When I first heard about the New York Times bestseller called Go The F— to Sleep, my only wish was that I had written it, because I sure thought it a thousand times when my kids were little. And clearly, so have millions of other parents who face that time of day with equal parts dread and exhaustion: bedtime.
But there is hope — and it comes in the form of a solution that is so simple, and thus far so successful, you will be smacking your forehead wondering, "Why didn't I think of that?" (Sort of like me and that book.)
It's called "the bedtime pass," and it works like this: Every night, parents give their child a five-by-seven card that is the bedtime pass. They explain to their child that the pass is good for one excused departure from the bedroom per night, whether that's to use the bathroom, get one more hug, report a scary dream, whatever. After the pass is used, the child may not leave the bedroom again, and the parents are not to answer if they call out.
"It really is that simple," says Connie Schnoes, director of National Behavioral Health Dissemination at the Boys Town Center for Behavioral Health in Boys Town, Neb. "The bedtime pass is all about the kids falling asleep by themselves in their own bed in a quiet, dark room. It gets the parent in the routine of putting them to bed, saying goodnight, and getting out, which is what parents typically want."
Preferably without having to resort to profanity.
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Schnoes conducted the original study on the bedtime pass as part of her PhD research. Patrick Friman, director of the Boys Town Center for Behavioral Health, had told her about a protocol he'd started using while in clinical service at Children's Hospital of Philadelphia, helping families of young children with sleep problems and other behavioral issues.
When Schnoes met Friman at Boys Town, he was still using the method, but no one had studied it. So Schnoes set up a pilot study with two boys, ages 3 and 10, and gathered data from 20 parents and 23 pediatricians who rated the acceptability of the bedtime pass intervention technique.
"Crying and coming out of the bedroom reduced to zero rates in both children," according to the paper outlining the study released in October 1999 in the Archives of Pediatrics and Adolescent Medicine. "Pediatricians rated the pass as significantly more acceptable than letting children sleep with parents and equivalent to ignoring. Parents rated the pass as more acceptable than either alternative."
Since then, larger studies have confirmed the effectiveness of the bedtime pass, particularly for children of preschool and early elementary school ages. In one study, 19 boys and girls aged 3 to 6 "demonstrated significant reductions in the time required to quiet each night. Treatment effects were maintained at three-month follow-up. Parents reported high levels of satisfaction." Another study also found that the pass completely eliminated an "extinction burst" —what we parents refer to as a complete meltdown.
The beauty of the pass is that it gives parents and kids an element of control in what frequently is an out-of-control, emotional situation. The kids know that if they truly need to leave their room they can, but only once. And the parents know they are giving their child an option, but after that one exit they can in good conscience keep the door closed.
"You have a plan, as opposed to reacting each night, over and over," Schnoes says.
The bedtime pass continues to be used at Boys Town and across the country as more pediatricians learn about it. And in case you're a parent out there who thinks that Schnoes' credentials as a specialist in behavioral pediatric sleep problems aren't enough to make her an expert, consider this: She's a mother of six.
"Trust me when we say there's desperation around sleep. I remember those days," she says. "Bedtime resistance is about escaping that experience of bedtime that is essentially like a giant time out—the day is over, we're done playing and we're hanging out in a dark room. With the pass, children have a way to escape that in a way that's acceptable."
Wendy Mitman Clarke has contributed to Smithsonian and other magazines. Copyright 2019 NPR. To see more, visit https://www.npr.org.