• Nadya Dich

Frequent night awakenings and independent sleep in children

If there is any child sleep problem that has the capacity to make your life completely miserable, it is this one. It is also one of the hardest to tackle on your own. Your child wakes you up multiple times a night, every night. This has been going on for months, and you don't see it ever ending. Maybe you've tried to change something, but your child got really upset and you didn't have it in you to persist. Everyone around you are giving you advice, often conflicting, and you just don't feel good about following it. Maybe they tell you to stop breastfeeding, but you are not ready to. Maybe they tell you to let your child cry it out, but it is against your parenting principles. Whatever it is, you are at the end of your rope, but you just carry on, sacrificing your sleep to what you believe to be your child's needs, hoping that one day they will "outgrow it".

Let us look at what those needs are and what is driving frequent awakenings.

Biological needs. Newborn babies need to eat every 2-3 hours throughout the day and night because their stomachs are tiny and breast milk and formula are digested fast. However, as babies (and their stomachs) grow, and as their circadian rhythms mature, their need to eat during the night rapidly decreases. A one-year-old can definitely go without food for a stretch of 7-8 hours, and by the time they are two, toddlers can make it without food all the way till breakfast. This is why many babies start to sleep longer stretches as they grow older and by age two, most children are capable of sleeping 11-12 hours without waking up at all (although they might still wake up once or twice a night at this age). A minority of children will, however, still be waking up several times a night (sometimes as many as 10!), even past age one. Often they won't settle unless they are nursed or given a bottle. This is not because their calorie requirements are different. It is because they have developed sleep associations either with sucking or with food (or both), which needs to be unlearned.

Emotional needs. Babies are designed to be dependent on us and seek comfort from us. Dependency on adults is their survival mechanism. From an evolutionary point of view, there is nothing wrong with a baby or toddler who prefers to sleep close to their parents. However, some of them can only fall asleep if they crawl on top of you, or stick their head into your armpit, or do something else that is truly uncomfortable for you. Moreover, they will do it multiple times a night, making it impossible for you to get a good night's rest. Sleeping in your armpit is not an emotional need, it's a sleep association that needs to be unlearned. It is possible to sleep next to your child, if that is what you prefer, in a way that is comfortable for everyone.

Whatever your child depends on to fall asleep is called a sleep association. We all have sleep associations. For many adults, sleep associations are supine position, a pillow, a cover, a dark room... For many babies, sleep associations are sucking (on a breast or pacifier), motion (being rocked or rolled in a stroller) or white noise.

Why are sleep associations key to night awakenings? Did you know that none of us sleeps through? Not even adults? During the night, we go through several sleep cycles (in adults, they are approximately 90 minutes long). We briefly wake up at the end of each cycle, and then fall right back to sleep. Most often, we don't remember those micro-awakenings and have an illusion that we've had 8 hours of uninterrupted sleep (but if you think about it, maybe you'll remember adjusting the pillow in the middle of the night or noticing the moonlight).

The problem with frequent awakenings in children is not that they happen, but that the child cannot fall back asleep without parental assistance. Usually, they will be asking for the same thing when they wake up (breast, pacifier, hug), because they have associated that one thing with falling asleep. So our task is to gently break those associations and replace them with something else, something that does not need us to wake up to provide. Usually, but not always, what the child will be looking for in the middle of the night is the same conditions that were present when the child fell asleep at bedtime. If they fell asleep with a nipple in their mouth, that is what they will be expecting to find (and disappointed not to find) when they wake up after each sleep cycle.

You can significantly reduce the number of nighttime awakenings if you work on those sleep associations. It will require persistence, patience, and support (to you). Some associations (for example sucking to sleep) are more difficult to break than others. Child's temperament, emotional issues (separation anxiety) and family situation (parents' long working hours) may further complicate the task. But I can promise you that you will not have to leave your child to cry alone, wean your child (unless you wanted to anyway), or stop co-sleeping (unless you wanted to anyway).

Family Sleep Counseling is a part of


Stress and Sleep Counseling