The Darya Rose Show
Oct. 12, 2021

Optimal sleep habits for kids with Dr. Chris Winter

Optimal sleep habits for kids with Dr. Chris Winter

Dr. Chris Winter discusses sleep habits of babies, young kids, adolescents and beyond, including how unhelpful sleep patterns emerge, and how to address them without the use of pharmaceuticals.

Dr. Christopher Winter has practiced sleep medicine and neurology in Charlottesville, Virginia since 2004, and has been involved with sleep medicine and sleep research since 1993.  Currently he is the owner of Charlottesville Neurology and Sleep Medicine clinic and CNSM Consulting. He recently stepped down as the Medical Director of the Martha Jefferson Hospital Sleep Medicine Center, a sleep center he established in 2004.  

Dr. Winter is an Echols Scholar graduate of the University of Virginia and received his medical degree from Emory University.  He completed his neurology residency at the University of Virginia. The recipient of research awards from the Sleep Medicine Society and the Associated Professional Sleep Societies, Dr. Winter has authored numerous scientific papers and abstracts dealing with sleep.  He is also board certified in sleep medicine by both the American Board of Sleep Medicine and by the American Board of Psychiatry and Neurology, as well as being board certified in neurology by the American Board of Psychiatry and Neurology. 

Winter’s current research focuses on sleep and athletic performance, and has consulted with dozens of professional sports teams from MLB, NBA, WNBA, NFL and NHL.
 

He is the author of The Rested Child, a fantastic book that I highly recommend, as well as The Sleep Solution.

Notice: Any purchases made through my links to Amazon will result in them sending us a few cents that will certainly not cover the cost of running this show.

Transcript

Darya Rose:

I'm Dr. Darya Rose. And you're listening to the Darya Rose Show where we bring a fact-based perspective to answer all those confounding questions that come up in our day-to-day lives, from achieving optimal health to making conscious choices about your purchases and raising kids that thrive. We are here to help you navigate your life with confidence.

Darya Rose:

Hello, and welcome to season two of the Darya Rose Show. I am so excited to be back and share what I've been working on for this new season. For these first few episodes, we're going to be focusing more on kids and some of the more difficult issues that come up when you're starting a family. But even if you don't have kids or if your kids are a bit older, there's a good chance you'll still find these topics very interesting and often helpful even for adults.

Darya Rose:

Today's episode is a great example. Dr. Chris Winter and I go into more detail on sleep, how unhelpful sleep patterns can emerge, and how to address them without the use of pharmaceuticals. Dr. Winter has practiced sleep medicine and neurology in Charlottesville, Virginia since 2004 and has been involved with sleep medicine and sleep research since 1993. Currently, he's the owner of Charlottesville Neurology and Sleep Medicine Clinic and CNSM Consulting. He recently stepped down as the medical director of the Martha Jefferson Hospital Sleep Medicine Center, a sleep center he established in 2004.

Darya Rose:

Dr. Winter is an Echols Scholar graduate of the University of Virginia and received his medical degree from Emory University. He completed his neurology residency at the University of Virginia, the recipient of research awards from the Sleep Medicine Society and the Associated Professional Sleep Societies. Dr. Winter has authored numerous scientific papers and abstracts dealing with sleep.

Darya Rose:

He is also board certified in sleep medicine by both the American Board of Sleep Medicine and by the American Board of Psychiatry and Neurology, as well as being board certified in neurology by the American Board of Psychiatry and Neurology. (laughs) A lot of certifications and quite the mouthful. (laughs) Winter's current research focuses on sleep and athletic performance. And he's consulted with dozens of professional sports teams from the MLB, NBA, WNBA, NFL and NHL.

Darya Rose:

He is the author of The Rested Child, a fantastic book that I highly recommend, as well as The Sleep Solution. One of the things I most appreciate about Dr. Winter's approach is his emphasis on language and psychology which if you're familiar with my work at all, you know that I find extremely important for creating changes in habits and behaviors. I learned a ton from speaking to Dr. Winter. And I hope you do so as well. Chris, welcome to the show.

Chris Winter:

Thank you very much. It's, it's an honor to be here.

Darya Rose:

Well, first of all, I just finished your book not too long ago, The Rested Child. And I am so passionate about this topic. I was really excited to have you on. I have literally spent hundreds of hours thinking (laughs) about sleep specifically children's sleep since I had my own. And I just actually got really lucky. I didn't have any family that could really help when my daughter was born. There was like no one in the area.

Darya Rose:

My husband and I lived in San Francisco. And neither of us had any experience with babies or (laughs) anything. So we hired a nanny to help us at night with the feedings and all that stuff. And I just got so lucky. She is an amazing sleep expert. And so, she taught me in those first three months so much about sleep that I would have never known. She did sleep training. And my kids were both sleeping through the night at like 10, 10 or 12 weeks, and by far, by far the best parenting decision (laughs) I think I ever made.

Darya Rose:

But more important, I now know what it looks like when my kids don't have enough sleep. And it's interesting because you'd think that would be kind of intuitive. But it's not because kids sleep so much. So, you know, it's easy to think, "Oh, well, they're getting tons of sleep." It's fine. It's enough sleep. But that's not... You know, they need so much that it's not always super intuitive how much they truly need. And when they do get over tired, it manifests really strangely.

Darya Rose:

So, you know, they get cranky which we all do. But, you know, when grown-ups (laughs) get tired, we tend to get sleepy and fall asleep whereas kids get hyper. And I've found that actually makes it a lot harder for them to fall asleep because they kind of lose the ability to relax. And they'll even wake up a lot if they do fall asleep. And it's, it's horrible vicious cycle. So, uh, I'm very grateful that I recognize these symptoms (laughs) before they come up and, and usually try to stop them from ever happening.

Darya Rose:

And it's definitely like one of the best things for the quality of life for everybody in my house. (laughs) Um, but I wanted to start by asking you what are the requirements for kid's sleep because, obviously, they're not the same as for adults.

Chris Winter:

They're not. And I really found it interesting to listen to what you just said just the idea that, you know, to some degree, sleep is a skill. I mean it can be coached a lot of times. People like your nannies will call themselves sleep coaches.

Darya Rose:

Mm-hmm (affirmative).

Chris Winter:

And so, there is a acquisition of a skill set there. And like you said, I think most parents don't really have any idea of what that looks like. And, you, so it is a gift to be able to create a situation where that parental expectation and the child's needs kind of meet really harmoniously. And, and it just... It really does change everything about having a child. And it does start, I think, with that recognition of how much sleep does a child need. It's a great first question because I, I think it's a logical first question. It's interesting that's the first thing you ask.

Chris Winter:

I find it sometimes to be the question that never gets asked when kids are, are born that you may ask a friend or a parent or some support person you have. Maybe, you've read, uh, you know, Blake Lively and Ryan Reynolds wrote a book about having a kid. And so, their kid needed 14 hours of sleep. So you think, "Well, I want my kid to look like their beautiful child. So I'll make my child sleep 14 hours." But the, the variance of a young child sleep is tremendous. I mean it can vary as much as eight hours in that first year. So if you and your best friend have babies at the same time within three days of each other, you may have [crosstalk 00:06:27]. Well, there you go.

Darya Rose:

(laughs)

Chris Winter:

So there could be an entire adult's night worth of sleep between your child and her child. And so, as you're kind of swapping notes, it's very difficult to kind of create your child's individual sleep schedule based upon what seems to be working for your best friend because that implies that both of your children need the same amount.

Chris Winter:

And so, you know, the kids who need a lot more sleep are obviously the "good sleepers" and the ones that tend to take after mom the trauma surgeon or dad the military general just kind of short sleeping phenotypes. They're kind of the bad sleepers because they don't need as much sleep as the other kids. So it's important to think about sleep need as a bell curve distribution-

Darya Rose:

Hmm.

Chris Winter:

... and not adults need eight hours. And, and that's the end of the thought.

Darya Rose:

Well, I'm curious then how do you know if your kid is struggling or if they're just a short sleeper?

Chris Winter:

Yeah. So I mean a lot of it has to do with how are they functioning and what does their behavior look like. Just like you said as children get older, it's easier to kind of figure those things out. Um, you know, for a lot of parents, an easy thing to do, if you can't get your child to wear a Fitbit is you could actually just kind of journal. And there's this fascinating graph that a mother did of her children... or her child whenever... It was like a big grid. And e- each column on the grid was a day.

Chris Winter:

It was just hundreds and hundreds of days, um, where she would fill in little blocks when the child was asleep and not fill in the block when it was awake. And you got this sense of this kind of chaos that eventually kind of morphed into a long nighttime sleep period and three distinct naps during the day. But it's just amazing to see it kind of represented graphically how it worked. Um, and you can see almost to the day when she began trying to sleep train, whatever that means.

Chris Winter:

And so, things like that are really helpful when you go back and look at, okay, let's look at the last three weeks. Let's add up all the little bits and pieces of sleep our child got, and divide by 24 days or however many days you kept your journal. You can get a sense of, okay, well, it seems like our child is averaging 16 hours of sleep per day.

Chris Winter:

Uh, and so, now with that number, you can start to kind of divvy it up. Well, how do you wanna divide up the 16 hours? We could do eight two-hour naps. Well, that would be, uh, interesting, probably horrific. But you can do it, I guess.

Darya Rose:

(laughs)

Chris Winter:

But what most parents are going to wan to kind of aim for is a nocturnal sleep period that kind of matches the parents or maybe the families, you know, one rest period that all the kids have if there's multiple kids in the house, and then two naps maybe your kid will have. Initially, when they're really little that they will kind of eventually drop as they mature.

Chris Winter:

So, you know, that's sort of the typical target. But, you know, I work with a lot of major league baseball players. And they want their kids up when they get home from the game, so they have a very phase delayed schedule. There's nothing right or wrong about any of those things. It's really just trying to figure out what does your child need and expect, and how can you best give it to them?

Darya Rose:

Fun fact, I have documented literally every single minute my kids have ever slept. (laughs)

Chris Winter:

Oh, that's really cool. What-

Darya Rose:

Yeah.

Chris Winter:

... what, what should we do with it?

Darya Rose:

Right.

Chris Winter:

That'd be a really interesting, you know, [inaudible 00:09:50] You could see all the lit- you know. So, so how old are your children? And what do y- what do you observe?

Darya Rose:

I have a two and a half year old and a three-year-old who's gonna turn four in a month or so. And, yeah, so, I, I have a, a monitor where I can see them. And I still use it because-

Chris Winter:

Yeah.

Darya Rose:

... this is so important to me. And every single night at bedtime, I watch them until they fall asleep. And then, I hit start. And I start the timer. And then, in the morning, uh, they usually wake up before me and just kind of chill in their room until I get them up.

Chris Winter:

I like that, just, you know, having a glass of milk and reading a magazine-

Darya Rose:

Yeah, exactly.

Chris Winter:

... and, oh, oh, hello, mother. You-

Darya Rose:

(laughs) [crosstalk 00:10:25]

Chris Winter:

... should read this article. This is so interesting.

Darya Rose:

(laughs)

Chris Winter:

[crosstalk 00:10:28] Look at this. [crosstalk 00:10:28]

Darya Rose:

[crosstalk 00:10:28] the funniest stuff.

Chris Winter:

... text to you. I'll text it to you.

Darya Rose:

(laughs) Yeah. I come into them with pajamas like... And once they came in and they had completely swapped pajamas, they're in cribs like across the room from each other.

Chris Winter:

(laughs)

Darya Rose:

And they're [crosstalk 00:10:40].

Chris Winter:

That's hilarious.

Darya Rose:

Yeah. But I'll go in the monitor. And I'll... I take videos of when they wake up. And I'll, I'll adjust my... the timer to get the exact minute they woke up, and... But it gives me such a good sense of how they're gonna act all day and what they can handle. As a average, they sleep probably between 10 and a half and 11 hours at night.

Chris Winter:

Yeah.

Darya Rose:

But, you know, if they're... if they get 10, I notice. And maybe, they need to go down for their nap a little bit earlier because, otherwise, they're gonna get over tired, and then have trouble sleeping or maybe we just don't wanna over stimulate them that day and our demands too much out of them that day. And it... it's been so tremendously helpful. So I'm glad that I'm not the only [crosstalk 00:11:19] (laughs)

Chris Winter:

[crosstalk 00:11:20] that does that offers you a really cool, you know, you know, conversation, you know, depending on where they are sort of developmentally of, oh, it looks like you, guys, were a little under slept last night. And I think that it's so important for parents to start those conversations about sleep early not that, oh, guys, could be a terrible day. You guys are gonna be a nightmare. And I'm really-

Darya Rose:

(laughs)

Chris Winter:

But j- just like hey, you know, you guys slept a little bit or a little underslept, no big deal. Yeah. It might be a little bit of a rough day. If somebody takes your ice cream cone away, you might really flip out. But that's how we all are. We don't get enough sleep. But, you know, my guess is over the next day or two, you all could probably have a couple good nights and totally make up for that.

Chris Winter:

Like our bodies were meant to be able to handle some nights that don't go well. And you can really start to kind of shape that relationship they have with sleep because you're collecting all this really cool data about it. And, and it's gonna be fun for you also to kind of watch how it changes because these are the years that sleep needs changes so rapidly-

Darya Rose:

Mm-hmm (affirmative).

Chris Winter:

... and, and see if they mirror you or maybe your partner in terms of how much they need. Are they night owls? Are they kind of morning-

Darya Rose:

(laughs)

Chris Winter:

... morning type. So that's really cool. That... That's a great... It's interesting that you care, um, because that care can kind of get transmitted into them that don't be anxious about it. But let's talk about it, and let's think about it, and how exciting it is, you know, to eat well and get some exercise in our day and to sleep well. And what happens when it doesn't go well? Y- you're sort of the gateway between them being like this excellent, confident, I would say, bulletproof sleepers as they get older or are they the people that kind of walk into my clinic many years from now when I'm about ready to retire-

Darya Rose:

(laughs)

Chris Winter:

... and should have retired 10 years ago. You know, well, Dr. Winter's peaked like 12 years ago. Don't go see that guy. Guy's living in the past. But they come in like I've always been a bad sleeper ever since I was little. You know, I used to swap PJs with my sister. And we'd throw them across the grid.

Darya Rose:

(laughs)

Chris Winter:

And ever since that time, I've been bad. So you can really help to shape that. And your interest will be conveyed to them, for sure.

Darya Rose:

Yeah. And we do have those conversations. And they, they help tremendously. And-

Chris Winter:

Yeah.

Darya Rose:

... actually, that was one of the things I liked the most about your book is how much you focus on language and psychology and identity around sleep. So can you actually go into that a little bit more because I just... I loved how you, how you discuss it?

Chris Winter:

Yeah I, I think about this a lot. So my clinic, I see adults and kids, um, just for sleep. So I'm a neurologist in, in my training. But I don't deal with strokes or migraines, stuff like that, directly anyway. And so, it's always interesting to see people when they come, how they talk about their sleep. And in my first book, I actually had a little chart. And it was just a two by two graph. So four blocks. And like the horizontal axis was, are you truly a good sleeper? Like is your sleep healthy or not? Yes or no.

Chris Winter:

And then, the vertical axis was how do you think of yourself as a sleeper? Great sleeper. Bad sleeper. So you come up with these four categories of people who are great sleepers who really are, people who are bad sleepers who really are. People who are great sleepers, but think they're bad, people who are terrible sleepers, but think they're great.

Darya Rose:

(laughs)

Chris Winter:

And it's interesting there's so much written about the psychology of sleep that the way we think about our sleep probably impacts our day-to-day functioning more than the way we actually sleep-

Darya Rose:

Hmm.

Chris Winter:

... which is fascinating to me. But, you know, hanging around hospitals and, and trauma surgeons, you, you do get that. Like what are you off to? I'm gonna go take somebody's spleen out. How was your call night last night? Oh, it was great. I got a, I got a good hour in the call room. Oh, wait a minute, you're gonna go take somebody spleen out. You just slept an hour last night? You think that's a good idea? Oh, yeah. I feel fine. I'm good. As long as I get my hour, I'm good. I don't think you're good. I think you're probably-

Darya Rose:

(laughs)

Chris Winter:

... pretty impaired if you've only slept an hour in the last 36 hours or something like that. But they believe, you know. And that's, that's probably the reason why more people die in hospitals because of medical error (laughs) than anything else. But then, there's also people who are actually pretty good sleepers, but are just kind of terrified by the whole process.

Chris Winter:

And so, I talked a lot about, in my new book, about sleep identity and the way we shape it. And, you know, it's always interesting to talk to new parents like you that, you know, you would never describe your son as, well, Casey, she's, you know, so, so smart and so good in school. But, you know, Brian, he's, he's dumb as dirt. Like with Brian-

Darya Rose:

(laughs)

Chris Winter:

... sitting there like trying to put two Legos together and failing miserably.

Darya Rose:

(laughs)

Chris Winter:

Like, you would never say that or if I said, "No, which is your dumb child," like, that parent would never come back to see me. But it's amazing how many parents will say, "Oh, this... You know, Keith is the worst sleeper. He's going to kill the entire family. I just... I don't understand why he can't be a good sleeper like his two sisters." And Keith's right there-

Darya Rose:

Hmm.

Chris Winter:

... trying to get your phone out of your purse or whatever he's up to. So it just... It's interesting to me that I don't know why you would, you would say one versus the other. I almost feel like when parents say that, they're kind of talking about like hair color.

Darya Rose:

Hmm.

Chris Winter:

Like they don't see it as really being, uh, uh, something that's gonna mold the way they think. It's kind of like, "Look, he's got dark hair. But Sherry's got blonde hair." It's just a fact. It's a trait. You can't do anything about that. And I, I do think that there is a self-fulfilling prophecy there. So I think that the way we talk to kids about sleep is really important. And I bet there's experts out there about eating and school performance and anxiety that would say the same things about their own realm. Oh, look. When a kid doesn't eat his food, you should never punish him or say he's a bad eater. You just like, "Oh, well, it looks like you're not hungry right now. But don't worry about that. We'll have food here if you need it." Like, these early years, kids are so impressionable.

Darya Rose:

Yeah.

Chris Winter:

So I think it's important for us to handle those things the right way. You know, bedtime is the right way, and, and nap's the right way because I think we can leave accidental impressions that aren't healthy.

Darya Rose:

Are you familiar with Carol Dweck and her work on Mindset?

Chris Winter:

I don't think so.

Darya Rose:

Sh-

Chris Winter:

But I'm not good with names.

Darya Rose:

(laughs) So, she's a, she's a psychologist at Stanford. And she has a book called Mindset. And it's about the way you talk, you can, you can give somebody either a fixed mindset or a growth mindset.

Chris Winter:

Oh, absolutely. Absolutely.

Darya Rose:

And if you, and if you believe your, your traits are immutable, you're not gonna work to, to improve it. And if... And so, they will be. (laughs) They will not change. But if you believe that you can fix it, then, you have the attitude of, "Well, I'm just figuring this out still." And then, you know, it's something that's solvable.

Chris Winter:

And I think that there's a lot of that in sleep. There are a lot of very malignant fixed mindsets in both adults and kids when it relates to sleep. Um, and sleep is something that we all have a lot of power over, in some ways. You know, I was dealing with a, a patient yesterday. It was a, an 80-year-old woman. And after, you know, a 45-minute explanation about the fact that her pills that she takes at night are not the reason why she sleeps, they're not the reason why anybody sleeps. Everybody sleeps. There's no such thing as not sleeping which that phrase drives me crazy. Like you see your headlines all the time why 70 million Americans can't sleep. That's not a true statement.

Darya Rose:

Right.

Chris Winter:

So after 45 minutes, I said, "Do you understand what I'm saying?" She goes, "Yes, I really do. I just need the pills to sleep though." (laughs) So you're kind of like, "We've got all the way back to go." And we did not collect $200." So it's tough. I mean-

Darya Rose:

Yeah.

Chris Winter:

... these things are really ingrained in people. Um, and it takes some time. And, sometimes, they're so ingrained they become part of our character. Like, I am Chris. I'm a sleep doctor and short with big ears. This is my wife. She is a school teacher. But like these are just parts of maybe who we are. And for some people, I am Carol. I can't sleep. That's part of my identity."

Chris Winter:

And when you start tinkering with it, you're kind of tinkering with something that's really protected. You know, if you don't take... You can't take that away from me. Like I, I'm the person who nobody can figure out how to get to sleep. Well, no, you're not.

Darya Rose:

Yeah.

Chris Winter:

So, you, you need to have a different identity because that's not a true identity. That's not always an easy conversation to have with, with adults. It's much easier with kids because they haven't quite gotten there yet.

Darya Rose:

Yeah. And that's what I was gonna ask you. So I think that you've made it pretty clear what we shouldn't say. We shouldn't tell somebody that they're... this child that they're bad at (laughs) something, that they have the power [crosstalk 00:19:43]

Chris Winter:

Yeah.

Darya Rose:

But what are specific things like for… a few examples of some spe- specific things or how we should talk to them if, if-

Chris Winter:

Yeah.

Darya Rose:

... there's something going on?

Chris Winter:

Yeah. I mean I think with things like insomnia, a kid who can't sleep, I think it's perfectly fine to recognize that validate it, oh, it sounds like you're having a little bit of trouble sleeping tonight. And I think our children are looking at to us to see how we respond to that. And I think in the book, I, I wrote something like we can sort of be panicky. Oh, my god. You've got to get some sleep. I don't know what can we do. We got to give you some melatonin gummy bears and take two of them for God's sakes because you've got a big spelling test tomorrow. And it's the one with restaurant in it. And I remember I was trying to spell restaurant-

Darya Rose:

(laughs)

Chris Winter:

... failing horribly. So now, there's this kind of a, like, I need to do it or else something bad will happen or there's the, you know, kind of the let's work the problem. There's a big problem here. What are some solutions for it? I, I think it's fine to kind of recognize... I always tell people handling it like your kid only eats half the sandwich. Do you want the rest of your sandwich? I don't. Really, because usually you eat all the sandwich, and you love it. Are you okay? Oh, yeah. I'm fine. I'm not that hungry. Okay.

Chris Winter:

Did you as the parent kind of mirror, okay, well I'm just gonna wrap the sandwich up. And my guess is you'll get hungry at some point in the future, and you can eat it later. No big deal.

Darya Rose:

Right.

Chris Winter:

And I think that we need to really sort of... Somebody asked me, "What's the one thing that you wish parents would do?" If you give one tip, I would say put less stress on bedtime, more on wake time maybe.

Darya Rose:

Hmm.

Chris Winter:

In, in other words... Uh, in fact I was talking to somebody recently. And I... Uh, when our kids were about six, we said, "You can go to bed whenever you want to. We don't care. Just be in your room and no TV screens. Read a book. Draw a picture from mommy. You know, study foreign affairs. I don't really care what you do. I just don't... Just stay in your room. Don't bother anybody, and go to bed whenever you want to."

Chris Winter:

What, what we didn't tell them was we're gonna wake up at the same time. I was talking to a woman. She said when her kids were three, they just kind of did away with the bedtime. And I think that's really empowering. Now, you can set rules in terms of how that will go. And we're gonna read your bedtime story at seven o'clock every night. We're not gonna read at 11 o'clock. But this idea that I don't wanna put you under pressure to sleep-

Darya Rose:

Hmm.

Chris Winter:

... I think, is really important. So I, I think that the way we sort of frame I can't sleep is really important. And I think everybody should have a plan for what that's gonna look like when your child comes out of their bedroom it's 10 o'clock at night and says, "I can't fall asleep," because-

Darya Rose:

Hmm.

Chris Winter:

... I think that can be the beginning of the end for some people. But I also think that it's okay to recognize if your child is struggling. Like if your child is waking up a lot during the night or is extremely restless or having terrible nightmares or grinding their teeth or you think they may be having reflux or something or just seemed extremely sleepy during the day, they're falling asleep in third grade classes, it's okay to say, "It looks like you're, you're kind of struggling here and maybe we're gonna try to figure out some ways to make your sleep even healthier."

Chris Winter:

It's like if their knee were hurting, you'd probably have that same kind of conversation. It seems like you're walking funny and your knees bothering you. Maybe, we should get a little help with that because the ice pack and the elevating your knee and the ACE bandage from Duane Reade's doesn't seem to be doing the trick.

Darya Rose:

Yeah. So like acknowledge that there's an issue.

Chris Winter:

Yeah.

Darya Rose:

And then, be the support.

Chris Winter:

Absolutely.

Darya Rose:

And, and not-

Chris Winter:

Absolutely.

Darya Rose:

... and not the, the judger.

Chris Winter:

Yeah, not panic. Yup. Great. Not panicking, not judging, not upset. It's not their fault. You know, just... Let's... We'll figure it out. Don't worry about it. This is... People have some difficulties with sleep from time to time. And we're gonna figure out what yours is. Nothing to worry about.

Darya Rose:

Awesome. So you mentioned, you know, you kind of hinting at sleep times and wait times. And let's talk about schedules because this is one of those things-

Chris Winter:

Yeah.

Darya Rose:

... that there are a lot of different opinions (laughs) in the parenting circles. And I've always been surprised by that because as a neuroscientist, it's, it's so obvious to me how important circadian rhythms are and especially for a developing brain.

Darya Rose:

But I know that there are a lot of parents that think that it's more natural to sort of follow the kids lead and have a more flexible schedule. Uh, what are your thoughts on schedules?

Chris Winter:

Yeah. I mean I think that there's, there's a couple things that are sort of packed into there. I, I don't think it's bad to follow a child's lead as long as the child is leading you to a schedule. I'm not certain that there were times when I was growing up that, that would have been the case if my parents had been like used to whatever you wanna do. I mean I just love to stay up late. And so, that would have directly impacted my ability to go to school.

Chris Winter:

Now, ow some parents might say, "Well, then we'll just homeschool." And when our child wakes up, we will start the school day then. I'm, I'm not here to really judge any of those things. I tend to fall towards your opinion of, I think, that brains like a schedule. I think brains work best on a schedule. And you can extrapolate when you look at shift work research and... with some, you know, people saying that shift work could be a class 2A carcinogen particularly-

Darya Rose:

Right.

Chris Winter:

... in women in breast cancer. Like our bodies... Uh, there was a great experiment a, a while back where they were giving two groups of people a candy bar every day. One group got it like at three o'clock every day. The other group got it at random times. And the group that was getting at random times, you could tell the body didn't know what to do with this Milky Way bar. And it's got like insulin was all over the place.

Chris Winter:

And, and the other group almost had like no metabolic consequence because the brain knew 3:00 PM on the nose, you were gonna get this, you know, Snickers bar in your gut. So it was prepared for it.

Darya Rose:

Right.

Chris Winter:

And I even remember working at a camp for kids with disabilities when I was in college that kids would eat who had diabetes. And then, we would come to the counselor and say, "This is what I ate." We'd calculate the carbs and give them their insulin.

Chris Winter:

I went back to that same camp when I was older as a, a physician just to fill in because they were hurting. If you're asking the sleep doctor to fill in this camp for kids with medical needs, you're, you're desperate for (laughs) [crosstalk 00:25:39] the bottom of that rung there. But, um, I remember being so freaked out because the kids would take their insulin, and then eat.

Chris Winter:

So you were calculating their insulin based upon what they said they were gonna eat. So if Frankie came over and said, "You know what? I decided not to eat anything." You're like, "Oh, just give you a lot of insulin like we've got to give you something to…"

Darya Rose:

Wow.

Chris Winter:

So, but to the whole point, I was talking to endocrinologist said, "Oh, yeah." I said, "It t just works so much better if there... if it's anticipating it rather than reacting to it." And so, I agree with what you said. So to me, I think it's fine to follow a kid's lead to a point. But I do think that children might be looking to us for some structure. And it was... Uh, I was on a... I, I did an interview one time. And we were kind of talking about this. And I said, "Well, there is a little bit of a bias here, and that I don't get a lot of people coming to my clinic saying I sleep in bed with my wife and my seven kids, and we're loving it. Can you help us make it even better?" Like, it's no.

Darya Rose:

Right.

Chris Winter:

That is not what we're, we're getting this kid will not sleep, and there's no schedule. And you... we need help kind of like maybe what you would have been had you not hired this nanny. So I just think everything not just sleep, but everything that our bodies do and our brains are controlling work better when there's sort of this anticipatory effect. And we've seen what happens when you take away those sight givers, all those time cues like in the pandemic.

Chris Winter:

I've got a senior in high school. And he lives in his room. I mean at least he did for a year and a half. He'd come down and grunt and get food and disappear back into his room. Again, all his classes were in his bedroom. His sleep was in his bedroom. His entertainment was in his bedroom. And it was really not a healthy situation. We need body movement. We need lunch at the same time. We need to catch a bus here and there and have basketball after school.

Chris Winter:

Like I think those things are really healthy. So trying to fit sleep into a schedule, I think, is extremely important. Plus, it allows the parents needs to be met too. I mean it's hard to get things done when you don't know what's coming. Like there were some nights when we would be on call in the hospital where I'd have a lot of time. But my wife's getting studying and done last night.

Chris Winter:

No. Oh, really? Were you busy? No, we didn't. We e only admitted two patients. Why didn't you get... Because I'm always anticipating it. It was no-

Darya Rose:

Right.

Chris Winter:

You know, but if a kid always goes down for two, three hour naps a day, (laughs) you can get all kinds of things done.

Darya Rose:

Yeah. Yeah. That is another thing we do because my kids are so comfortable in their beds. And they know they have that downtime whether they're asleep or not. They, they do... We do the nap time. And they stay there. And, [crosstalk 00:28:08], yeah-

Chris Winter:

Good for you.

Darya Rose:

... I don’t know how I would get anything done. (laughs)

Chris Winter:

And that's why I named it... So that's why I named the book The Rested Child because that's another dialogue that I think we don't have with our kids which is you all just kind of hanging out in your room swapping PJs. It's dark. It's quiet, not a lot of stimulation. You can rest if you want to, but you don't have to.

Chris Winter:

There's positivity in that too. If we... I have this absolute view of sleep as the only thing good in a bad is when you're unconscious. We really, A, put a lot of pressure on ourselves in particular kids. Like I've never... We never called it nap time. It was always rest time because you have control over resting. You don't necessarily have control over when you fall asleep sometimes.

Chris Winter:

And that idea that, hey, how was your rest time, it was pretty good. I read a Judy B. Jones book, awesome, did you fall asleep? No. That's okay. Something you got a lot of good rest and kind of quiet relaxation that's very healthy for you. So instilling in kids there that sleep's great. But even if you just rest and are quiet for a period of time, that can be remarkably refreshing.

Darya Rose:

Yeah, you know, my oldest, she's starting to get away from the nap. We always do the rest for just an hour in the afternoons and... But like once a week, she'll do it. You know, once a week, she'll sleep-

Chris Winter:

Yeah.

Darya Rose:

... either 20 minutes. Sometimes, she'll sleep an hour and a half, you know. (laughs)

Chris Winter:

Yeah. Absolutely.

Darya Rose:

But like usually for like 20 minutes. But, but she's still just... She really... She loves that time alone, you know. And she doesn't get a lot of time alone. Kids, they're usually doing stuff. So it's, it's quite nice. Yeah.

Chris Winter:

It's so, it's so interesting you said that because-

Darya Rose:

Otherwise, I wouldn't shower. (laughs)

Chris Winter:

... I've always said.. That's right. (laughs) It would be very different hygiene situation. No. It's funny. I, I was telling somebody that I think the secret to sleep is either being neutral or actually feeling positive about being alone in bed awake. And it's interesting. I did an academic lecture one time on insomnia. And it was all based upon the truly awful, mean-spirited reviews of my first book on Amazon because they're this tour de force of amp... of, of insomnia thinking, uh, this doctor has no idea what it's like to have years of insomnia. It's a living nightmare.

Chris Winter:

Somebody... One of them used the phrase deep fried brains. I mean... Uh, and when you read it. You think, you know, if, if I didn't tell you what the context was, you'd be like, "Ah, what is this? Some sort of prison camp labor situation?"

Darya Rose:

(laughs)

Chris Winter:

No. It's people who are in their comfortable bed at 65 degrees, and they're just awake. And they have such awful terrible, it makes me sad just thinking about it, thoughts about that situation. And then, your daughter is saying she kind of likes it-

Darya Rose:

Hmm.

Chris Winter:

...and that there is something insulative about that like that's a child that will never have a night of insomnia in her life. Now, she'll have sleepless nights. But when you don't interpret it as something negative, when somebody says to me, "It takes me two hours to fall asleep," my first question is, "How do you feel about that?" If the answer is, "Oh, I love it." (laughs) So, I, I mean, it's, it's the only time I have a quiet moment. Um, I can plan out a vacation or what to get my partner for a birthday or just think about the last episode of White Lotus and what it meant, you know, whatever.

Chris Winter:

Like you think about whatever you like. When you start to kind of feel neutral or positive about being in bed awake, insomnia really doesn't have teeth anymore.

Darya Rose:

Oh, that's amazing.

Chris Winter:

There's nothing, there's nothing scary about it. So teaching your kids to really enjoy that quiet time is just solid gold.

Darya Rose:

That's awesome. I, I love that frame because I do... I am somebody who I'll, I'll wake up sometimes like earlier than I would prefer. But I do get a lot of thinking and problem solved during that time.

Chris Winter:

Abs- absolutely.

Darya Rose:

And, yeah.

Chris Winter:

Yeah. What was that girl's name in college? Remember the one who always did that funny thing with her hair and then, like, you, you know, it's a great time for your brain to think of those important questions.

Darya Rose:

Yeah. (laughs) So, so there's this phrase that people utter. And it's never wake a sleeping baby. (laughs) What are, what are your thoughts on that?

Chris Winter:

So I would probably go back to what you said in your thoughts as a neuroscientist. I would say there's caveats. You stayed too long at your mother-in-law's house because you feel guilty because you don't see her that often. And so, the night we got home late, we put the kids in bed. And we should be getting up around seven. But they're still asleep. Oh, let them sleep because-

Darya Rose:

Mm-hmm (affirmative).

Chris Winter:

... through no fault of their own, they got short-changed their night. I think that when you start looking at schedules, there is a tendency for parents to say, "You know, we put our kid down for the nap. This should be from 10:00 AM to 11:00 AM." That's what we want. That's our schedule that we want if that's, if that's your thing.

Chris Winter:

And we put our kid down. They kind of, hmm, hmm, they wanted something, this and that. Finally, we looked on the mod, and they fell asleep at 10:50. Well, the nap's supposed to end at 11:00. So that's a tough choice. You haven't gotten the groceries put away. They're literally just sitting there.

Darya Rose:

Hmm.

Chris Winter:

You've got a ton of emails to do. You're taking some graduate classes online. I can see where a parent might say I'm going to let them sleep. So I can do a few things, make a few phone calls. In our house, uh, nothing. So that's the right thing to do. Uh, we would wake them up.

Darya Rose:

Hmm.

Chris Winter:

Uh, we would do it nicely. Hey, little guy. And they were kind of like, "What's going on here? Like I just fell asleep. So you need to let me sleep." And, you know, because, you know, our thought was we gave them the opportunity. They didn't really want to use it. So that opportunity is passed. And now, we're gonna move on to the, the next part of our day.

Chris Winter:

So, you know, when you do it that way, then, it becomes like trying to keep kids asleep in, you know, the car seat going to the grocery store. Like that was… I feel like I did that for like seven years. That was like my job. I didn't feed the kids or dress the kids or birth the kids. But I kept them awake in the car, like had little wet washcloths. I'd give them, and they'd chew on them and fuss about taking their shoes off or whatever.

Chris Winter:

Anything I needed to do to keep them awake until the next opportunity. So sort of like there's no penalty here. You can stay awake during your naps, if you like. But this is how the day will go. And as long as you do it nicely and not punitively because what I wanted, I wanna have a conversation with that baby's brain. And the conversation is sleep here, or you're not gonna get it. And I know as a neuroscientist that brains have to sleep. And if you have a kid who won't eat Brussels sprouts, lock them in a room with Brussels sprouts. Don’t, don't do that. I'm just kidding.

Darya Rose:

(laughs)

Chris Winter:

But delete the Brussels sprouts eventually. You know what I mean?

Darya Rose:

Don’t write a, don’t write a book about feeding- (laughs)

Chris Winter:

Yeah. Don’t do that. We're not gonna do... Don’t, don’t lock kids in any situation. But, you know, so we would always just kind of do it nicely. So I don't think I agree with that tendency. Now, again, if you're one of the parents like, "Look. We look to our kids for everything." We let them sleep anytime any way they want to. Again, that's your choice as a parent. There's nothing wrong with that.

Chris Winter:

I just think there could be some consequences of predictability in your own schedule down the line. But as long as you're informed about the fact that you have no schedule with anything and your kids start school in six months where there is a pretty discrete schedule, that might be a really difficult transition since your kid has never known a bedtime or a wait time. (laughs) It just kind of free flows which, again, I don't meet many people like that. But there might be some people out there who kind of subscribe to that. But I think brains like to know what's expected of them. I really do.

Darya Rose:

Yeah. We were talking earlier about when kids get overtired. And so, we, we were the wake up family-

Chris Winter:

(laughs)

Darya Rose:

... especially early on. We would wake them up at the end of nap time. But I, I started making exceptions in just the overtired cases because-

Chris Winter:

Sure.

Darya Rose:

... what I would find is when if they would have a bad nap, then, they would... Sometimes, they would start waking up in the middle night and, and fussing and crying. And I couldn't get it fixed until they would get a solid nap and during the day.

Chris Winter:

Yeah.

Darya Rose:

And, and then, they would not be overtired anymore. And then, they would... it would fix like the whole… You know, it'd be like a multi-day bad cycle thing. And it would fix it. So, yeah. And, and usually, I would s- And sometimes I would wait until like the end of like the sleep cycle. So-

Chris Winter:

Yeah.

Darya Rose:

... especially newborns, I usually sleep in these like 20 to 25 minutes cycles, be like, "Okay. You fell asleep 10 minutes before nap, is supposed to be over. I'll give you 10 more minutes. But then, you're done." (laughs) [crosstalk 00:35:59]

Chris Winter:

But see, but, see, to me, that's a kid-centric plan. You've got to plan for it. You, you have monitored and studied your children to know I'm going to do this because it's actually ultimately gonna benefit them-

Darya Rose:

Right.

Chris Winter:

... not because I've got 30 more minutes of, of Nine Perfect Strangers on a watch and, ,and this is a great opportunity to get that done. So uh, you know, to me, there's always gonna be exceptions. And you're doing it because you feel like this is ultimately gonna benefit them. They're gonna have a better night coming up. It’s gonna break this cycle. So those kinds of educated changes in the schedule, I think, are, are really smart. And that's the way napping I think should always be looked upon even as we get older as a tool for a greater good when you always have your eye on that. Oh, I didn't... My flight was delayed last night in the LaGuardia. So I'm gonna take a nap around lunchtime to kind of get myself ready for this evening thing I've got going on because my sleep last night wasn't that great. So you're always using that to kind of balance out some rough spots. I think that's perfectly fine.

Darya Rose:

Okay. Excellent. Oh, you know, let's talk about light and sleep as well because, you know, when you're talking about circadian rhythms, and I'm like right with you. Like I am pretty militant about sleep time and meal time in my house. And I mean I don't deviate by five minutes. And I think the hardest thing about it is getting other caregivers to comply (laughs) [crosstalk 00:37:25] like, "No, no, no." Not, not 20 minutes late, not 20 minutes early. Like if it's more than five minutes-

Chris Winter:

No.

Darya Rose:

... like you will get my wrath. But, um... (laughs)

Chris Winter:

No. That's a thing. Our daycares, you're like, "Hey, how'd the day go?" Well, he took a three-hour nap. You're like, "No." (laughs) [crosstalk 00:37:39] Anyway that's, that's good for you.

Darya Rose:

But I know that light is super critical for setting circadian rhythm. So can you talk about light and sleep? And, you know, another question I have specifically with kids is light and naps because the, the morning I think I know what you're gonna say. (laughs)

Chris Winter:

Yeah.

Darya Rose:

But and nap... for nap time, it's a little tricky because there's a sun out. So we don't think about all that.

Chris Winter:

No. I think light's really important. Light and temperature are really strong indicators to a brain of where they are in space, unfortunately, just because of air conditioning and heated homes unless you, you camp outside a lot or live in a yurt which is fun. My son lived in a yurt in Boise for a while. That'd be a good time.

Darya Rose:

(laughs)

Chris Winter:

Um, that we don't really expose ourselves to that lost temperature and that gradual... Although with, you know, smart thermostats, you can kind of set that up where after dinner, your house is starting to cool down a little bit and… But light's really important because it's the sort of the main regulator of melatonin in a brain. And so, like you said, when you wake a child up, you wanna expose them to a really bright light.

Chris Winter:

So we always told, you know, parents, "When they wake up, they're gonna go from a very dark nursery or bedroom into a bright lit environment, either somewhere bright in their home, or you go outside or eat outside on the front porch." We had a little light box right next to our changing table. So even if it were sort of gray or wintry, they would always get that sort of pop of light. And we wouldn't turn it on until the wake-up time that we wanted.

Chris Winter:

So let's say, you know, everybody's supposed to wake up at, you know, seven o'clock or whatever. So if our daughter or son woke up at 6"40 or 6:00 or 5:45, you know we wouldn't force them to do anything. But we wouldn't turn any of the lights on. We just kind of sit around in sort of a dark bedroom and look at kind of boring toys and not really interact a lot. And then, when... Just like you said, uh, we were kind of like that too. Three, two, one, boom. Turn on the light. Change the diaper. Suddenly, dad gets really excited and much more dynamic and much more interactive than the kind of quiet boring father that was playing two minutes ago.

Chris Winter:

And so, that, that change in life is really important for your child understanding, oh, we went from this very dark environment for the last few hours to a very bright environment. This is the time the day begins. If you wanna get really scientific about it, you get those little alarm clocks that as the light goes on, it's like a sunrise-

Darya Rose:

Hmm.

Chris Winter:

... which is kind of fun too because you can say to your kids, "Look. If you wake up and sun hasn't come up on your bedside table, maybe leave mommy and daddy alone. But if the sun is starting to rise, it's time to make pancakes," you know, kind of thing. So brains respond really positively to that your question about naps is, I think, it should probably be the same.

Chris Winter:

I mean we always try to tell people nap in a dark environment. And when the nap is over at that time, okay, it is two o'clock. Go somewhere bright. Go play with the dog or put the baby in a jog stroller, and go around the block a couple of times. So you really wanna kind of create those state changes of dark to light fasted to fed, cool to warm, quiet to active, socially isolated, socially interactive.

Chris Winter:

Uh, and those things really help set the stage for that two o'clock nap every day. We, we even tell our athletes, "Look, if you're gonna nap before a baseball game, that's fine. Go get your training done. Do your BP. Then, you got two hours. Grapple something to eat." And the player will go into like a recovery room or a nap room that they have built for them. And they'll, they'll be there. And I always tell them "When you're done, just go get on a treadmill in the bright workout area and just jog or be on an exercise bike for five or 10 minutes just so you go from that dark quiet environment to something a little bit busier."

Chris Winter:

You know, the TVs are blaring and the music. And you're on your exercise bike. Just to get yourself. And end the nap that way every time. So you don't have that kind of post nap funk or inertia that some people exper- experience where they were kind of sleepy, took a nap. And now, they feel worse.

Darya Rose:

Yeah. That's basically, yeah, what we do as well. And, and on the other flip side at night, for example when... especially in the summer when the sun stays up pretty late up here in the Pacific Northwest, I put the light super dim in the bathroom.

Chris Winter:

(laughs) Yeah. Yeah.

Darya Rose:

I close the shades in the playroom which is right next to it. So that it's dark in there, and then go get their diapers on and their jammies on. And then, we walk to their bedrooms. We keep it dark in there. And, and it's just amazing how it... how much it works. I mean they just... You see an instant chain from like, you know, crazy hyper kids. And they just... they start to wind down. And you can just see that they're getting ready for sleep.

Chris Winter:

Roxanne Prichard is the sleep researcher in Minnesota. And she's lovely. Everybody sleeps lovely. There, there's... It's hard to find people who aren't. It's such a fun community. But she takes her kids camping the week before school starts every year just to be in a place where it's getting dark, and there's the temperature and all these things are so sleep promoting. But it's hard to stay awake in the dark.

Chris Winter:

Like where I live, we lose power a fair amount which is strange because we're very close to the University of Virginia. (laughs) I don't know what's wrong with the grid in that area. So the power goes out and, you know, all right, whatever. And you... We have a couple of little lanterns we put around. And we generally have internet. And we have a computer with a battery. It's my wife. Let's watch an episode of whatever in bed. It'll be fine. Man, we always... Like 9:15, we're out cold.

Darya Rose:

(laughs)

Chris Winter:

We're like, "Well, did you fall asleep?" I feel... I didn't even see the opening credits last night. And we weren't that tired. In fact, I told an NBA player one time who's struggling with his sleep. He lived by himself. A cinema headlamp. I said, "Just put this on. Don't turn on any light in your house just when it's bright outside. But as it starts to get dark, put your headlamp on and navigate your house with that." And he said it was really hard for him to even make it to his bedtime without feeling sleepy. I mean darkness does work. If you're in that kind of romantic very white kind of environment-

Darya Rose:

(laughs)

Chris Winter:

... where just a few little lights are on, you're not so dark that you're tripping over stuff. But just... It- it's amazing what it'll do not only your kids. But watch out yourself. I mean it'll really... I put a pair of blue blocker glasses on, those yellow lens glasses-

Darya Rose:

Yeah.

Chris Winter:

... that kind of help with that stuff. But I put them on at lunch time one day. Just left them on. Just to see what would happen. By seven o'clock, I was... I, I was like, "I can't do it anymore. I got to take these off because I, I cannot.. I feel myself like struggling to stay awake already." And I'm, again, somebody you usually stay up much later than that.

Darya Rose:

That's amazing. I find that that's often true on islands as well like in Hawaii.

Chris Winter:

Yeah.

Darya Rose:

Just everybody just shuts down like seven o'clock. (laughs)

Chris Winter:

Yes. Yes. It's really powerful. So, you know, this little blue blocker glasses are great. Here, if you got to be on your home... your computer at night because of your work, just put these on. They, they do help.

Darya Rose:

That's awesome. And in, in this book, you mentioned light therapy. What is that?

Chris Winter:

Yeah. So, well, light therapy, I would say, is technically people who have like seasonal affective disorder which is common in like Pacific Northwest, Alaska because of lighting situations particularly in the winter. It just... It doesn't... It's not sunny. You know, those same neurotransmitters, this is talking to the choir here that, that deal with mood and, and motivation and, and the way we feel are also the same neurotran- transmitters that initiate regulate sleep.

Chris Winter:

And so, for a lot of individuals, if, if you give them light exposures at certain times, it can make them feel better, but can also really affect sleep in a positive way. So if you have a child who is really, really night-ran, you know, and they've got calculus first period. They're really hard to wake up in the morning. Pulsing light, particularly blue green light, but even just bright full spectrum light, at certain times, can really help with that.

Chris Winter:

In fact, Phyllis Zee, Z-E-E, is a, another sleep researcher. And she's wonderful too. She's a real circadian researcher. I remember seeing a presentation she did with like all three of her kids woke up and had these like little visors on in the morning that had this light underneath the visor that I guess was rechargeable. So every morning, she just walked into their bedrooms, put their visor on. And they're like brushing their teeth and getting dressed with this light shining down in their face to help them really regulate make that morning easier.

Chris Winter:

The flip side is if your grandma and grandpa keep falling asleep at 7:00 PM at night, you can give that light to them later in the day to kind of push the night longer. So those things can be really helpful for getting a kid on a bit of an earlier or later schedule or if you're traveling. They can be very helpful with jet lag, a shift workers. So my son used to play travel baseball which was the work of the devil.

Darya Rose:

Mm-hmm (affirmative). (laughs)

Chris Winter:

You had to get up at like three in the morning and drive to like Washington DC and lose three games by combined, you know, 80 runs, and then drive home for God knows what reason. Um, so he would wake up in the morning and put these goggles on that had these lights in them so So that he felt like it really woke him up. So, you know, when the first pitch would happen at 8:00 AM, he was awake and ready to go even though he was getting up at, you know, five to, to get going. So those things can be really helpful to kids. And they're so passive that nobody-

Darya Rose:

Yeah.

Chris Winter:

... really cares about them.

Darya Rose:

Oh.

Chris Winter:

And then, there's also really cool lighting you can put in your house that has like a lot of blue green in it or none. And you really can't tell by looking at the bulb. So if your kids tend to be kind of night owls and it's hard to get them to go to bed, just take all the bulbs out of their bedroom, put the ones that have no blue green in them. So when they turn on the lights and they're playing with their toys and stuff, kind of like what you were saying when the lights were dim, it made them quiet... It can, it can do the same thing even though the intensity of the light's a little bit bright.

Darya Rose:

Hmm, that's interesting. Before we... You know, I do wanna move on to older kids.

Chris Winter:

Yeah.

Darya Rose:

In fact, before we completely leave the baby world, let's talk a little bit about co-sleeping. Are, are there benefits from co-sleeping or I mean and [crosstalk 00:47:34] as well.

Chris Winter:

I think th- I mean there, there's a lot of research that says there is in terms of different attachment things, you know, a lot of cultures feel like when you co-sleep, there's not as much sleep problems that, that persist. I don't have a problem really with co-sleeping as long as safety is considered. Um, and it's one of those things where I, I just looked the other day. I think that I've seen 32,300 patients and, and that's adults and kids. Um, I have been privy to five babies dying including... It's really four. One was not my patient, but was a family... a direct family member of somebody who works for me

Chris Winter:

And it's awful as you can imagine. We don't need to go into that. You can imagine it's terrible. And everybody who did it said, "I will never do it again." These were all-

Darya Rose:

Mm-hmm (affirmative). That's not a small number.

Chris Winter:

It's not. It, it, you know, I think it worked out to be point... Uh, I, I did the percentages and was trying to have some analogy. And it's not a small... I don't think one's a small number.

Darya Rose:

Correct.

Chris Winter:

One is too many for a career. They kind of... I, I don't really like to think about them a whole lot particularly this situation that e exploded the family, divorce soon followed. Uh, one became very alcoholic, felt very guilty about the situation. Um, I just can't imagine that.

Darya Rose:

Right.

Chris Winter:

So outside of the safety perspective, I, I don't really have.... So once a kid gets one year old and beyond, that's really up to a parent, I think. It's... I think it comes with some thing... You know, somebody was saying, "Well, you know, they have better attachment." But, you know, the problem becomes are you able to have a child in your bed long enough for them to say, "Okay. Well, ell I'm done with this. I wanna go to my own bedroom."

Chris Winter:

And I do think that we can consider the parents needs there that I think parents need a little bit of time separated from their child. Again, this might... This is more of an opinion than a scientific fact. So, you know, me being able, able to have some time with my wife at the end of the day and talk and not have children. ... In fact, I w- I had it... I was working with an NBA player who slept with both of his kids because his wife demanded it. And one wet the bed every other night.

Darya Rose:

Oh.

Chris Winter:

He said, "Chris, I don't know what I'm gonna to do because I'm not getting the sleep I need to perform my best because I'm getting up and changing [inaudible 00:49:56] all the time." So I don't... I mean I just had this belief that it's probably better for a kid to kind of develop that independence. But there is research that would say that there are benefits to co-sleeping too. And it's lovely to have a little kid with you and, you know… But I think that parents should do whatever they wanna do. But I think in that first year of a child's life, he or she needs to be like in a bassinet next to your bed, not in bed with you.

Chris Winter:

So this idea, we just have him next to me, and he'll nurse whenever he wants to. This kind of scares me. I mean, I, I sleep so deeply. I could easily roll over into our child. And I would never know it, you know.

Darya Rose:

Yeah.

Chris Winter:

So I think you have to be very careful with that.

Darya Rose:

Yeah. It's really... That's really, really tragic. Um, yeah. That's... That was my fear in thinking about these things, is, is just always safety. But I also... I appreciate that my kids know how to sleep without me. And part of me wonders if they would sleep as well if they needed me there, you know. (laughs)

Chris Winter:

Well, I think... [crosstalk 00:50:56] And I think that there is a counter a body of evidence counter to that, that would say that you're creating a sense of confidence. I mean my kids are 19... 17, 19, and 23. We were sitting on the dinner table talking about this. Um, I said, "Maybe, we made a mistake. Would you all like to join us tonight in our bed?" You know, they were all like, "No. God, no." But, you know, I, I don't know the answer to that.

Darya Rose:

Yeah.

Chris Winter:

You know, I think both sides should listen to one another. But I do think that for what... Uh, in fact, I said to somebody I've never seen that person in my clinic. We don't see a lot of co-sleeping. In fact, it's usually people who have decided we would like to sleep in our bed and have our kids sleep in, in that bed. But there's lots of cultures that don't do it that way.

Darya Rose:

Hmm. Right.

Chris Winter:

In fact, somebody was giving me a hard time because in the book, I said, "We used to sleep on pile on top of each other in caves."

Darya Rose:

Hmm. (laughs)

Chris Winter:

Um, but we also used to smoke in operating rooms and banish people with leprosy. I said, "We evolved." And they were giving me our time. But the word evolve because I said, "No. Evolve just means going from something very simple to complex." That's all the word evolve means. And that's how I'm using it, not that one's better than the other.

Darya Rose:

Mm-hmm (affirmative).

Chris Winter:

My car has evolved. I don't think that's great because when the little computer screen goes out, I can do nothing with the car. I can't fix my car. I can't change its oil anymore. I used to be able to do all these things. So, yeah, you just have to do what's right for you. But, uh, my kids, we went camping one time. I was like, "Okay. Guys, you need to go to bed." They went right into the tent. " Right, right. Sleep. And these other parents are like, "Oh, my God. You are so lucky to have such good sleepers." There's no luck involved there.

Darya Rose:

Right. [crosstalk 00:52:29].

Chris Winter:

I created that, you know. So that's not like the, the short arm of gene, you know, whatever, like, that they got the good sleeping gene. No, no, no. We created that. I think, I think it's a gift that you give your kid to have that confidence. I don't know.

Darya Rose:

That's the exact word that our nanny has used. She said it's a gift to, to teach your children this skill because sleeping is a skill.

Chris Winter:

It is.

Darya Rose:

Yeah.

Chris Winter:

My son was kind of a, you know, he is. But he's not anymore. But he's kind of an elite swimmer and swam at the Naval Academy. And I mean on the biggest night, tomorrow, you need to make this time or you probably won't get a lot of great college offers out cold in five minutes.

Darya Rose:

(laughs)

Chris Winter:

Like just kind of… You know, just that-

Darya Rose:

Yeah.

Chris Winter:

That they weren't really interconnected. The... I need this. This is important. I've got to get some sleep because I'm out of sleep. It's no big deal. So I do think it's a skill that you can develop and create that kind of confidence, not that you can't if your kid slept with you for a period of time, I suppose.

Darya Rose:

Yeah, yeah. Um, I noticed you're wearing a aura ring.

Chris Winter:

Oh, good eye.

Darya Rose:

Yeah.

Chris Winter:

Yeah.

Darya Rose:

(laughs)

Chris Winter:

No. This was actually my Naval Academy son. He, he was wearing it because they gave it all the people on the swim team. And, and he said, "My sleep's awesome every night." So he just stopped wearing it. awa So, so-

Darya Rose:

Oh my gosh.

Chris Winter:

[crosstalk 00:53:49] So I'm actually writing an article for Psychology Today because this watch tracks my sleep. My ring tracks my sleep. And my bed tracks my sleep. And I'm... Here, I'm gonna write an article about how do those three different pieces of equipment compare over like a month's period of time because these things always get a bad rap for being inaccurate.

Darya Rose:

Mm-hmm (affirmative).

Chris Winter:

Sure. Maybe, they're not as accurate as a sleep study. But they're pretty close. And they can be really instructive to some people if you use them the right way. So anyway, yup. Good eye for you.

Darya Rose:

Yeah. It helps me a lot actually as I've been wearing one for years. And I used to not have sleep problems. But after my second daughter was born, she was sleeping through the night. So it wasn't her fault. (laughs) But I, I started having sleep issues.

Darya Rose:

And one, onoe of the things that was... Well, one of the things I learned was that my REM sleep wasn't as good as my deep sleep. And I've since fixed that which is awesome. But also, I've noticed that sometimes, you... I mean earlier, we talked about perception versus reality. I... Sometimes, I would feel like I was awake for like two or three hours in the middle of the night.

Chris Winter:

Yeah.

Darya Rose:

And then, my ring would be like, "Oh, no. You slept great." And I was like, "Are you gaslighting me right now?" (laughs) What's going on?" But I, I found out recently, I, uh-

Chris Winter:

I think you just gave me my title for my article.

Darya Rose:

(laughs)

Chris Winter:

There... There's something. There's a kernel of bri- brilliance in there.

Darya Rose:

(laughs) But I've recently learned that, that what they're the least accurate in is knowing when you're awake.

Chris Winter:

Yeah. But they're... But if you said I think I was awake for two hours, my ring said I fell asleep in 22 minutes, I'm gonna believe your ring. And that's a thing. That, that perception of sleep is so fascinating to me.

Darya Rose:

Mm-hmm (affirmative).

Chris Winter:

And we can run into a lot of problems when we listen to adults or kids who... I met a guy who said... He said, "I, I lived in Germany for six months. I didn't sleep while I was there." And I said something like, "What do you mean by that?" And he said, "Do I stutter? Like I didn't sleep." I'm like, "You think you went six months without sleeping?" He's like, "I know I did."

Chris Winter:

So these things can be really malignant sometimes. So I find... Uh, in fact, we had a, a very high circuit court judge. She came to see me. And what really turned the tide for her was a, a monitor because she would wake up and write in her journal slept 38 minutes, or whatever she got. And then, the, the, the ring or the watch would say, "Six hours."

Darya Rose:

Hmm.

Chris Winter:

And the husband says it's definitely six hours [inaudible 00:56:11] because I woke up twice last night to check on something, and you were asleep. And so, that really sort of tamped down a lot of her anxiety about things because there is this kind of fulfilling. I took me three hours to fall asleep last night, but I'm reading these great articles about how sleep can prevent from dementia. There's a lot of dementia in my family. So oh God, really got to fall asleep much faster than two hours tonight, and that anxiety can screw up.

Chris Winter:

And it just kind of feeds on itself versus these devices can often block that cycle of, oh, well, it looks like I did a little bit better than I thought I did. Well, that's good. So it may not be perfect. But they're pretty close. Like last night, I was looking at bed, ring and watch. Um, I had to catch an early flight today. It was 5:27, 5:32, 5:55.

Darya Rose:

Mm-hmm (affirmative).

Chris Winter:

So that's pretty good, you know. And that's what I would have guessed. So all three of these things are... They may not be accurate. But they're pretty damn precise.

Darya Rose:

Cool. Yeah. I, I also learned that the most accurate... There's with REM sleep because you're completely paralyzed-

Chris Winter:

Yup. Yup. Most of the, the older devices that we use that use body movement. They can grab rim pretty easily because, you know, in fact, one woman, we were looking at her data. And she said, "I didn't sleep." And I said, "Well, your Fitbit says slept six hours." And she said, "Oh, that's wrong." I said, "It thinks I'm... it thinks I'm asleep." But I'm actually awake. I said, "Oh, you just have your non-dominant arm sitting there on the bed not moving it for six hours." (laughs) It's tough, it's tough to fool it in, in that way. But, yeah.

Chris Winter:

So it's, it's... Yeah, we always wanna take these things with a grain of salt. But, you know, they do have a power in them in that unlike that perfect sleep study or, you know whatever that means. This is giving you a much more longitudinal look at your sleep which can be really helpful.

Darya Rose:

Yeah. Well, let's talk about sleep studies. So why would somebody get a sleep study and how does that go?

Chris Winter:

Yeah. I, I think that sleep studies are generally helpful when somebody feels like there's a disturbance in sleep that really can't be identified. I mean somebody's like, "Look. Uh, ever since I've started sleeping with my dog, I feel tired during the day." I, I might have an idea where you could fix something. But if somebody's like, "Look, you know, I eat well, exercise. You know, r my kid's very healthy but, you know, he just completely tears a bed up every night or he's always hot or he screams out three or four times during the night." You know, sometimes a sleep study is a very helpful tool to look at the overall health of somebody's sleep if there are things that might be affecting that.

Chris Winter:

Now, given the fact it's only one night, so if somebody says, "Look. I think my child's having a seizure once a year," that can be tough, um, you know, to capture something. But they're extremely helpful studies. I mean I, I... We were just talking the other day. I said, "I don't think I've ever done a sleep study in somebody where I felt like well that was a waste." Like that, that did nothing for us because, usually, by the time a problem gets to the point where it's in front of a doctor, it's pretty well established within sleep.

Chris Winter:

I mean when we look at sleep happening adults by the time the husband finally comes to see us, his sleep apnea is terrible. Like, "Wow, where have you been for the last seven years," because you stopped breathing 83 times an hour. Well, my wife's been saying that for a while, I guess, you know. It's when I fell asleep at the stoplight and wrecked the butcher. You know, that's what broke the, you know… And it was kids, they never have those kinds of dire outcomes. And that's why those could be so delayed in children in terms of getting them.

Darya Rose:

How old does a kid have to be to do a sleep study?

Chris Winter:

It really depends on the lab. I mean you can do them very soon after birth. Uh, those really, really little babies have completely different rhythms and patterns to their sleep and their brain activity. So in those individuals, I would highly recommend a true pediatric sleep specialist versus I am a sleep specialist, NC kids. But the little kids are almost as completely separate. So each lab and each specialist will have their cutoffs. We see in our clinic a kid of any age, sleep lab will only do kids two or above. Uh, if not, there's another place they can go for those neona- those very young sleep studies which are, like I said, just a completely different situation a lot of times.

Darya Rose:

Yeah. Well, ell let's talk briefly about ADHD because I know that it's very, very common and getting more so. (laughs) And, uh, I, I'm curious the role of sleep.

Chris Winter:

Yeah. I mean I've wrote a lot about this in the book. Uh, I, I don't think any child who is being looked at as potentially having ADHD should be diagnosed until they have a sleep evaluation. It doesn't mean, mean they have to have a sleep study. But they just talk to a sleep specialist about that to make sure that that's healthy.

Chris Winter:

I would like to pretend that, that is my original thought. It is not. There have been doctors a generation before me, Mary Carskadon at Brown who've been beating that drum for a very long time saying a lot of kids that we are calling ADHD actually have undiagnosed sleep disorders which does make a little bit of sense if you think the idea of a kid who is jumping up and down doesn't pay attention in class. He's hyperactive. When you give him a psychomotor stimulant calms down.

Chris Winter:

And when you frame it in the idea of like you were talking about your kids when they get all, you know, wound up because they're excessively sleepy, if you take that feeling of sleepiness away, they kind of settle down because kids don't really respond well to that feeling. So it does make sense to me. And when you look at the number of sleep problems even in adults that affect memory, concentration, mood, irritability, this shouldn't be a particularly profound statement.

Darya Rose:

Right.

Chris Winter:

Even my wife would be like, "Chris, you're, you're really irritable. I want you to lay down because you had a bad call night when you were, you know whatever." So I think those things can be, you know, definitely one of the same.

Darya Rose:

That's a great, great point. Oh, and the other thing that I was surprised to hear you mention in the book is about narcolepsy and how common that is. I was really, really surprised to hear that.

Chris Winter:

Yeah. I mean common... Uh, I don't know that I would necessarily describe it as being common. Um-

Darya Rose:

S- sure, but I thought it was really, really rare. And it's, it's (laughs) not apparently really good.

Chris Winter:

Yeah. So, but, but I think what, what happens is, is that people think of it as being super rare. Like you're gonna see it once in your career. And I think that's a very problematic way to think about it. Narcolepsy is not all that uncommon, one in 2000 people in the United States. But when you look at a sleep center, like where I work, it's probably one in 20 people.

Darya Rose:

Hmm.

Chris Winter:

So within a week, you're gonna say, "We, we have a lot because these individuals, they tend to come from a long way away." And so, we just don't do a great job of diagnosing or really even giving a lot of attention to a child who's tired a lot. In fact, when they're really little, they're awesome sleepers.

Darya Rose:

(laughs)

Chris Winter:

My child puts himself to bed. And my child cries until we let him have a nap, like, "Okay. That's awesome. Good for you." But, you know, at some point, that becomes really strange. Like now, she's not... doesn't wanna play soccer anymore because she really just wants to come home and take a three-hour nap. And those are the things we have to be on the lookout for.

Chris Winter:

We've diagnosed two major league baseball players with narcolepsy. [crosstalk 01:03:35] So you can't be successful with a condition that makes you want to sleep all the time. And when you look at these individuals, they're extremely creative in terms of how they keep themselves awake. Got a young woman who built a desk on a treadmill because she realized, "As long as I'm walking, I'm fine."

Darya Rose:

Hmm.

Chris Winter:

Well, you shouldn't have to walk to be able to do your geometry homework or whatever you're working on like. And so, we just kind of give those things a pass. Plus, there's always a negative connotation to it. if your child always falls asleep in class, there may not be the nicest words in their evaluation. You're lazy. You should try harder. Maybe, you should get more sleep and be off of her phone more because she's so tired when she comes to school.

Chris Winter:

And a lot of times, has nothing to do with that. So if your child's having seizures at school, that's gonna be a very different response from the teachers and administrators that if your kid's like falling asleep in school, that's often looked at as sort of a character flaw. And so, those things are very difficult to, to weasel out. So that was actually the first chapter that I wrote in the book just because it was the most meaningful in terms of what I see in my practice because if you can figure these kids out early, you can change their lives.

Darya Rose:

Yeah. Imagine. [crosstalk 01:04:50] I imagine. Yeah.

Chris Winter:

Yeah.

Darya Rose:

All right. Well, I don't wanna hold you up anymore. I really appreciate all your wisdom. That was amazing.

Chris Winter:

Well, I appreciate your time. These are fun questions. You do a really good job.

Darya Rose:

And where can people find more about your work or find you online?

Chris Winter:

Yeah. So Twitter and Instagram. I'm D-R Chris Winter, Dr. Chris Winter. Um, I have a webpage, wchriswinter.com. And then, my newest book we're talking about, The Rested Child, my first book, The Sleep Solution are on Amazon, Kindle. Uh, if you love the sound of my voice, (laughs) uh, you can find it on audible. And I'll read it to you for 13 hours or whatever the situation is.

Darya Rose:

(laughs) I did.

Chris Winter:

Oh, there you go. It is... It's very multitask, right? Um, so, yeah. So, so, I'm around. It's Winter and sleep. It's t's not too hard to find.

Darya Rose:

Awesome. Well, Chris, thank you so much for your time.

Chris Winter:

You bet. Um, thank you for your platform.

Darya Rose:

Anytime. Thank you so much for joining me today. If you enjoyed this episode with Dr. Winter, please, share it with a friend. Word of mouth is how we grow this show and how I can keep doing this work. If you have a little bit of time, I would also really appreciate it if you could go over to Apple and leave us a review. A five-star review would be awesome if you feel like we earned it. And that would also really help to keep the show going and make sure that we always continue to get great guests. Thank you so much. And I will see you next time.