That “Cry-It-Out” Study: 5 Important Take-Home Messages You Should Know
In response to the publication of the recent study on sleep training methods in Pediatrics, many of the headlines focused on the conclusion that the cry-it-out method does not harm kids. In reality, the implications of this are more nuanced than those headlines would lead you to believe. Here are 5 things you should know:
1) This paper was important because there are few studies that have evaluated sleep training methods using scientific designs. This one is especially interesting because the research team followed 225 7-month-olds – reported by their parents to have sleep issues – for 5 years. This longitudinal design permitted the researchers to examine short- and long-term effects of sleep training.
2) The study examined 2 types of sleep-training methods – controlled comforting and camping out. Controlled comforting is a variation on what you might think of as cry-it-out (or pure extinction). In contrast to pure extinction (which is let baby cry until they fall asleep – however long that is), controlled comforting involves settling a baby in to sleep, leaving the room, and establishing short intervals of tolerated crying (say, 2 minutes) before going in to soothe the baby. These intervals can be increased slowly with the idea being that baby will stop crying and fall back asleep. Camping out involves starting off in the room with baby – typically next to or near baby – and waiting until baby falls asleep before leaving. After a period of success, the parent then changes the routine by sitting in the room, but not right next to baby, and again staying until baby is asleep. And here the idea is that parent can get to the point of leaving the room before baby falls asleep. In the study, 3 conditions were used. Some parents could choose to be trained (by a nurse) in either controlled comforting or camping out (conditions 1 and 2) – and some parents were offered just general advice but received no sleep training.
3) The results were that either sleep training method was successful in improving the babies sleep and reducing levels of maternal depression – both conditions produced better results than no sleep training. So in the short term sleep training worked.
4) The positive effects on sleep did not extend out for 5 years. This is not surprising, as each developmental period raises new sleep challenges. In terms of kids’ outcomes – behavioral and emotional – there were also no differences across all 3 groups. Sleep training (either method) had no positive or negative effects. The headlines here were that “cry-it-out” didn’t harm kids. Well, not exactly. Controlled comforting did not have negative consequences 5 years later – and neither did camping out. The camping out part of this was typically left out of many news stories.
5) The key takeaway is that when parents are trained in reputable methods, they work to reduce sleep problems and indirectly help parents sleep better and feel better. Parents can feel comfortable choosing either controlled comforting or camping out, based on the results of this study. What didn’t work so well was not receiving instruction in sleep training – in the short term, these families continued to experience all the negative stuff that happens when baby won’t sleep at night. Keep in mind the point made above – the sleep training will certainly take for awhile, but sleep problems could happen again during different developmental periods (e.g., age 2, age 5). The inference to be made, however, is that sleep training will work again, but it will of course be somewhat different and tailored to the age of the child.
This study is a welcome addition to the scientific literature and also to the endless debates about sleep training that we all have. Modern sleep training methods work – especially if parents are trained to use them properly and stick with them. And you can feel comfortable picking a method that suits your style. Just remember to talk to your pediatrician (or other experts) when you are ready to start – and also remember that these kinds of sleep training methods are typically recommended for infants at least 6 months of age.