We are in the midst of a cultural shift in the way sleep is perceived. Not long ago, it was common to hear people brag about how little sleep they could get and still function. But with a continuous stream of new research being published about the importance of sleep for health, well-being, and performance, it is unsurprising that attitudes toward sleep are shifting. There is now a virtual tidal wave of content being published on the internet about how to optimize sleep, but there is one topic many people gloss over — children.
If a child is not sleeping well, neither are the parents
Any new mother can tell you about the challenges of getting sufficient sleep with a newborn that wants to feed every few hours. But prospective parents may not be aware that a child can continue to have challenges sleeping well beyond the need for night feeds. Often those problems last for years. Researchers believe that 20–30% of children younger than school age have trouble sleeping.
There is no shortage of people who will give you advice on how to get a child to sleep through the night. But it’s much harder to find insights that are based on scientific research rather than someone’s personal opinion. There is useful information out there, for people willing to dig deep enough. As a sleep-deprived parent, I was determined to find it. This knowledge has made bedtime much easier to manage and it has stopped the regular nightly disruptions that were making us all sleep-deprived and irritable. Our two eldest children — three and five years old — go to bed with minimal protesting and very rarely cry out for the comfort of a parent at night. We’re all sleeping better now.
Sleep requirements change throughout childhood and adolescence
Children actually sleep a lot. At two years of age, most children have spent more time asleep than awake. Overall, a child will sleep for 40 percent of his or her childhood. The challenge for parents is that a child’s sleep can be irregular and doesn’t align well to when parents want to sleep.
Sleep researchers have collected lots of data about sleep in children. So there is very good information about how long children sleep at different ages and at what time of day (napping vs. nocturnal sleep).
Newborns have irregular sleep schedules
The immense variability in sleep duration for children below one year of age is striking. Some parents appear to get lucky with good sleepers. The bad news for most new parents is that nighttime sleep during the first year of a child’s life is usually quite irregular.
Newborns do not distinguish between night and day. It takes them a few months to develop a normal circadian rhythm. Newborns feed on-demand approximately every 1.5–3 hours and likely will need diaper-changing during the night as well. They tend to sleep 2–5 hours, then spend 1–3 hours awake. Researchers call this a polyphasic sleep pattern because it is characterized by multiple phases of sleep throughout the day. Most adults tend to have a monophasic sleep pattern, meaning that they sleep in one consolidated stretch during the night. A child develops a consolidated nocturnal sleep pattern 2–6 months after birth.
Sleeping patterns gradually shift until children reach adulthood
As children age, their sleep requirements gradually change. Daytime sleep declines steadily, and the number of naps declines. One-year-olds usually nap twice a day. At 18 months they tend to go down to single nap. By age five, regular napping usually stops. Total sleep duration declines throughout childhood until late adolescence, when it reaches the eight hours required by adults. Before they reach adulthood, adolescents experience a natural, but temporary shift in their circadian rhythm. That shift will make them want to stay awake later and wake up later than the rest of the family.
Resisting bedtime and night wakings are the most common sleep challenges, and they are both learned behavior
Children’s sleep patterns become more regular around one year of age. But it is also around this time that new sleep challenges can begin to emerge. Children develop a drive for more independence and autonomy. They also become physically able to escape their cribs on their own. Developmental milestones can disrupt sleep. So can separation anxiety when children transition to their own room or nightmares and other parasomnias (more on those shortly). But the most common form of challenge is behavioral and can be categorized into two groups:
- Resisting bedtime: stalling or refusal to go to bed.
- Night wakings: problems staying asleep, usually requiring a parent’s assistance to return to sleep.
Both are learned behavior derived from the interaction between the child and the parents. They can be incredibly frustrating, but learned behaviors can be modified.
Overcome bedtime resistance with a consistent bedtime routine
As children develop and become more independent, they attempt to gain more control over their environment. Testing limits is a way for children to learn about their span of control and what constitutes appropriate behavior. Such limit testing frequently takes place at bedtime in the form of stalling, protests, or requests to go to the bathroom or have another drink of water. Some testing of limits is inevitable, but for some parents, bedtime can be a painful battle of wills with the child. Such conflicts are most likely the result of unenforced limits and boundaries. When parents give in to a child’s protests or requests, they reinforce the undesired behavior, making it more likely to reoccur in the future.
The best way to overcome bedtime resistance is to set and stick to a consistent bedtime routine. A bedtime routine means repeating the same pattern of activities each night. Routines have the effect of reducing stress at bedtime because children know what to expect, making the transition between activities easier to manage. Sleep specialists recommend a short routine between 30–45 min of quiet activities that are enjoyable for the children and parents. Activities can include bathing, putting on pajamas, brushing teeth, reading, and singing songs. The routine should have a gradual progression toward the child’s bedroom and should avoid any backward steps, which would reinforce resistance.
Think of your bedtime like a little machine that you run every night to help your child transition from wake to sleep.
As children get older, they will want a greater sense of control, which can be achieved by allowing them to make decisions within clear boundaries. Such choices can include which pajamas to wear or which book to read, but should not include changes to the routine itself.
Nobody sleeps through the night — self-soothing is the goal
A rudimentary understanding of how the sleep cycle works can help clarify why hoping a child will sleep through the night is an unrealistic expectation. Sleep researchers have discovered that sleep is not a uniform block of unconsciousness, but a cycle of varying brain activity. Adults generally complete four to five sleep cycles per night, each lasting about 90 minutes. The sleep cycle progresses through several stages from wakefulness to increasingly deeper sleep, before returning to a more active stage known as REM-sleep. Brief awakenings are common during the REM stage.
Newborns have much shorter sleep cycles and spend more time in REM sleep. Sleep cycles get progressively longer until they reach adult-like durations when children reach school-age. The critical takeaway is that everyone goes through several sleep cycles each night with a brief period of partial wakefulness that can occur at the end of each cycle. Everyone wakes up during the night, but most people fall back asleep quickly and forget that they were ever awake.
Night wakings are the result of the inability of the child to fall back asleep without help. They usually occur when a child has learned to associate falling asleep with something else such as the presence of a parent, a pacifier, a rocking motion, hand-holding, etc. If the child wakes up during the night, and that thing is not present, he or she will usually cry for help.
Whatever children need to fall asleep at bedtime, they will also likely need during the night to return to sleep.
Children need to learn to fall asleep independently — without parental intervention — this is often called self-soothing. Experts recommend that parents begin putting a child to bed drowsy, but awake when they are 3–6 months old, so they can start learning to self-soothe.
Sleep training methods can be used to overcome frequent night wakings
Sleep training consists of a set of techniques derived from behavioral psychology that can be used to correct unwanted behavior. It is not appropriate for children younger than six months old. There is some controversy around sleep training, which tends to focus around one of the most drastic methods, known as Cry-It-Out. This method involves ignoring a child’s cries until he or she falls asleep. Psychologists and sleep experts debate whether the process is too distressing for the child. It also proves incredibly difficult for parents to ignore a crying child for long. Luckily, there are several gentler methods which have proven to be effective.
A regular sleep schedule and consistent bedtime routine are considered the gentlest methods for addressing sleep challenges. But to overcome night wakings, the child needs to learn to fall asleep without help from a parent. It is necessary to break or replace associations that require a parent to be present. One approach is to provide an alternative form of comfort such as a stuffed animal — although this can backfire if the beloved toy goes missing.
Several methods work through gradual withdrawal. Children slowly get used to falling asleep on their own, without the sudden shock from the complete absence of parental comforting. There are two main approaches:
- Ferber Method: Involves leaving the child alone in bed for progressively longer intervals before returning to comfort the child. The child will probably cry, so the parent needs a firm resolve to stay away until the time is up.
- Camping Out: Parents gradually withdraw their presence by moving farther away from the child every few days. It may start with the parent lying next to the child, then moving to a chair next to the bed, and later moving the chair to the other side of the room. The aim is to continue withdrawing until the parent is outside the room when the child falls asleep. The process can take several weeks.
Bizzare nocturnal behaviors are common in childhood and usually resolve on their own
Bedtime resistance and nighttime wakings are the most common sleep challenges that parents face. But there is another class of challenge — referred to by experts as parasomnias — which include nightmares, sleepwalking and other strange nocturnal behaviors. Parasomnias are common in preschool-aged children and are usually harmless, occurring in children who are healthy and happy. They tend to go away without treatment as the child enters adolescence. When it comes to nightmares, parents generally do the right thing by providing comfort and empathy. Other parasomnias can be trickier.
One of the most frightening parasomnias is the night terror, which is not to be confused with nightmares. With a night terror, the child is not dreaming and may even appear to be awake. The child may sit up, cry, scream, and thrash about. Experts believe that night-terror sufferers are caught between a sleeping and waking state. That could explain why the children remain unresponsive to a parent’s efforts to calm and console them. They also generally do not remember the night terror when they wake up the next day. The most important consideration with parasomnias like night terrors or sleepwalking is ensuring the child’s safety by avoiding a fall or an accident.
With the right knowledge, parents don’t need to be sleep-deprived anymore
For parents, dealing with sleep challenges can be exhausting. Sleepless nights can turn into unproductive days. Irritability caused by sleep deprivation can compound the problems and make coping with them harder. But the good news is that small and gradual changes applied consistently can make all the difference. With the right guidance, most children can become good sleepers. Regular sleep schedules and consistent bedtime routines are essential guidelines for the child, making the process predictable and easing the transition from waking to sleep. Allowing children to make certain choices gives them a sense of control without the process descending into chaos. Importantly, falling asleep alone is a skill that children need to learn. Parents can help by putting young children to bed drowsy, but awake. As children get older, parents should gradually withdraw their presence to ease the children into self-soothing.
After doing all this research I was amazed that the information was so hard to find. Having this knowledge sooner could have spared me many sleepless nights and sleep-deprived days. I hope this article can help other parents in a similar situation. There is a lot that parents can learn from dealing with sleep challenges — not least the appreciation of a good night’s sleep.