entirely missing (maybe my phone wasn’t plugged in those nights or something?) but this was pretty fascinating to me. Apparently I only slept past 6 am once in the last month 🙂


  • Reply Gillian October 23, 2019 at 7:37 am

    Kid sleep is so fascinating. Wait until your kids head toward puberty. My 12 year old is definitely heading into puberty (andrenarche is in FULL swing!) and getting him to sleep before 10 pm is impossible. Sadly during the week he has to be up by about 7:10. On the weekends he will stay up until 11 and sleep until at least 9. Even though I know this shift is biological it is crazy to watch in action. The hardest part of this is that I am definitely more on your sleep schedule. So I am often sleeping (or I want to be sleeping) before he is in bed. Luckily my husband is more of a night owl.

    My younger three kids are still solidly in the school-age phase and are asleep by 8:30 and up by 7 on their own almost every day.

    • Reply Sarah Hart-Unger October 23, 2019 at 10:43 am

      yesss! If you haven’t, read Til Roenneberg’s fascinating book on chronotypes:

      Teens are wired to watch the fire all night 🙂 And then sleep until noon.

      • Reply Gillian October 23, 2019 at 11:44 am

        I will check it out!

        On the residency front though, I would take a q4 overnight schedule over a nightfloat system any day. I know more programs are getting away from 27 hour shifts. However, I never slept well on night float and by the end of a two week rotation would be soooo blue from the lack of social interaction. I guess either way residency is tough though.

  • Reply Krista October 23, 2019 at 7:50 am

    Sleep is so interesting, as is being able to see natural rhythms develop. Our school district is pushing to have high schoolers start two hours later than they currently do (so 9:20 am) and move elementary to 7:30. Our current start time is at 8:10. I absolutely hate the idea of changing things, as do many teachers and coaches and parents of kids who have sports, after school jobs, or help with taking care of siblings who get out after them that this will affect. Apparently these time match up with natural circadian rhythms. I never minded the early high school start time and loved being out earlier. It is also easier for kids that age to get up and get themselves to school. If my little kids start earlier to have to get up even earlier. Ugh! And it’s not as easy as I’d like to get them to bed early. Anyway, supposedly studies support this even though plenty of high performing schools (like our alma mater) are still on the whole schedule. Even many of the students say they will just stay awake even later, and many will have to if their extracurriculars go even later.

    • Reply Sarah Hart-Unger October 23, 2019 at 10:42 am

      ohhh yeah, I can see the rationale for changing but I can also see why it would be logistically very challenging!
      I do kind of think that HS students would just stay up even later. Their problem isn’t probably absolute time; it’s that they are sort of set on a longer cycle (ie, their ideal circadian day would be longer than 24 hrs!). No easy way to fix that 🙂

      • Reply September Gerety October 23, 2019 at 11:23 pm

        Our district shifted high school start times this year, and my teens have still been going to bed at about the same time (of their own accord – I don’t have any control over bedtimes!) In the past, I would exhort them to get more sleep and they would argue that there was no point in going to bed if they weren’t tired. The change has made our mornings much nicer, without any change to our evenings.

  • Reply Heather October 23, 2019 at 9:06 am

    I was both sad and relieved to learn there is a genetic component to short sleeping. I wish I was a short sleeper, but I’m thankful my kids aren’t.

    • Reply Sarah Hart-Unger October 23, 2019 at 10:41 am


    • Reply Susannah October 24, 2019 at 7:59 am

      My husband is an example of this! And one of my sons has definitely inherited it.

  • Reply omdg October 23, 2019 at 9:20 am

    I remember realizing how messed up residency was when I caught myself reflecting on how grateful I was that my daughter didn’t seem to need as much sleep as I do, because it was hopefully not going to limit her career potential the way I sometimes worry my sleep needs have interfered with mine. She goes to bed at around 9 and gets up at 7 which is on the low end of appropriate for her age. I need a solid 8.5 hours each night, and if I sleep badly one night, I need to make up for it. I feel like this is a significant problem, but there’s nothing I can do about it, and I try not to talk about it because most people recoil with horror at that number, tell me I’m lazy, or tell me that it is incompatible with having a successful career in my field (so far, it hasn’t been).

  • Reply Lisa of Lisa's Yarns October 23, 2019 at 10:40 am

    I wish I needed less sleep but I’m a 7.5-8 hour kind of person. I find I need more sleep since having our son. I did ok with sleep deprivation in the first year but once he started to sleep through the night at a year it was like my body was trying to catch up on lost sleep (even though I know that is not possible). Pre-kid, I could do ok on 7-7.5 hours of sleep. Our little guy is 19 months. He goes to bed around 7pm and wakes up around 6-6:30 usually. This week he’s been waking around 5:30 as I think his 2-year molars are coming in/bothering him. But we leave him in the crib until I get out of the shower around 6:15. He’s not all out crying when he wakes up, more so kind of whining here and there. I’m hoping by leaving him in the crib he’ll learn that it’s time to wake up yet! He has to be up by 6:30 at the latest so we can get out the door at 6:50 but I rarely have to wake him up. On the weekends he will very occasionally sleep until 7. I wish that happened more often!

  • Reply Nikki October 23, 2019 at 11:59 am

    Oh boy every time we have a bad sleep week (have a 21 month old, so it still happens, usually after travel or related to minor illnesses, etc), I realize sanity is such a fine line and so so connected to sleep. The power of being rested! Glad you were able to go to bed early:)!

  • Reply Dominique October 23, 2019 at 3:16 pm

    Could you have Annabelle read on the couch with you/by herself in the evenings starting at 8 or so? You could make it special somehow – special blanket or something. This would probably help get Cameron to bed earlier, too.

  • Reply Andrea Gubert October 23, 2019 at 4:07 pm

    Wow I can’t ever imagine waking up at 4:45 even if I went to bed at 9:30. I absolutely love getting 8+ hours sleep and I feel like I function best on that. Was definitely able to get away with less before I had my daughter almost 4 years ago but I feel like with the sleep deprivation of the first year I just value and treasure sleep more than ever so if I can fit 8 hours or more in – why not?! I’m also the type of person that will never ever wake up naturally before 9 am (always need an alarm) and I could actually sleep forever… if I didn’t set an alarm I could easily sleep for 12 hours… and no I don’t have high tsh! Lol

  • Reply Meredith October 24, 2019 at 6:20 am

    I am an eight hours a night kinda gal…my two year old, unfortunately, is not and still wakes multiple times a night 7 days out of 10. Sometimes I barely make it to lunch before I have to close my office door and kip with my head on the desk for twenty minutes just to get through the rest of the day.

    I’ve been blaming exhaustion largely on my son but when I spoke to my doctor, he ordered a sleep study and it turns out I have severe sleep apnea. I now have a CPAP machine and what a difference the makes…when my son settles long enough for me to use it.

    • Reply KGC October 24, 2019 at 11:16 am

      In reply to Meredith (on my phone and not sure this will show up in the right place): have you considered a sleep consultant for your son? I cannot imagine my kids (3.5 and 7 mo) not sleeping all the way through the night – I’d be even more of a shell of a human than I am now. I bought a sleep consultant online course when my second was born to make sure we got off on the right foot with sleeping and it’s worked beautifully and given me confidence in knowing how to handle schedule changes or disruptions. Given how important sleep is, maybe something to consider? It was inexpensive ($32 for the newborn course I bought) and she goes up to age 5 with courses or even one-on-one consulting. I hope this doesn’t come across as judgy or preachy but it hurts me to think about waking up that much at night! Happy to share the info if you’re interested.

  • Reply Catherine Boland October 24, 2019 at 2:05 pm

    As a parent, I’ve always believed the philosophy that sleep begets sleep – no clue which sleep training book i gleaned that from when by kids were babies – and have done early-ish bed times. With middle school age children and their activities, I would love to have my kids in bed by 9:30 every night, but that isn’t always happening.

    Two interesting anecdotes – I share this one as you’re a ped endo – one of my kids has MatUPD7 Russell Silver Syndrome and has always gotten by on less sleep than his brothers, often falling asleep later and waking up earlier naturally. I’ve always wondered if the lack of sleep is related to the genetic diagnosis. Second anecdote as we’re in the Washington area and my kids are big Washington Nationals fans – they’ve been trying to stay up to watch the World Series and no matter what are asleep by 10:00 because they just can’t keep their eyes open any later.

    • Reply Sarah Hart-Unger October 24, 2019 at 2:52 pm

      Very interesting, and I bet it could be related! I don’t have many RSS pts actually … but i had a pt in fellowship that had it and was extremely high energy.
      10 pm is my cutoff too and was as a child as well (obviously I stayed up later as a teen and in college but prior to that 10pm I was always more than DONE)

      • Reply Catherine October 27, 2019 at 3:32 pm

        RSS is rare enough that I’m not surprised you don’t have many patients. The endo who diagnosed our son didn’t have any other patients, either. But he nailed the diagnosis, which was confirmed by genetics, based on clinical symptoms alone. It was funny – in hindsight, everything we ever questioned about our son made sense once he was diagnosed! I’m also done by 10:00 most nights and was even in most of high school. I just don’t function well if I don’t get enough sleep.

  • Reply Margaret October 25, 2019 at 5:33 pm

    Rotating shift worker with a 7 month old here. Sleep is critical – if hard to get! Definitely helps me to have patterns/habits and I sleep better than many of my shift working peers. Then again, I’ve always been a big sleeper. In fact I never stayed up all night until I had to for work!

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