How does DrLullaby work?
Users start by completing screening questions to help DrLullaby understand the problem. Please carefully think about what type of problem(s) you select as whatever you click (trouble sleeping alone, refusing bedtime, mind racing/frustration) will dictate the set of weekly assignments you can access during your program.
You will have free access to DrLullaby so you can try the daily sleep logs, and see how an example lesson looks and feels (i.e., sleep hygiene), see the data you can access during your program via dashboard access, and view your set of customized set of lessons. Once you submit payment and begin your program, you can then click open your full sleep program.
While you go through making changes included in your lessons, you must continue completing daily sleep logs and weekly distress scales. We encourage you to continue looking at your dashboard data and clicking each data point (to view graphs) to see your progress and determine which changes are most helpful. When you complete your final weekly assignment, you can then view your averages, graphs and distress score through the dashboard to see the progress made.
We encourage users to complete lessons one after the other as you can then complete your entire program within only 2-3 months. After completing your program, you will continue to have access to your lessons and sleep logging capabilities throughout the year. Many users continue keeping sleep logs to stay on top of efforts to change and re-read/view weekly assignments again and again throughout the year for reminders.
What will I learn in the weekly assignments?
DrLullaby includes all of the lessons taught by sleep experts in clinic. You will have access to videos teaching each concept, graphics reviewing those concepts, reading material and worksheets for more elaborate details. The combination of this approach to teaching you how to execute the sleep solutions are designed to cater to all learning styles. If you follow the behavior change suggestions through DrLullaby, most people see improvement.
My lesson hasn’t opened
You will need to subscribe to access all lessons in your custom sleep plan.
How do I know my sleep progam is finished?
Most programs end with a weekly assignment called “Maintenance and Relapse Prevention”. Once you have opened your lesson, then your program is complete. At that point, many users go back to the dashboard to see if any progress or improvements were made (e.g., improvements with distress scale, total sleep time, time to fall asleep, time awake during the night, or sleep efficiency). After completing initial exposure to the lessons, you can then re-open lessons and view the lirbary of additional strateiges. Most users continue completing sleep logs after completing the sleep program to help maintain gains.
How many lessons are in my custom sleep plan?
Most users have anywhere from 4 to 8 lessons. The number of lessons you have in your set of customized strategies is based on age and type of problem you selected. Just because you received a smaller number of modules does not mean you will have less benefit from the app. We try our best to not assign you strategies that would have no relevance to your problem and perhaps would even produce confusion. In the event that you have a lesson that is not very relevant or applicable, we hope you can learn something helpful and instead focus on the next lesson with more relevance. Most users do not find benefit from all lessons, as this is not the goal. The goal is to at least see some benefit from something you learned through your set of lessons. Our data shows that most people who use DrLullaby see improvement in their sleep data when comparing initial numbers to numbers if they adhere to lesson changes.
How many lessons do I complete per week?
Please work on one new lesson each week. This is consistent with the approach used in clinic. We'll give you one strategy per week to not overwhelm you with too many changes at once. We want you to really focus on trying your best at making each change. We find that if you try to make too many changes at once, then you can not fully dive into the change and may not see maximum benefit from that change.
Why was I assigned these lessons?
The custom sleep plan you received are based on our best effort to assign you evidence-based strategies relevant to age and type of problem you endorsed during your screening questions. DrLullaby includes a patent pending algorithm to assign a customized set of strategies based on years of formal training in Behavioral Sleep Medicine. Training in evidence-based pediatric sleep strategies are complex as different age groups and types of problems require different types of behavior changes in order to fix the problem. The complexities of sleep disturbance were carefully considered when developing the algorithm embedded in DrLullaby.
What does the distress score mean?
DrLullaby includes a Sleep Stress Scale based on clinical experience and training in Behavioral Sleep Medicine. You will get a score of mild, moderate or severe based on how you answered your weekly distress scale. It is very important that you complete the distress scale each week that you are completing weekly assignments in order to best understand the effectiveness of the changes you are working hard to make.
Why do I have to fill out sleep logs?
Sleep experts have patients complete sleep logs in clinic. The data collected from the sleep logs allows patients to see whether they are progressing towards their sleep goals. We collect total sleep time information (including naps). You can look at the “Sleep Need” module to see if the total sleep time average is getting closer to the recommended sleep need for your age. Sleep logs are also helpful for viewing the average time to fall asleep and length of time awake at night in order to gage progress while making changes from the weekly assignments. The sleep efficiency is also calculated based on sleep log entries. See below for more information on sleep efficiency.
How accurate are sleep logs?
Research shows sleep logs are a valid and reliable tool when compared to the gold standard measures of sleep (e.g., polysomnography). That said, the main reason for using sleep logs for DrLullaby is not necessarily because we are accuracy focused, but more because we care most about the perception of the problem and related distress.
Even ifyou are not completely accurate with the sleep log entries, the data is considered valid and reliable because it is the same user's best guess compared to their best guess each day/week. We do not want you to spend too much time filling in sleep logs or worry too much about accuracy but instead see it as a quick way to enter your perception of the problem each day. Consistent entries with the sleep log are extremely important to get the most out of your DrLullaby experience.
What does sleep efficiency mean?
Sleep efficiency is the percent of time one is sleeping compared to the amount of time they spend in bed. Most people who sleep more than 85% or 90% of the time they are in bed have adequate sleep efficiently. That said, it is very important to understand that sleep efficiency can be misleading for children whose parents are involved with sleep because they will have a high sleep efficiency due to parent involvement. For example, a parent who lays in bed with their child at the start of the night, resulting in the child then falling asleep in 5 minutes, then lets the child come into their bed in the middle of the night, resulting in a night awake time of less than 5 minutes, will then have a sleep efficiency above 90%. This does not mean there is no problem with sleep! Such families can rely on sleep efficiency as a barometer of healthy and effective sleep habits. This is why we also include the Sleep Stress Scale and have you note the level of involvement with sleep in the sleep logs. Such families can have a goal of putting “no involvement” in their sleep log and lowering their Sleep Stress Scale, as opposed to focusing on sleep efficiency (and even time to fall asleep or time awake).
What should I do after my sleep program is finished?
After your sleep lessons are finished, we want you to continue using sleep logs to maintain gains and re-open lessons and library strategies for reminders. We know that anyone with a history of sleep problems is unfortunately vulnerable to relapse of sleep problems. Such relapses are common in times of stress, change, travel or illness. Our goal is that you immediately re-open a helpful weekly assignment and re-implement changes at the first sign of relapse to old problems. You should then also use the sleep logs during that time to make sure the re-implementation of strategies was helpful.
For parents using DrLullaby for children - how do I know which problem to choose?
Please spend time carefully considering which problem(s) to select. The problem(s) you select will directly impact the set of customized strategies you can access with DrLullaby, so the problem(s) that you choose are critically important. We provided extra detail within the app so users can understand what we mean by each type of problem listed. The age will automatically dictate which types of problems you can choose from. We ask that you click the icon next to each problem and spend a few minutes reading and thinking carefully before selecting the problems that apply. Do not just quickly pick all problems listed. If you select a problem that truly does not apply, you may waste time on lessons that are not relevant to your family. That said, even when selecting the appropriate problem(s), the algorithm is not flawless. That means, you will still end up with strategies that are not a “perfect fit” for your child. We still hope you learn something from even the indirect fitting strategies and can patiently wait for the next lesson and/or learn from the others in your customized set of strategies.
What does DrLullaby suggest for children who are refusing naps?
Please apply the lessons regarding falling asleep at the start of the night to naps. For example, if a family is working on a gradual parent removal program, and are at the step of putting a chair in the middle of the room while their child falls asleep and returns to sleep, they must do their best to do the same for naps. As well, the 3 step relaxing pre-sleep ritual is selected (e.g., bath, book, music) at bedtime, should also be applied (in a modified fashion - unlikely to have 2 baths!), before the nap. Use of a behavior chart or reward for nap rule following (e.g., child gets a sticker or gets to pick from a dollar store prize box) can also help with progressing towards successful naps. Naps should always be completed at the same time daily and in the same sleep location as nighttime sleep (unless at school). We typically try to encourage families not to start naps after 2pm as they can then interfere with nighttime sleep.
Most children stop naps by 5 years old, but some stop naps even earlier. If despite your efforts to follow these suggestions, your child does not fall asleep for their nap, it is ok to either let them rest instead, or have them get up after 30 minutes of effort. The goal for successful nap behavior does not have to be sleep accomplished, but can instead be following nap rules (e.g.., “You must get into bed within 5 minutes of mom saying - nap time - and stay in bed until mom says - nap over”).
How does DrLullaby suggest addressing early morning awakenings?
Families should set a rule that children should stay in their bed from bedtime until waketime. This rule should be very clear to children and verbally stated (or visually with picture boards for visual learners) nightly. Putting up a poster with visual reminders of this rule (e.g., print out related images from a google image search) can be helpful. Some families benefit from a “ready-to-wake” alarm clock (e.g., alarm that turns from red light to green light when a child is allowed to leave their bed. Use of a behavior chart to enforce rule following (e.g., child gets a sticker or picks from a dollar store prize box when they stayed in bed until scheduled waketime) can be an excellent way to emphasize the importance of following this rule. Parents must bring their child immediately back to their bed if they try to leave the room before the scheduled waketime. We suggest putting a bell on the child’s door (e.g., can use a dog collar with bells or just nail a bell to the top of their door, or even use an inexpensive front door alarm) and the parents’ door. The bell on the door not only signals the parent to bring the child right back to their bed, but also startles the child and reminds them to follow the rule.
As mentioned with naps, the goal should be to follow the rules instead of pressuring to sleep. We find that when children understand that there is no option to get up and play, or see their parents, they eventually get bored, close their eyes again and return to sleep. Therefore, it must start with an emphasis on rule following and removing any pleasurable or reinforcing aspect to getting up before the scheduled waketime. Some children need less sleep than others. The DrLullaby app includes information on sleep need for each age group. It is possible that your child is already getting enough sleep if they are consistently waking before the scheduled waketime and not returning to sleep. If this is the case, this even more so emphasizes the importance of simply getting your child to follow the rules and stay in bed quietly (perhaps at that point, they are allowed to look at a book), as we do not want parent sleep disturbed.
Can I use my FSA/HSA on DrLullaby?
Sleep deprivation treatment is eligible for reimbursement with a Flexible Spending Account (FSA), Health Savings Account (HSA), or Health Reimbursement arrangement (HRA).
The DrLullaby app and coaches do not directly diagnose or treat disease. The DrLullaby app aids in and provides support through
sleep deprivation treatment. The DrLullaby app guides users through the existing basic aspects of
sleep deprivation treatment.
Your DrLullaby receipt (e.g.,, app store payment confirmation) can be submitted for reimbursement through your FSA or HSA benefits. We advise you to check with your FSA/HSA administrator before purchase to check whether DrLullaby is eligible for reimbursement. They’ll also be able to provide you with more information specific details regarding usage, qualifications, and protocol
Once you’ve subscribed to DrLullaby, simply send the receipt to your FSA administrator who will be able to guide you through the reimbursement process.