Dream Nannies founder Kim Martin knows what it's like for a parent to suffer from sleep deprivation. Her first son didn't have a good night's sleep for 18 months. But when a friend came in and sat with her through the night, Kim realised just how supportive this simple act could be. Thanks to one of the techniques now used by Dream Nannies, her son's sleeping problems were solved in one night.
With three years' experience as head teacher at a nursery school, Kim knew she wasn't the only one having to cope with interrupted sleep. Parents often came in complaining of a rough night. 'There was clearly a need for a service that could support these people,' Kim recalls. 'You can read books or see your GP, but having someone there with you makes all the difference.
'Other services already existed, where a nanny would come in overnight just to give the family a rest, but that still left a gap in the provision,' says Kim. 'Nobody offered both support and a solution to the problem.'
Dream Nannies was set up to put these two aspects together. Kim set about researching the market and writing a business plan, and her agency, supplying nannies known as 'sleep consultants', has now been running for about six months.
'The response has been phenomenal,' says Kim. 'The youngest child on our books is eight weeks old and the oldest three and a half years, so we need lots of staff, since the needs of families are so different.'
The reasons behind sleep disturbances can be as varied as the children themselves. Some might be early risers, while others have never had a complete night's sleep. Many simply experience an event that interrupts their usual sleep pattern, such as illness or moving house. Sometimes, the cause may have a deeper psychological component. 'One child had been feeling neglected by his busy father,' says Kim. 'This was made worse because an older sibling was receiving more attention, partly because he was more articulate and able to interact on a different level with the father.'
But sleep problems are not always the result of emotional distress. A child may be genuinely hungry, or may have a physical problem such as constipation, all of which affect their ability to sleep.
It is for this reason that Dream Nannies' nannies don't just rush in and start using techniques to encourage sleep. An initial consultation with the family is a vital part of the process. This is important to assess what the problems are and what has been done to try to resolve them. It also helps build relationships with the whole family. If a child likes a consultant, they are more likely to feel comfortable when she appears in the middle of the night in place of 'mummy'. The early meetings are also a time to understand the parents' needs, so while some nannies take on the role of carer for the night, others share the task with the mother, or just offer advice.
Before beginning a sleep training programme, consultants spend time observing the child during the day. Being aware of eating patterns or bathtime routines, for example, can often give an indication of the problem. If the child has an early bath, and then spends the next half-hour playing energetically with older siblings, it is not surprising he is reluctant to go to sleep. Sometimes a simple change, such as altering a bathtime, or not reading stimulating stories before bed, can break the pattern of poor sleep. So it's important to get to the root of the problem as soon as possible. It is this aspect of the work that can make the consultant's role particularly satisfying, and prevent it from simply being a formulaic approach to sleep disturbances.
Sometimes, there is no obvious reason for a child's sleep problems. In these instances, Kim has found the technique of 'controlled crying' to be of enormous benefit. The method, pioneered in the US by Dr Richard Ferber, director of the Centre for Paediatric Sleep Disorders at Boston Children's Hospital, involves letting a child cry for a set period of time before an adult comes to offer reassurance. Some parents or nannies may find it difficult to ignore a crying child, even for a short period, and this has made the method controversial. 'People need to do whatever is right for their family,' says Penny Hames, child psychologist and author of Help Your Child To Sleep (NCT/Thorsons, Pounds 6.99). 'The method does seem to work, but, psychologically, it's often more of a concern for parents than for the child. They don't feel abandoned; they are so young they don't remember.
All that happens is they have a good night's sleep.'
Dream Nannies sleep consultant Fiona Knight used controlled crying with her own children, and enjoyed a complete night's sleep with her son after six weeks, and her daughter after only two. She now uses it in her work with other families (see box).
Being adaptable is the key to becoming an effective sleep consultant. Each new placement brings a different situation, and success depends on having a flexible attitude. To help consultants learn their role, Kim Martin has set up a training programme that offers a comprehensive introduction to the field. Subjects include sleep cycles and the concept of 'core sleep', along with ways of expanding it. The medical causes of insomnia and recognising different types of crying are further topics in the training.
Kim says, 'We also look at sleep associations, the ways children fall asleep that are adult-dependent, for example, cuddles or rocking, and those associations that are not adult-dependent.'
Each consultant is given a manual to use as a learning and record-keeping journal. Kim encourages consultants to view their role as professionals, and to keep up to date with trends in the field via new publications and the internet.
Sleep consultants earn up to 14 an hour, but it is not always an easy job. 'Working as a sleep consultant is a challenge,' says Kim. 'But there is a real sense of achievement. A marriage could be breaking down because of sleep deprivation, and you can go in and say, "I'm going to take over, I'm going to do it all for you". The combination of support and a guaranteed night's sleep is often enough to salvage a relationship. And it's a wonderful feeling when the family acknowledges that it's what you have done that has brought about the change.'
Contact Dream Nannies on 020 8255 9272 or see www.dreamnannies.co.uk
CASE STUDIES
Fiona Knight has been a nanny for 13 years. When her second child came along, she found that working as a sleep consultant meant she could continue using her skills and experience, and still get to spend time with her own children during the day.
Fiona has had three placements so far. After a consultation with the first family, the mother decided she wanted to take on the role herself, so she calls Fiona once a week for a progress report and to ask advice on specific issues.
In the second placement, Fiona worked alongside the mother, and the programme was a clear success. 'In the morning, I saw the relief on the mum's face - it was the first night's sleep she'd had in months. It's a fantastic feeling to know the family is going to be sane again,' says Fiona.
In her current placement, Fiona is working with a young boy who has had a series of unsettling events. He was moved out of his bedroom while builders worked on the house, and then when he returned to his room, his parents moved out of their bedroom.
'On the first night, I let the mum do what she normally does, so I could observe his reactions,' says Fiona. 'The next night, I went in and rubbed his tummy, or stroked his back, and reassured him that everything was all right. And I gradually increased the time between visits, from five, to ten, to 15 minutes. On the third night he was really good. He woke at 10pm and we had an 18-minute session, then he was fine until 5am. After that, he slept again until 6.30am. He normally wakes up every hour or two, screaming, and then is up at five, so for the mum this was fantastic.
'The work can be quite hard, especially if you're not good functioning on little sleep yourself, but the benefits outweigh the difficulties,' says Fiona. 'There is immense satisfaction in knowing that you've helped a family in despair.'
