Tossing and Turning: Understanding Night Wakings in Children Ages 2-8 and How to Help Them (and You!) Sleep Through the Night

Why Do Children Wake Up at Night?

There are several common reasons why children may wake up during the night. One of the most basic reasons is hunger or thirst. As children grow, their metabolisms work overtime, and they may need a snack or drink before morning. Nightmares or night terrors can also jolt a child awake, leaving them feeling scared and in need of comfort.

Another frequent cause of night time awakenings is the child's need for physical closeness or security. Young children often seek the reassurance of a parent's presence, especially if they've had an unsettling dream or are adjusting to a new environment or routine.

Underlying medical conditions can also disrupt a child's sleep. Allergies, asthma, or ear infections may cause discomfort or breathing difficulties that wake the child. Gastroesophageal reflux disease (GERD) or constipation can also lead to night time arousals due to pain or discomfort.

In some cases, a child may simply struggle to self-soothe or resettle once they've woken up. This can be due to sleep associations (e.g., needing a parent present or a specific routine to fall asleep) or developmental factors, such as separation anxiety or an inability to self-regulate emotions.

By understanding the potential causes behind a child's night time awakenings, parents can better address the issue and help their little one get the restful sleep they need for healthy growth and development.

Sleep Needs by Age

Children's sleep needs vary widely by age. From ages 2-8, most kids require between 10-12 hours of sleep per night for optimal health and development. Here are some general guidelines for recommended sleep amounts and bedtimes:

Ages 2-3 Years Old

Need: 11-14 hours of sleep per day (including naps)

Ideal Bedtime: Between 6-8 PM

Ages 3-5 Years Old

Need: 10-13 hours of sleep per day (including naps until age 5)

Ideal Bedtime: Between 7-9 PM

Ages 5-8 Years Old

Need: 9-11 hours of sleep per night

Ideal Bedtime: Between 7:30-9 PM

Sufficient sleep is crucial for a child's growth, immune function, brain development, behaviour, and academic performance. Overtiredness can manifest as hyperactivity, crankiness, inability to focus, and meltdowns. Pay close attention to your child's sleep cues and make adjustments as needed to their schedule to ensure they're getting adequate rest.

Establishing a Bedtime Routine

A consistent bedtime routine is crucial for helping children wind down and prepare for a good night's sleep. The routine should be calming, predictable, and follow the same sequence every night. This consistency helps cue the body and mind that it's time to transition into sleep mode.

An effective bedtime routine might include the following activities:

1. Warm Bath: A warm (not hot) bath can be a soothing way to relax the body and mind before bed. The warmth and gentle massage of the water can help release tension and promote sleepiness.

2. Gentle Massage: A light massage can be incorporated into the bedtime routine, either during or after the bath. This can help further relax the muscles and provide a sense of comfort and security.

3. Putting on Pyjamas: Changing into comfortable, breathable pyjamas can signal to the body that it's time for sleep. This step can also be a calming ritual in itself.

4. Brushing Teeth: Good oral hygiene is important, and making teeth brushing a part of the bedtime routine can help establish healthy habits.

5. Reading or Storytelling: Sharing a book or telling a calming story can be a wonderful way to wind down and engage in quality bonding time. This activity can help stimulate the imagination while promoting relaxation.

6. Quiet Time: Allowing for a period of quiet time, such as listening to soft music or engaging in gentle stretching or deep breathing exercises, can help settle the mind and body before bed.

7. Goodnight Routine: A final goodnight routine, such as a special goodnight phrase, a kiss, or a tuck-in, can provide a sense of security and reinforce the bedtime ritual.

Consistency is key when establishing a bedtime routine. By following the same sequence of calming activities each night, children's bodies and minds will learn to recognize the cues and prepare for sleep more easily.

Creating a Sleep-Friendly Environment

Creating an optimal sleep environment can significantly improve your child's ability to fall asleep and stay asleep throughout the night. Here are some key factors to consider:

Room Setup

- Darkness: Keep the room dark by using blackout curtains or shades to block out any external light sources. Even a small amount of light can disrupt a child's sleep cycle.

- Noise: Minimize noise levels by using white noise machines, fans, or earplugs to create a consistent, soothing sound environment. Sudden or intermittent noises can cause a child to wake up.

- Temperature: Maintain a comfortable, cool temperature in the room, typically between 65-70°F (18-21°C). Overheating can disrupt sleep.

Transitional Objects

Providing your child with a special stuffed animal, blanket, or other familiar object can help them feel secure and comforted during the night. These transitional objects can be especially helpful during times of stress or when adjusting to new sleep routines.

Nightlights

While complete darkness is ideal for sleep, some children may feel more comfortable with a soft, dim nightlight. Choose a nightlight that emits a warm, soothing glow and place it away from the child's direct line of sight to avoid disrupting their sleep cycle.

By creating a sleep-friendly environment tailored to your child's needs, you can promote better sleep quality and help them wake up feeling rested and refreshed.

Managing Night Time Fears and Nightmares

Night time fears and nightmares are common occurrences for children, often causing them to wake up and seek comfort from their parents. While these experiences can be distressing, there are several strategies that can help manage them effectively.

Calming Strategies

When a child wakes up frightened, it's essential to remain calm and reassuring. Speak in a soothing voice, offer hugs and cuddles, and validate their feelings. You can also try deep breathing exercises, telling a calming story, or playing soft music to help them relax.

When to Intervene or Allow Self-Soothing

In some cases, it may be appropriate to allow your child to self-soothe and work through their fears independently. This can help them develop coping mechanisms and build resilience. However, if your child is persistently distressed or unable to calm down, it's best to intervene and provide comfort.

Dream/Nightmare Discussions

After a nightmare, it can be helpful to discuss the dream with your child. Encourage them to share their feelings and thoughts, and reassure them that it was just a dream and not real. You can also use this opportunity to teach them coping strategies, such as visualizing a happy place or repeating a calming mantra.

It's important to note that frequent or intense nightmares may be a sign of underlying stress or anxiety. If your child experiences recurring nightmares, it may be beneficial to consult with a paediatrician or a child therapist for further guidance and support.

Sleep Associations and Self-Soothing

One of the most common reasons children wake up during the night is due to sleep associations or the inability to self-soothe. Sleep associations are the conditions or habits that a child associates with falling asleep, such as being rocked, fed, or held by a parent. When these associations are present at bedtime but not maintained throughout the night, it can lead to frequent night wakings.

Habits that can disrupt independent sleep include:

- Being rocked or held until fully asleep

- Falling asleep while feeding or with a bottle/sippy cup

- Requiring a parent's presence or physical contact to fall asleep

While these habits can be soothing and effective for getting a child to sleep initially, they can become problematic when the child wakes up during natural sleep cycles and is unable to recreate the same conditions independently.

To help children learn to self-soothe and break sleep associations, it's essential to phase out these habits gradually. Some methods to consider include:

1. Gradual Fading: Slowly reduce the level of parental involvement or the intensity of the sleep association over time. For example, if your child falls asleep while being rocked, gradually decrease the rocking time each night until they can fall asleep without it.

2. Positive Routines: Establish a consistent and calming bedtime routine that doesn't involve sleep associations. This could include a warm bath, reading a story, and singing a lullaby in the child's room.

3. Comfort Objects: Introduce a special stuffed animal, blanket, or other comfort object that the child can learn to associate with sleep and self-soothing.

4. Sleep Training: Consider implementing a gentle sleep training method, such as the "fading" or "check and console" approach, to help your child learn to fall asleep independently and self-soothe when they wake up during the night.

It's important to be patient and consistent when phasing out sleep associations, as it may take time for your child to adjust to the new routine. Additionally, it's crucial to ensure that your child's overall sleep needs are being met and that there are no underlying medical or emotional issues contributing to the night wakings.

When to Consider Sleep Training

Sleep training methods can be effective for helping children learn to self-soothe and sleep through the night. However, it's important to understand the different approaches and their potential pros and cons before deciding if sleep training is right for your family.

One common method is "cry it out" or extinction, which involves putting the child in their crib awake and allowing them to cry until they fall asleep without intervention. While this can be effective for some children, it can be emotionally difficult for both parents and children. Potential pros include faster results and improved sleep for the whole family. Cons may include increased stress and potential emotional harm to the child.

Another approach is "fading" or graduated extinction, where parents gradually increase the time between responding to their child's cries. This can be a gentler approach but may take longer to see results. Pros include a more gradual transition and potentially less stress for the child. Cons could include inconsistency and a longer training period.

Other methods like bedtime fading, chair method, and pick up/put down aim to teach self-soothing through different techniques. It's important to research each approach thoroughly, consider your child's temperament and needs, and be consistent in implementing the chosen method.

Ultimately, sleep training can be a personal decision based on your family's values and circumstances. It's generally recommended to first establish positive sleep habits and address any underlying issues before considering formal sleep training methods.

If you are considering sleep training, why not get in touch and let us help guide you through the process and support your family. Our Therapists can work with you and your family to find the method that is most appropriate to your circumstance. Drop us an email at info@earlyinterventionaustralia.com or call on 03 8522 1927 and we can discuss potential options of support.

Addressing Underlying Medical Issues

While behavioural factors often play a significant role in children's night wakings, it's crucial to rule out potential underlying medical issues. Certain sleep disorders or other health conditions can disrupt sleep patterns and contribute to frequent awakenings. If your child's sleep difficulties persist despite implementing behavioural strategies, it may be time to consult with a healthcare professional. Tracking the sleep disturbances is key. Keep a log of how often, why and outcome to aid your conversation.

Sleep Disorders

Sleep disorders like sleep apnea, restless leg syndrome, or periodic limb movement disorder can cause frequent disruptions during the night. Sleep apnea, characterized by pauses in breathing, can lead to fragmented sleep and excessive daytime sleepiness. Restless leg syndrome involves an irresistible urge to move the legs, often accompanied by uncomfortable sensations that can interfere with sleep onset and maintenance.

ADHD and Other Conditions

Children with attention deficit hyperactivity disorder (ADHD) or other neurodevelopmental conditions may experience challenges with sleep regulation. The hyperactivity and impulsivity associated with ADHD can make it difficult for children to settle down and fall asleep, leading to frequent night wakings. Additionally, conditions like autism spectrum disorder or anxiety disorders can contribute to sleep disturbances.

When to See a Doctor

If your child's sleep difficulties persist for an extended period, despite consistent implementation of sleep hygiene practices, it's advisable to consult with a paediatrician or a sleep specialist. Seek medical advice if your child exhibits signs of sleep disorders, such as loud snoring, gasping for air during sleep, or excessive daytime sleepiness. Additionally, if your child experiences persistent nightmares, night terrors, or other sleep-related behaviours that concern you, it's essential to discuss these issues with a healthcare professional.

Remember, addressing underlying medical issues is crucial for ensuring your child's overall well-being and promoting healthy sleep patterns. Early identification and appropriate treatment can help alleviate sleep disturbances and improve your child's quality of sleep.

The Importance of Daytime Habits

A child's daytime habits can significantly impact their ability to sleep through the night. Diet, physical activity, and screen time are crucial factors that can either promote or disrupt a restful night's sleep.

Diet: A well-balanced diet rich in nutrients can contribute to better sleep quality. Ensure your child consumes a variety of fruits, vegetables, whole grains, and lean proteins throughout the day. Avoid giving them sugary or caffeinated beverages, especially in the afternoon and evening, as these can interfere with their ability to fall and stay asleep.

Physical Activity: Regular physical activity during the day can help children expend energy and promote better sleep at night. Encourage your child to engage in age-appropriate physical activities, such as playing outdoors, participating in sports, or engaging in active games. However, it's essential to avoid intense physical activity too close to bedtime, as this can have an energizing effect and make it harder for them to wind down.

Screen Time: Excessive screen time, particularly in the hours leading up to bedtime, can disrupt a child's sleep patterns. The blue light emitted by electronic devices can suppress the production of melatonin, the hormone responsible for regulating sleep-wake cycles. Establish screen-free periods before bedtime and create a calming routine that promotes relaxation and prepares the body for sleep.

By maintaining a balanced and healthy lifestyle during the day, you can help ensure your child's body and mind are ready for a restful night's sleep. Consistency and routine are key, so make these daytime habits a priority in your family's daily routine.

Building a Personal Sleep Plan

To effectively address your child's night time awakenings, it's helpful to create a personalized sleep plan tailored to their specific needs and your family's routines. This plan should incorporate strategies that target the root causes of the night wakings and provide a structured approach to gradually improve your child's sleep habits.

Start by keeping a sleep diary or log to track your child's sleep patterns, including bedtime, wake times, nap times, and any notable events or behaviours during the night. This data can help you identify potential triggers or patterns contributing to the night wakings.

Based on your observations and the strategies discussed in this guide, outline a step-by-step plan that addresses the specific challenges your child is facing. This may include adjusting bedtime routines, modifying the sleep environment, introducing new sleep associations or self-soothing techniques, or addressing underlying medical or developmental issues.

Consider creating a visual chart or progress tracker to monitor your child's sleep over time. This can help you identify areas of improvement or regression, and make necessary adjustments to your plan. Celebrate small victories along the way, as consistency and patience are key when establishing healthy sleep habits.

Remember, every child is unique, and what works for one may not work for another. Be prepared to adapt your plan as needed.

With a tailored sleep plan, consistent implementation, and a supportive environment, you can help your child overcome night time awakenings and develop the essential skills for a lifetime of healthy sleep habits.

If you are still struggling, reach out to us. We are here to help.

T: 03 8522 1927

E: info@earlyinterventionaustralia.com