Sleep is an essential part of your children’s growth and development--it helps them stay physically healthy and remain alert during the day so they can explore and learn.
It can be challenging and stressful to ensure that your child is getting enough restful sleep, especially when their difficulty sleeping is also keeping you awake!
But Pathfinder Health is here to help.
In this article, we’ll go over the basics of children’s sleep–how much they need, why it’s important, and how to overcome some of your baby's sleep challenges.
In this article:
How does sleep work?
Sleep may seem simple–you’re awake and then you’re not–but it’s actually a very complex process. Knowing how sleep works can help you reach a better balance between sleeping periods and waking periods for both your child and yourself, improving everyone’s health and well-being.
Sleep consists of two main types: Rapid Eye Movement (REM) sleep and non-REM sleep. Each type has a different role in development as well as feeling rested and energetic.
REM sleep
REM sleep involves higher brain activity than non-REM sleep and is believed to be the stage when dreaming takes place.
Non-REM sleep
Non-REM sleep is the time when our bodies rest and recover. Non-REM sleep typically occurs in three different stages that involve progressively slower brain waves as we enter deeper sleep levels.
Sleep cycles
Together, REM sleep and non-REM sleep form a sleep cycle. Our brains switch back and forth between these two stages multiple times per night.
Sleep cycles vary in length depending on the individual, but usually follow a pattern of light sleep followed by deep sleep.
As children get older, their sleep cycles get longer.
Newborn babies experience different types of sleep:
quiet sleep (similar to non-REM)
active sleep (similar to REM)
indeterminate sleep
Newborns begin their sleep cycles with REM sleep, not non-REM, and usually only sleep for one or two sleep cycles at a time. Around three to four months, infant sleep begins to change.
We'll discuss this period–known as the “four month sleep regression”–below.
The percentage of REM sleep is highest for infants and young children and begins to decrease as children get older.
Why is sleep important?
Ensuring good sleep is a vital part of keeping your child healthy–both physically and mentally–and promoting their development.
Below, we briefly describe some of the many ways that sleep affects your child’s health.
Physical health and growth
Getting enough sleep is essential for ensuring that your child has enough energy throughout the day to be physically active.
Children who aren’t physically active enough due to lack of proper rest are at increased risk of obesity, high blood pressure, and diabetes.
Moreover, insufficient sleep can affect hormone release, which can lead to additional appetite stimulation and consumption of more calories.
Sleep is also necessary for your child’s physical growth and development. As much as 75% of their human growth hormone (HGH) level is released into their bloodstream during sleep.
HGH is vital to your child's growth, but it is also essential to helping their body heal and repair itself and regulating their metabolism.
Immune system health
Lack of sleep can affect your child’s immune system, leading to more frequent illnesses and making it difficult for their bodies to fight off the viruses to which they will inevitably be exposed at school, daycare, playgroups, and other activities with other children.
Studies have shown that children are more susceptible to colds when they are sleep deprived.
Mental and emotional health
As an adult, especially as a parent, you know that sleep affects your mood and mental health. When you don’t get enough sleep, you can feel tired, cranky, and irritable all day and have trouble concentrating on tasks. The same is true for your child!
Good sleep is necessary for emotional regulation in children of all ages, especially toddlers and preschoolers who are still developing skills such as impulse control or self-calming techniques.
When kids don’t get enough restful sleep at night, they may be unable to process overwhelming emotions and this could contribute to outbursts or tantrums during the day.
Getting enough rest can also help reduce stress levels in kids, which helps them stay focused on tasks during school or other activities.
Memory
Quality sleep helps your child’s brain develop memory recall functions, which are critical for learning new things and remembering facts.
Sleep is also the time when your child’s brain sorts through and stores information, replaces chemicals, and even solves problems.
How much sleep should my child get?
Sleep is essential; yet, according to the National Sleep Foundation, nearly 30% of children and 75% of teenagers are not getting the right amount of sleep.
The following table lays out the American Academy of Pediatrics (AAP) recommendations for how much sleep, on average, children need at different ages. Your child may sleep more or less than this amount and be perfectly healthy and developing at the expected rate.
If you have any concerns about the amount of sleep your child is getting, consult with your healthcare provider.
As the above table shows, your child's total sleep should include a number of naps, depending on their age.
During their first 2 years, they will periodically drop a nap until they are taking only 1 afternoon nap per day.
"Wake windows" refer to the amount of time that a baby is awake in between periods of sleep, either naps or bedtime. When your child is a newborn, their wake time will generally be quite short. As they get older, they will need a longer wake window to be tired for their next sleep time.
What does it mean when your baby "fights sleep"
"Fighting sleep" is an expression parents sometimes use to describe the frustrating experience of a baby or child who is clearly tired but struggles to fall asleep or stay asleep.
Many babies cry briefly when first put down for day or nighttime sleep, but a baby who fights sleep will continue to fuss even though you have met all of their physical needs.
Why do babies fight sleep?
Depending on their age, there are many reasons babies fight sleep. Some of these factors can continue to be an issue even for toddlers and older children.
1. Newborn sleep confusion
It is completely normal for your newborn to sleep for only brief periods throughout the day and night.
Brand new babies have no concept of day and night and need to eat every 2 to 3 hours, so they sleep in short cycles with no regard to the hour.
To a newborn, being awake at 3:00 am is no different than being awake at 3:00 pm!
Don't worry, though--your baby will begin developing their circadian rhythm between six and twelve weeks and will begin to sleep more during the night.
2. Sleep regressions
True sleep regressions
Sleep regressions are common for babies and young children, even those who normally sleep well. These generally occur during a time of significant growth and development, such as when your baby is about to achieve (or has just achieved) new milestones, transitions to fewer naps, is teething, or begins to experience separation anxiety.
During a sleep regression, your child might take longer to fall asleep, wake more frequently during the night, skip naps, or take shorter naps.
The timing of sleep regressions may vary by child, but in general, most children go through a sleep regression around the following ages:
6 weeks
4 months
8-9 months
15 months
18 months
2 years
Sleep regressions usually last between 2 to 6 weeks, after which your child's sleep should return to normal.
You might be tempted to change your child’s bedtime or nap routine in response to a sleep regression or introduce a new method to help them fall asleep, such as rocking them to sleep or sleeping in their room.
Resist the urge! Sleep regressions are temporary but the bad habits you create in response to them can persist for years.
Instead, maintain your usual routine and encourage your child to be extra physically active during the day so that they will be tired and ready for sleep.
If your child is still a baby, you can also offer additional feedings, since sleep regressions can coincide with growth spurts.
And of course, be ready with extra comfort and affection to help both of you through a tough period. The sleep regression will end eventually!
The 4 month sleep regression
The exception to the above is the 4 month sleep regression. This is not a true sleep regression, but a permanent change in how your baby sleeps.
Your baby is beginning to cycle between periods of light and deep sleep, just like you do, but they will also begin waking between cycles.
Helping your child learn to fall back to sleep independently is the best way through this period of adjustment.
3. Sleep debt
A sleep debt (or sleep deficit) is the difference between the amount of sleep your child should be getting and the amount that they are actually sleeping.
Over time, a sleep debt can build as your child experiences continued sleep deprivation.
This will generally manifest in your child seeming grumpy when they wake up, being less alert, and/or having more tantrums or fussiness.
It might seem counter-intuitive, but being overtired can actually cause your child to fight sleep even more, continuing the sleep debt cycle.
When your child becomes exhausted, their little body is flooded with two hormones, cortisol and adrenaline.
Cortisol helps to regulate their sleep-wake cycle and adrenaline is part of the fight-or-flight response.
Higher levels of these hormones lead to an overstimulated baby who will struggle to fall asleep and stay asleep.
Remember the popular saying: "sleep begets sleep." If you are dealing with a sleep debt or your child is consistently overtired, it is likely time to adjust their nap schedule or move to an earlier bedtime to allow for more sleep.
4. Skipping a nap
Related to the above, your child will not sleep better at night if they skip a daytime nap. Young children have a biological need for naps.
If they skip a nap, they will generally become overtired and have trouble sleeping later. Having consistent naps, on the other hand, will help your child sleep better at night.
However, there might be times when you should wake your baby if they have been napping for too long. It’s important to preserve your baby's sleep schedule, including nap times and bedtime.
Contrary to popular belief, the old adage, "never wake a sleeping baby" is not always good advice!
If you find yourself frequently having to wake your child, it might be time to adjust their schedule.
5. Excessive screen time
Young children who receive more media exposure or have a TV, computer, or mobile device in their bedroom generally go to bed later and have fewer hours of restful sleep.
This is even true for babies--screens can leave them overstimulated and cause them to miss the sleep required for their development. For information about the effects of screen time on children, check out Kids and Screen Time: A Guide For Parents.
How do I help my child stop fighting sleep?
1. Create a nap and sleep schedule
Be sure to follow your baby's sleep cues when determining your schedule. Sleep cues include the following, but can be different for every child:
Fussiness
Rubbing eyes
Yawning
Decreased activity
Not interested in play
Disobedience (toddlers and older children)
If you find that your baby is fighting sleep, it may be that you are trying to put them down for naps or bedtime at the wrong time.
The same may be true if your baby is consistently falling asleep before their nap time.
Keep in mind also that as your child grows their sleep needs will change.
You'll need to revise their sleep schedule based on sleep recommendations for their age and how long a wake window they need before the next nap or bedtime.
2. Provide a safe, calm place to sleep
Make sure that your child has a dedicated and restful environment for sleeping, whether they share a bedroom with parents or a sibling or sleep in their own room.
Try to remove distracting items, such as books, electronic devices, and light-up or noise-making toys, and preserve the bedroom as a place for sleep.
The best sleeping space is a quiet and dark room. If there is too much noise around your child's bedtime, a white noise machine can help neutralize these sounds.
You can also use blackout curtains to keep the room dark for naps and help your baby sleep later in the morning.
It’s also essential to ensure that your child’s sleep space is safe. The following tips will help you provide a safe place for your child to sleep.
For more tips about sleep and other child development issues, download the Pathfinder Health app.
Sleep safety tips for bedtime and naps
Healthy babies are safest when sleeping on their backs at night time and during naps.
Your baby should sleep in your room until they are at least 6 months old.
Your baby should not sleep with anything in their crib. This includes blankets, stuffed animals, and loveys.
Stop swaddling when your baby shows signs of rolling over from back to tummy, usually by 3 to 4 months.
Make sure that your baby does not overheat while they are sleeping. Try to keep the room where they sleep at a comfortable temperature and dress them in no more than one layer more than you would wear. Instead of a blanket, you can use a sleep sack or warm sleeper that leaves their head and face free.
When your child is 12 months old, you can introduce a transitional object, such as a stuffed animal, blanket, or other lovey, to provide comfort and security at bedtime. Don't force it though--not every child likes sleeping with a lovey.
Consider transitioning your toddler from a crib to a bed when they are between 2 and 2 1/2 years old. At this age, they may be able to climb over the crib rail and could fall and injure themselves.
For more information on safe sleep, visit the Pathfinder Health app or view the AAP’s 2022 safe sleep guidelines.
3. A bedtime routine
Creating a consistent bedtime routine is one of the most important things you can do to help your child fall asleep and sleep through the night.
Consistency teaches your child to associate certain activities with sleep.
It also makes them feel safe, which helps them fall asleep more easily.
Begin by starting the routine at the same time every night. Your child’s bedtime may shift somewhat as they grow older, drop naps, and begin daycare or school, but you should have a consistent bedtime within each childhood phase.
For most young children, an early bedtime is best, to ensure they get enough sleep.
Help your child prepare for sleep and get enough rest by keeping the hour before bedtime loving and calm.
During this time you should limit physical activity, turn off screens, and focus on quiet activities and cuddles, such as reading a book together.
When bedtime arrives, carry out the same soothing bedtime ritual every night. This routine shouldn’t be complicated–just calm and consistent.
An average bedtime routine might look roughly like this:
The times of this routine might be different depending on the age of the child, but this same routine can last your child for years.
4. Help your child fall asleep independently
You might notice that the bedtime routine above does not include “rock your child to sleep” or “nurse/give your baby a bottle.”
From a very early age, it is important to establish good sleep habits by teaching your baby to fall asleep on their own.
This is what is known as "sleep training." Otherwise, they will need your help to fall asleep whenever they wake at night.
Though it can be comforting for babies to be rocked or cuddled, try putting yours gently in bed before they actually fall asleep.
Falling asleep independently will help them feel less anxious if they wake up later when you are not there.
5. Plenty of physical activity during the day
Making sure that your child has plenty of physical activity during the day will help them feel tired and fall asleep more easily at bedtime. Playtime is important for babies and older children!
6. Limit screens
To prevent your child from being overstimulated by screens but under-tired due to limited physical activity, try to limit their screen time to the amount recommended by the American Academy of Pediatrics (AAP) for their age group.
You should also end your child’s screen time at least one hour before bedtime. For more information about screen time, see Pathfinder Health’s article.
The Takeaway
Getting enough sleep is essential for your child’s health, development, and well-being. There are many things you can do to establish and maintain healthy sleep habits—and eventually your efforts will pay off and your child will (mostly) stop fighting sleep.
If you need assistance, remember that Pathfinder Health is here to help! We have suggestions for calm bedtime rituals, tips for safe sleep, and plenty of activities that will help tire your little one out so they will sleep more soundly.
Sources:
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