'Sleep lady' in St. Louis solves snoozing issues

Sunday, December 28, 2008 | 8:11 p.m. CST

CHESTERFIELD — The cyst on her eye was the size of a grain of sand — something doctors usually find in soldiers suffering from severe sleep deprivation, not high school teachers.

But last year, Wentzville resident Amy Kiehl, the mother of a 7-month-old with a nearly all-night appetite for her mother’s attention, had developed just such a combat wound.

The math teacher was so tired, she was messing up equations and pausing to add simple numbers. And though her husband was sympathetic, he wasn’t the one getting up three times a night to soothe a crying infant.

“It got to the point where it felt like I was drunk at work,” she recalled. “I was so sleep deprived I was dizzy, sick to my stomach and couldn’t think straight.”

So, like thousands of parents from the St. Louis region trying to solve the riddle behind their children’s sleep issues, Kiehl drove herself to a nondescript building at St. Luke’s Hospital in Chesterfield. She had come for a fateful 90-minute consultation with “the Sleep Lady.”

Six days later, little Natalie Kiehl calmly lay down in her jungle-themed crib and slept through the night.

“If anyone had told me it would take less than a week, I would not have believed it,” Kiehl said.

The Sleep Lady is Nancy Birkenmeier, a woman whose ability to conjure fast-acting and minimally tearful bedtime spells for parents has made her a fairy tale figure with area parents.

A nurse at St. Luke’s Sleep Medicine & Research Center, Birkenmeier has been working in the pediatric sleep field for nearly two decades. Twenty years ago, Birkenmeier said, the center, then based at Deaconess Hospital, was turning away parents in desperate need of help for their children. That led her to jump into the field in its infancy.

Although there are a growing number of sleep research and sleep centers in the region, Birkenmeier stands out with parents because of the detailed one-on-one consultation she holds and her exacting, step-by-step plans that map out most every detail of a bedtime routine.

Thousands of books now offer differing techniques for putting children to bed. Some advocate letting infants cry it out until they go to sleep. But Birkenmeier argues plenty of alternatives are available to easily reduce anxiety for parents and crying for children.

After all, says Birkenmeier, “Saying good night is goodbye, and that’s hard for children.”

She also firmly says there’s more than one way to woo a cranky child into a sleep pattern.

She offers parents options — not just rules — that better fit their beliefs and comfort levels.

That’s why on Internet blogs, in car pool lines and in play groups, she has been credited with magic powers — and saving marriages.

Stay-at-home mom Kristen Swearngin of St. Louis said her son Charlie’s poor sleep and napping habits were definitely straining her and husband Mike’s relationship.

“I just was starting to grow so tired and resentful because I was up twice a night, and I never got any rest,” said Swearngin, whose son’s sleep problems were solved.

Birkenmeier, the mother of two adult children, said she didn’t have sleep problems with her own children. But she said she feels the pain of parents such as Swearngin.

“It’s really all about sanity,” Birkenmeier said. “You just cannot maintain sanity when a child has you up all night, night after night.”

With the holidays in full swing and trips under way over the river and into the minivan, Birkenmeier is in the midst of her busiest season.

Holiday family trips, hotel and guest bedrooms, rocking-chair-loving grandmothers and impromptu car seat naps can wreak havoc on sleep routines.

Not that there’s anything wrong with rocking a child to sleep or an all-night cuddle with mom and dad in a guest bed, says Birkenmeier. Parents are doing what they need to do to get overly stimulated kids to sleep in unfamiliar circumstances.

But by January, Birkenmeier says, parents have trouble breaking their little ones’ newfound love of sleeping next to an adult or rocking to sleep. That’s when the calls increase.

“What increases even more is a certain tone in a parent’s voice, which suggests they’re bordering on panic,” Birkenmeier says.

Adults need about eight hours of sleep a night. But little children need a lot more: about 14 hours for a 6-month-old and 13 for a 2-year-old. Overtired children often become overactive, may have trouble learning and ironically have a harder time getting and staying asleep.

Recent studies suggest sleep deficits in children contribute to obesity later in life. Despite these findings, a 2004 survey by the National Sleep Foundation concluded that, like adults, the majority of children in the U.S. fail to get the minimum number of sleep hours recommended for healthy development and optimal daytime performance. And Birkenmeier says parents — trying to stuff traditional parenting duties and full-time job responsibilities into a 24-hour day — routinely hedge on the hours their children need to sleep.

Kids transitioning from a crib to a bed are often challenging because they can come up with as many excuses to delay the inevitable as there are stuffed animals in the world.

Birkenmeier says there’s often an obvious solution here that many parents resist: putting the child back into a deep crib.

So, what was the spell that worked on little Natalie Kiehl?

She was so comforted by nursing, she was using it as a way to go to sleep over and over again, Amy Kiehl said. When Amy went to Natalie during the night, the smell of breast milk on her was “like torture.”

So Birkenmeier gave Amy literal marching orders.

Two hours before Natalie’s bedtime, Amy left the house and did not return until husband Scott had put their daughter to sleep using a detailed checklist to soothe her way. It sent the message that mom would not be there to rescue her and also took the aroma of mom’s breast milk out of the house.

Birkenmeier stresses that a sleep plan, no matter how nuanced, will work only if parents fully commit to it. A good sleep plan, she says, is “short and sweet, very predictable and nonnegotiable.”

Birkenmeier has one other kind message of advice to parents: Lighten up on the guilt.

“I’m just amazed at what parents put themselves through,” she says. “They say, ‘Oh my gosh, I caused this. It’s all my fault.’”

But as Kristen Swearngin can attest, the Sleep Lady wants to deliver a happily ever after.

“I never really started truly enjoying motherhood until I got a good night’s sleep a few nights a week,” she said.

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