So, here's the problem: we are not entirely certain that a standard, regular bedtime routine is going to be possible with The Boy. We know how important it is to establish a consistent routine in terms of time and sequence of activities and daytime naps. We are not entirely sure it is even possible.
The first factor are the inpatient chemo stays. We are fairly sure that The Boy associates cribs with the trauma of his surgeries. That makes sleeping in the crib cruel to inflict upon him. He isn't allowed to sleep in a hospital bed by himself yet, which means that progress towards independant sleep takes a step backwards every three weeks.
Put that aside for the moment. Let's talk about the chemo itself. It affects The Boy's fatigue cycles in a slightly different fashion as the cycle develops. During chemo and early in the cycle, The Boy will take a few more rests during the day. During chemo, he will still fall asleep at normal times at night; however, he might wake up at 3AM and decide that he still wants to play. After chemo and early in the cycle, his more frequent daytime rests will usually mean falling asleep later at night.
As the three-week chemo cycle continues, The Boy will start to normalize to a more usual toddler sleep schedule: a nap around 1PM, lasting 90 minutes or so; and a bedtime at some point between 8 and 9 o'clock on a normal night.
There are some nights, however, that he just will NOT fall asleep. I'm not entirely sure what the common factor is on those nights: diet, amount of daytime activity, one or both parents being out and away from the house. Any or none of these can be factors. I'm kind of chalking this one up to "normal" toddler behavior. I know that I have plenty of fluctuation in my sleep cycles, and I have bouts of insomnia where I canNOT stay in bed for any length of time.
Now, the more unpleasant aspect: I really think that The Boy has some pretty disturbing nightmares. I'm not entirely sure what is giving me that impression. I have a pretty good read on The Boy's physical and facial cues; probably, a better read on him than my wife does, at least for the moment. I recognize what's going on in that impy li'l brain of his, and everything about his body language screams nightmare to me. His "talking" in his sleep, the type of violent motion while he sleeps (kicking, flailing, etc., is all common to toddlers; I think this is different), and his demeanor upon waking all are red flags to me. The way he gets out of bed, screaming and crying, and sprints into the kitchen, which is his comfort room... it's weird. I know that normal toddlers don't like being in bed, for the most part, but his reaction is really quite off.
I wouldn't blame him if he had nightmares. Here's a kid that had a tumor growing in his belly for an unspecified length of time; it was starting to bother him when Daddy took him to a doctor, then for a gooey ultrasound (which was kind of fun). Then, Mommy and Daddy went back to the doctors office, and they started crying while talking to the doctor. That night, someone came and stuck him a WHOLE bunch of times with a needle and wouldn't stop even when he was screaming and crying... when they finally stopped sticking him, they took his thumb away and wouldn't let him suck it, and they made him sleep in a big, scary, metal crib while Mommy and Daddy spent most of the night on an air mattress, trying to help that boy sleep. Then, they sliced him open, ripped out 10% of his body mass, and started shooting nasty toxic chemicals into him. About half of the people that that baby met were dressed in hospital scrubs and tried to poke him, jab him, touch him, look at him, or otherwise bug the crap out of him.
Oh - and, to make matters worse, the tumor regrew. The second surgery was worse than the first, because - even after several 2 hour car rides (which are lots of fun for 14 month old boys) - the nurses wouldn't take care of him and let him get sicker and wouldn't let him eat and wouldn't let him sleep with his mommy and his daddy. Then, they started injecting him with worse chemicals, but he got to spend most of the hospital nights with Grandma, which was good because Grandma is fun and nice. But, they keep bothering him all night when he's in the hospital, changing his diaper every two hours. Plus, they won't let him crawl on the floor, or walk in the hallway, or play with other little boys and girls, or go to the playroom and play with all the cool toys...
It hurt to try to walk for a really, really long time. His hands and his feet and his legs and his belly all hurt him a lot because of chemo.
Isn't that enough to get nightmares? My own, personal theory is that these nightmares are making sleep particularly unpleasant for him. Because he remembers reliving those experiences when he sleeps, he doesn't want to go to bed at night.
I'm re-reading the Ferber sleep book. He's about more than the "cry it out" method that many advocate. I'm hoping to find some ideas that will allow us to compensate for his personal issues, because a well-rested baby is a happy baby - and a happier Musical Daddy.
What do you think? Any bedtime ideas?