To Co-Sleep, or Not to Co-Sleep?

It was always so reassuring to me, to reach over and place my hand on my child’s chest or back, to feel the slow, rhythmic flow of air in and out, like waves on the beach. I could place my head close to him, feel his sweet breath on my cheek, and feel a closeness seldom attained in waking hours. I knew that he, too, fell asleep easier, to the sound of my own breaths. He was close enough to be lulled to sleep by my heart, sometimes. For many months, growing into years, this was our arrangement. It became more troubling than reassuring as little knees and elbows grew sharper, and were thrown with greater force. That seemed the ideal time to move my son into his own bed, a development which proceeded in stages over several months but resulted in more restful sleep for both of us. Sleep-sharing (or co-sleeping) is a family habit that brings with it much debate in our country. In affluent Western society, we have ideas about personal space that are uniquely our own. Here in the United States, composed of nuclear families with 2.2 kids, living in single family dwellings with 3.1 bedrooms, parents sleep together and kids sleep separately, often in their own rooms. Around the world, where other concerns “personal space” unimaginable, families often share one-room dwellings, whole bedrooms, and single beds together. The generate warmth from each other, and take comfort from the closeness of loved ones. In ancient times it was the same for many. In all likelihood, more of the human experience has been spent in a common bed than in separate ones.

So why do we Americans balk at the idea of a common bed for the whole family, or even for parents and an infant? One concern is safety of the youngest members. The Consumer Product Safety Commission issued an opinion in 1999 that children under 2 should not share the family bed, based a study of deaths. But the diagnoses of these deaths attributed to “overlying” are not themselves well studied, nor are they distinguishable from SIDS (Sudden Infant Death Syndrome). The vast majority of overlying cases involve heavy use of alcohol or drugs by the parent(s), or extreme obesity. These factors were not included in the CPSC study. The study also did not consider SIDS cases where co-sleeping did not occur. It has long been argued that the family bed markedly reduces SIDS cases. Co-sleeping is the norm in Japan, which boasts the fewest SIDS cases of the industrialized nations.

The CPSC also ignored other benefits to sleep-sharing, including better facilitation of breast-feeding. This arrangement allows more sleep and less late-night activity for the mother, enhancing her abilities to care for her young during daylight hours. The American Academy of Pediatrics has reluctantly admitted this benefit to co-sleeping.

Another concern is propriety, or “we just don’t do it that way here”. Americans value their personal space, and can be reluctant to share it with certain people, or under certain circumstances. We have the space to spread the family out for sleeping, so why not use it. But it is these hours, the darkest and most frightening, that are frequently the only ones we expect our children to spend completely alone. There is some evidence that maintaining physically close relationships with infants contributes to the child’s enhanced social abilities later in life. Other studies indicate that newborns without adequate physical closeness may grow into more shy, withdrawn children. Children who are frightened release stress hormones and catecholamines ("adrenaline"), which have been associated with long-term memory damage. Our conventional belief that children should be allowed to “cry it out”, or taught to “be tough” is supported by no scientific evidence. If one does decide to co-sleep with an infant, there are certain guidelines to follow, which are available in books, parenting magazines, on the web, and other places.

This is what “experts” say on the topic, but the personal experience of parents is just as valid. Transitioning my son into his own bed at what seemed to both of us to be an appropriate age was not difficult. I put him to bed in his own bed, and moved him to mine if he woke up during the night. Gradually, he slept longer in his own bed, and spent less time in mine. In our case, we had the bed to ourselves, so there was plenty of space in a double bed. I’ve always cherished this shared experience, and believe that it contributed to the close relationship that we continue to share. Circumstances have changed, however, since those days. I share that same double bed with a partner, and there is significantly less space for an infant. Considering the value of sleeping with the first one, my partner and I came up with a solution. Inspired by a product I’ve seen hawked at various discount stores, we built our own add-on-bed. With a wood frame, upholstered in foam padding and bright colors, our new “crib” is the same height as our bed, has rails on 3½ sides, and an opening facing our bed. With this arrangement, I can slide the baby in and out of bed as she wakes. She’ll be close enough that I can touch her when I need reassurance that she’s ok or when she needs comforting, can whisper to her softly as she drifts off to sleep, and can bring her closer or move her back to bed without having to leave my own. But I also won’t have to worry about her falling out of my bed or taking a hit from her father’s wild elbows. Without having put the bed to use yet, I’m enthusiastic about this compromise between the benefits of co-sleeping and the practicalities of bed space and life-long sleeping habits. And if her brother needs to be close as well, there’s always space on Dad’s side of the bed for a sleeping bag.

This account was written with reference to:

David Servan-Schreiber, M.D., Ph.D
Clinical Associate Professor of Psychiatry, Univ. of Pittsburgh School of Medicine Chief, Division of Psychiatry, Shadyside Hospital Medical Director, Center for Complementary Medicine Former Co-Director, Clinical Cognitive Neuroscience Laboratory, Carnegie Mellon University and University of Pittsburgh

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