Sleep Center

No, being able to “self-soothe” is an important developmental skill that all babies can learn.

Research on many kinds of sleep training have not found any harmful effects on the baby or on parents from letting your baby cry. It sets the stage for being able to learn to manage their behavior and emotions over time.

Of course, if your baby is sick or in pain, you need to respond if he cries at night.

The major reason babies wake up and have a hard time falling back asleep is that they have learned to fall asleep with their parents’ help (like being rocked or nursed) at bedtime.

Almost all babies do wake up briefly about every hour to hour and a half — this is normal!

For the most part, sleep “associations” at bedtime like a pacifier or blanket can actually help your baby fall asleep and stay asleep more easily.

It is important that your baby be able to use these comfort objects by herself so that a parent does not need to be there. If your baby is too young to find a pacifier when it falls out of her mouth after falling asleep, it won’t work as a comfort object.

Any objects in a baby’s crib need to be safe.

• Do not put pillows in your child’s crib if he is under age 2.
• Do not put a pacifier attached to a string around your baby’s neck.

It is important to know the difference between bed-sharing and room-sharing.

• The American Academy of Pediatrics (AAP) does not recommend bed-sharing until a baby is 1 year old due to the risk of sudden infant death syndrome (SIDS) or suffocation (lack of oxygen).
• The AAP does support room-sharing.

If you decide to have your baby sleep in bed with you, for cultural or other reasons, please talk about it with your child's primary care provider.

After your child turns 1, bed-sharing does not appear to increase the risk of SIDS.

The decision to have a “family bed” depends on many things. Many parents bring their baby into bed to try to solve his sleep problem. This is often a short-term solution and may cause an even bigger problem (how to get the baby out of your bed) in the long run.

Most babies go from two naps a day to one nap when they are between 12 and 18 months old.

Most children stop napping by the time they are 5 years old.

There is a big range of how children nap during this transition time. Most children go through a challenging period of “giving up” naps.

Keep in mind:

• The total amount of sleep your child gets in a 24-hour period is just as important — and perhaps more important — than “nighttime sleep” and “daytime sleep.”
• What matters as much as how much sleep your child gets “by the numbers” is that your child seems happy, alert, and well rested during the day. However, flip-flopping between napping and not can increase sleep difficulty so it is better to choose one schedule.
• If your child needs an early morning nap (before 10 a.m.), she may be waking up too early; that nap is actually the last part of their nighttime sleep.
• A late afternoon nap (after 4 p.m.) can get in the way of falling asleep at bedtime. Children usually need to be awake for at least four hours before they’re ready to fall asleep again.

Young children often bang their heads (and rock their bodies) before going to sleep, which can be understandably upsetting to parents. However, there is no evidence to suggest that, in healthy children, head banging results in any harm or injury.

Your child is likely having what are called sleep or night terrors.

These happen during deep sleep, which means that even if your child seems somewhat awake (eyes open, crying out “Mommy!”), she does not recognize or respond to you. She may not want to be held or comforted.

Sleep terrors are common in young children and are related to sleepwalking. Children often have both, usually toward the beginning of the night. They last just a few minutes (but may feel much longer to a parent!).

Because your child is asleep, she does not remember being upset the next morning. Sleep terrors do not mean that your child has had any type of traumatic (upsetting) experience.

The most common trigger for sleep terrors is not getting enough sleep. This is because our brains try to make up for lost sleep by increasing the amount of deep sleep during the night. Since sleep terrors (and sleepwalking) happen during deep sleep, this increases the chances that your child will have a night terror.

Not wanting to go to bed is common at this age. Whether you let your child into your bed is your choice, but you should know a few things first.

• If a child is not ready for sleep at his scheduled bedtime, he may fall asleep more easily if bedtime is set a little later.
• Sometimes the amount of time children are expected to be in bed is longer than the amount of time they actually need to sleep. As a result, they have trouble falling asleep, wake up too early, or stay awake during the night.

If neither situation above is true, it may help to think about your child’s behavior as a nighttime tantrum.

Just like it is not good to “give in” to your child’s tantrums during the day, giving in at bedtime should not be acceptable either. If you give in, it teaches your child that this bad behavior works and makes it more likely that he will continue this behavior.

Young children often do not act sleepy (yawning, complaining of being tired) and instead “act out” when they are overtired.

Your child may be cranky, frustrated, over-active, and have little control and attention span. All of these behaviors could mean that your child is not getting the quality or amount of sleep he needs.

No. In general, school-aged children who get enough sleep don’t fall asleep during the day, unless they have a sleep disorder (like sleep apnea).

If your child seems to constantly need more sleep or seems sleepy during the day, you should talk to your pediatrician.

Growing pains usually happen during the night and wake children up with symptoms in their legs.

While it is not clear what causes these symptoms, growing pains may be linked with the sleep condition called periodic limb movement disorder. This causes very restless sleep and kicking movements during sleep.

Another cause of leg discomfort can be restless legs syndrome, an urge to move the legs especially at bedtime.

A common reason older children have a hard time falling asleep is anxiety.

This may start out as worrying about school, friends, or family. But it can also turn into worrying about falling asleep itself: “If I can’t fall asleep, I won’t be able to wake up in the morning, then I’ll be late for school and then I’ll get detention and everybody will be mad at me.” This can cause a vicious cycle of more worrying, leading to more problems sleeping, leading to more worrying. And so on.

You can encourage your child to keep a “worry journal” that he can write in well before bedtime to “get rid of” anxieties before going to sleep. Or, he can listen to a relaxation app before turning out the lights.

It might help your child to work with a counselor or therapist on his anxiety.

Nightly loud snoring can be a symptom of sleep apnea, especially if it happens along with mouth breathing, noticeable breathing pauses, restless sleep, sweating during sleep, snorting, or gasping. Conditions that increase children’s risk of sleep apnea include large tonsils, allergies, asthma, being overweight, and a family history of sleep apnea.

If your child snores or has any of these other symptoms, talk to your pediatrician. Your child might benefit from an overnight sleep study to look into the problem.

The melatonin that you can buy at the pharmacy or supermarket is a man-made form of the hormone that our brains naturally make to help us sleep. Studies show that relatively large doses (3 to 5 mg) given 30 minutes before bedtime can help, especially in children with developmental disorders such as ADHD and autism.

However, all possible short and long-term side effects of melatonin use in children are not known. Also, if you do not include behavioral strategies to address your child’s sleep problems, melatonin is like a Band-Aid. The sleep problem is likely to come back once your child stops taking it.

If you are thinking about trying melatonin, read more and talk with your child’s pediatrician.

Yes. It's like having permanent jet lag.

Sleeping in on weekends until noon or 1 p.m. does not solve the problem of not getting enough sleep during the week. It may even make things worse, because sleep schedules that vary night to night can interfere with the body’s natural sleep-wake cycle (called circadian rhythm).

Think what it would be like to fly back and forth between Boston to Los Angeles every weekend and expect your body to adjust to that schedule.

Around the time that kids go through puberty, their bodies’ circadian rhythms and sleep patterns change and they become “night owls.” This is normal, but some teens shift to a very late bedtime and wake time.

As a result, they cannot fall asleep until very late and cannot wake up at the right time in the morning, because it feels like the middle of the night.

This can lead to frequently being late or even missing school, and can be a serious problem. Fixing it often involves gradual adjustment of sleep patterns, timed exposure to light, and melatonin, which usually requires consultation with a sleep specialist.

Most teens are sleepy during the day simply because they do not get enough sleep. Others may have a sleep disorder, like sleep apnea, that disrupts their sleep so they don’t feel rested in the morning.

A very rare but important cause of extreme sleepiness (despite getting good quality sleep) is a neurological sleep disorder called narcolepsy. There are special tests that can tell if your child has narcolepsy. A neurologist or sleep specialist should conduct these tests.