What parents want to know about sleep for children (and for themselves): the where and when and why and most of all, how much.

Real Life Stories

Sleep and bedtime routines are the topics that come up most often when groups of parents of children of all ages get together. Here are some of their descriptions of some bedtime problems:

- My baby can’t decide whether it’s day or night.
- Elissa comes out of bed at least five times before she gets to sleep.
- Jimmy has more energy than he’s had all day when it’s time to go to bed.
- We let Scott fall asleep in front of the television set, but he wakes up when we carry him to his own bed.
- Sometimes we’re so desperate to get Carrie to sleep that we drive around for two hours because the motion of the car seems to lull her.
- Spencer falls asleep right away if I’m in his bed with him.

And so on…

A Closer Look at Sleep

What is a normal Sleep Pattern?

As with most behaviors, what’s normal varies, even in infancy. As infants develop they gradually spend less time sleeping and more time awake and tuned in to their surroundings. Infants sleep in short spurts and don’t differentiate between night and day, so they seem to be awake more than they really are. They sleep erratically because they spend twice as much time as adults in the rapid eye movement (REM) stage of sleep. During this REM phrase, which accounts for half of their sleep time, babies wake easily and tend to twitch, jerk, suck, make noises and flutter their eyes.

Sometime between 3 and 4 months of age, babies settle into the rhythm of a sleep-wake pattern based on a 24-hour cycle. By 6 or 7 months most babies reach the milestone their parents have been eagerly anticipating - they begin to sleep through the night and will require only two or three short naps during the day. By 8 or 9 months about 2/3 of all infants sleep six to eight hours, and by 12 months most babies get a good night’s sleep.

At 1 and 2 years of age, most children sleep about fourteen hours a day altogether. From age three to adolescence, children need gradually less and less sleep. They seldom nap after the toddler period and nighttime sleep slowly decreases from about twelve hours in the preschooler to about ten hours in the preadolescent.

Sleep strategies established early on will promote smooth sleeping habits as the child grows. As children try to figure out the world, familiar bedtime routines provide valuable structure and predictability.

What can interfere with Sleep

Anxiety about separation, which may first occur at about 8 months of age, can be a factor. A child usually has the security of his mother’s or a caregiver’s presence during the day, but when he is on his own at night he may become anxious. Although separation anxiety is a normal developmental phase, some children experience it with great intensity.

Since going to sleep represents a time of separation from the family, even older children may feel lonely at night. The child may not have learned how to soothe himself and to gradually make the transition to sleep.

A child with sleep problems may have established certain associations with falling asleep and may have become accustomed to such habits as falling asleep in a parent’s bed, long and protracted bedtime routines, falling asleep with a parent or in front of the television set, etc. Some children imagine scary or violent images which may be triggered by television shows, news stories, or things they may have overheard, as they drift off. They may complain that they can’t sleep because of monsters or robbers. Every child has some anxieties and may have occasional nightmares. A child may insist on elaborate rituals; another may demand that a parent lie down with him, that he be read to, sung to, rocked. Resistance to going to sleep may be used as an attention-getting mechanism from a child who may not receive enough emotional support during the day.

Poor sleep in the later childhood years is usually not an isolated problem and is likely to be a manifestation of other stresses, such as moving, changes in families, worry about school achievement, peer concerns, etc.

What you can do ?

In the early years

To help the newborn sleep for longer periods, gradually stretch out the periods between feeding. Sometimes waking the baby shortly before you go to bed to give him a last feeding, may increase the number of hours of sleep. Encourage the baby from the earliest age to learn to go to sleep by himself.

At about 3 or 4 months of age, when the baby settles into a 24-hour sleep cycle, help her differentiate between day and night activities. During the day keep the house light and don’t bother about keeping everyone quiet. Don’t encourage long naps; they may interfere with nighttime sleep. Also keep the baby active during the day so she’s tired at bedtime. Let her nap in her swing, infant seat, or carriage, so that her bed or crib is associated with night time sleep. If she naps more than three or four hours at a time, wake her. Follow daily activities with a calming bath, gentle rocking and lullabies before bed. At night use the opposite strategy from what was done during the day. When you put her in her bed, keep the lights dim and pull down the shades. If you feed her during the night, don’t make it a playtime. Put her back in her crib when she’s sleepy but awake. The point is to let her learn to fall asleep on her own in her own bed, not in your arms. You’re setting the stage for expectable routines and consistency.

If a baby over 5 or 6 months of age wakes at night, give him a little time to see if he settles down on his own. Sometimes a drink of water or a bottle will help. If he cries or is sick or in pain, he needs consolation, but before rushing in, ask yourself what the meaning of the cry might be. If you do go in, don’t pick him up. Talk, pat, reassure him, and provide a favorite toy, and he may go back to sleep. If his cry signals “I want attention now” and it goes on for more than five or ten minutes you may want to follow the advice given by Richard Ferber, M. D., author of Solve Your Child’s Sleep Problems. Dr. Ferber advises parents to:

- let the child cry for five minutes, then go in for a couple of minutes to reassure him and pat him on the back, without picking him up,
- repeat the process during the night, by lengthening the interval that you allow your baby to cry. Move from five minutes to ten and then to fifteen.
- continue to return and comfort the child every fifteen minutes until he falls asleep.

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