I’m going to be honest here– I don’t love the term “sleep regression” because I feel like the term is imprecise. Eagle eyed readers may note that I put the term “regression” in quotes. Am I throwing a bit of shade on the concept? Maybe. . . but tired parents still need help, even if the term is slippery. There’s a lot of talk about sleep regressions happening at certain ages (The “8 month sleep regression!” The “Two Year Old Sleep Regression!”). If you search on Google, you’ll find a ton of search results on this.
If you search the medical literature, however, you won’t find anything.
Why is this? Because it’s terrible when your kid wakes up at night, but it isn’t usually predictable.
Are sleep regressions real? Yes, but. . .
Almost every parent has experienced the frustration of a child sleeping poorly after a period of good sleep. These episodes seem to fit my definition of a phase: an annoying and inexplicable thing your child is doing that will probably get better soon, and that I as a pediatrician don’t have a great explanation for. So let’s call them regressions and be done with it.
Sleep regressions can have a few different forms:
- Babies or toddlers waking up crying
- Bedtime battles or refusals
- Nap strikes
- Early morning awakenings
That being said, I don’t believe in the million different flavors of sleep regressions (the 4.75 Month Sleep Regression! The Left Handed Child who is 9 Months Old Sleep Regression! The Christmas Eve Sleep Regression!) Ok wait, that Christmas Eve one is real.
Here’s a video on more of this weird sleep regressions.
When do sleep regressions occur?
The problem is that there are only certain time periods when sleep regressions seem to predictably occur. Perhaps we could call these the Big Sleep Regressions.
- Potty training and sleep regressions. Potty training usually occurs between ages 3-5 (later for boys then girls). For whatever reason, this seem to be associated with night time awakenings. It makes sense. Children are usually getting a ton of positive reinforcement during the day. Then they wake up at night and are worried about whether or not they can hold it until morning. So they are crying out, either to use the potty, or because they are wet. (Part of potty training readiness is learning to dislike the sensation of a wet or soiled diaper. Early morning awakenings are also common. Here are some nice articles on potty training and sleep from The Baby Sleep Site and Heaven Sent Sleep.
- Major motor milestones and sleep regressions. Like potty training, this seems to be associated with night time awakenings. The most commonly associated milestones include crawling (ages 6-12 months), walking (ages 12-15 months) and pulling to stand (in between these milestones). Imagine how excited you are by being able to move around. Then you have a normal night time awakening out of REM sleep and just wanting to walk but you are TRAPPED IN A CRIB. Terrible, right? That’s when you call for your mom. Fortunately, these seem to get better once your child has mastered the new skill.
- When children are getting ready to get rid of a nap. This is when things get a little tricky. Infants may drop their third nap anytime between 6-15 months of age. Toddlers usually drop a morning nap between 18-24 months of age. And preschoolers give up their nap between 3-5 years of age. Whenever a child STARTS to get ready to drop a nap, they are less tired at bedtime. So, most commonly, children will “fight sleep” by having problems falling asleep when they are taking a nap they don’t really need because they have less sleep drive at bedtime. Less commonly, they may wake up during the night because, again, they got too much of their sleep during the day. If this is the case, they may play quietly in their room.
If you are struggling with naps, I have a guide to nap issues here.
What about all the other sleep regressions that you’ve heard about?
Jodi Mindell, one of the best pediatric sleep researchers around, examined the issue of predictability of sleep regressions.
“In 2018, she decided to do her own informal analysis using survey data she’d collected from a prior study she’d published in the journal Sleep in 2012. Dr. Mindell examined the sleep patterns of children aged 6 years and under, looking for spikes in night wakings at specific ages. Her analysis, which was based on data from thousands of mothers but which hasn’t been peer-reviewed or published, turned up nothing. Just 28 percent of the 300 or so parents of 3-month-olds she surveyed had complained about sleep problems (leap 3, according to “The Wonder Weeks”). Just 30 percent of the 300 or so parents of 5-month-olds reported more frequent night wakings (leap 4). Those percentages don’t suggest that all infants follow the same schedule of regression and growth, said Dr. Mindell: “The data clearly indicate that there’s no specific age at which all of a sudden you see a shift in sleep.” (From “Are Sleep Regressions Real?” in the New York Times.)
Remember those Google suggestions from the image above? I think they are often related to transitions away from naps. Which happen at different times in different kids. It’s really variable.
Sleep regressions as a concept feel similar to “wake windows”— an idea that has a lot more traction among sleep consultants and on parent message boards than in the scientific literature. It doesn’t mean that
Still struggling?
Most sleep regressions will pass quickly if you just stay consistent. However, here’s my handy dandy guide to dealing with sleep regressions. I also covered sleep regressions on our podcast episode on busting sleep myths. I also have a guide to nap strikes.
Leave a Reply