# Dr. Craig Canapari > Evidence-Based Sleep Solutions for Exhausted Parents Public Ghost content for AI and LLM tooling. This file includes a bounded export of public pages first, then recent public posts. Append `.md` to any post or page URL to get the content in Markdown (for example, `/example-post.md`). ## Pages ### Dr Craig Canapari's Blog URL: https://drcraigcanapari.com/blog/ Last updated: 2026-03-30T16:41:37.000Z _No content available._ ### Archives URL: https://drcraigcanapari.com/archives/ Last updated: 2014-04-09T20:08:15.000Z _No content available._ ### Thank you. URL: https://drcraigcanapari.com/thank-you-no-sttk/ Last updated: 2018-02-02T16:49:55.000Z _No content available._ ### Imprint URL: https://drcraigcanapari.com/imprint/ Last updated: 2025-12-23T00:34:51.000Z _No content available._ ### Login URL: https://drcraigcanapari.com/login/ Last updated: 2014-01-22T20:29:19.000Z \[login\_form\] \[password\_recovery\_link text="Lost Password? Click here to reset your password."\] \[logout\_link text="Logout"\] ### Profile URL: https://drcraigcanapari.com/profile/ Last updated: 2014-01-22T20:32:04.000Z \[member\_profile heading\_text="To change your account information, please fill out the form." show\_email\_address="1"\] \[logout\_link text="Logout"\] ### About Me URL: https://drcraigcanapari.com/about/ Last updated: 2026-04-30T15:32:46.000Z ![Dr. Canapari with patient in his exam room. ](https://drcraigcanapari.com/content/images/wp-content/uploads/2014/01/ysm48190176canapari.jpg) I'm the guy on the left I’m a pediatrician at [Yale-New Haven Children’s Hospital in New Haven, CT](https://www.ynhh.org/physicians/craig-canapari?ref=drcraigcanapari.com), specializing in the care of children with breathing and sleep problems. I'm also a husband, dad, dog dad, mediocre paddleboarder, and even more mediocre runner. I live outside New Haven with my wife and our two boys. Once my first son was born, I learned the vital lesson that there is often a gulf between textbook “perfect” parenting, and what actually works in the real world. ## How this website came to be It wasn’t long after I began my practice that I started to get phone calls and emails from friends, friends of friends, family members and their friends, and my wife’s cousin’s mailman. They all had questions and needed advice. Why does their kid get up at night? Do those tonsils really need to come out? My academic background was in breathing issues like asthma and sleep apnea. I quickly realized I would need to get up to speed on behavioral issues as well. I spoke to mentors, read books and articles, and assembled everything I could into detailed handouts for parents. I then realized that it was going to be easier to share this information online, as it was easier to share a link. I made a connection with Dr. Wendy Sue Swanson, one of the first pediatrician bloggers writing online, and wrote [my first post for her back in 2012 on toddler night wakings](https://www.wendysueswanson.com/toddler-sleep-4-reasons-toddlers-wake-up-at-night/?ref=drcraigcanapari.com). With her encouragement, I soon started this website. There are few pediatric sleep specialists nationally, which makes it hard for people in need of help with sleep issues to access care. There are relatively few web-based resources as well. At this site, you can find help: not direct clinical care, but advice which will hopefully point you in the right direction. My goal is to provide simple, evidence-based information to families and physicians. In 2019, I published[ *It's Never Too Late to Sleep Train: The Low Stress Way to High-Quality Sleep for Babies, Kids, and Parents*](https://amzn.to/2PfthnX?ref=drcraigcanapari.com), which is my guide to fast, effective, simple sleep training from birth through school age. I'm really proud of it. Here are the topics I'm most passionate about: - [Normal sleep in children](https://drcraigcanapari.com/sleep-101/) - [Treating sleep problems](https://drcraigcanapari.com/sleep-training/) - [Helping teens sleep better](https://drcraigcanapari.com/teen-sleep-information/) - Validating parent's decisions about their children's sleep. [My most recent project is starting The Sleep Edit Podcast.](http://drcraigcanapari.com/podcast) ## Academic biography I graduated *cum laude* from Yale with a degree in English, and attended medical school at the University of Connecticut. I did my residency in Pediatrics and my fellowship in Pediatric Pulmonology at Massachusetts General Hospital in Boston, and stayed on there as an attending physician in the Division of Pediatric Pulmonary Medicine from 2007\. I also boarded in Sleep Medicine after doing my sleep medicine rotations at Brigham and Women's Hospital and Brown University. In 2013, I returned to my old college stomping grounds at Yale, where I am an attending physician in Pediatric Pulmonology, and Director of the Pediatric Sleep Center. Here, I have built a comprehensive sleep program for children, the first of its kind in Connecticut. We have three sleep laboratories, many sleep physicians, and now have a sleep psychologist helping us with behavioral issues. I’m boarded in Pediatrics, Pediatric Pulmonology, and Sleep Medicine. [Here is my very official and fancy faculty page at Yale.](https://medicine.yale.edu/profile/craig-canapari/?ref=drcraigcanapari.com) [Here is my Google Scholar page.](https://scholar.google.com/citations?user=0J53qOwAAAAJ&hl=en&ref=drcraigcanapari.com) [Here is my Linked In page.](https://www.linkedin.com/in/craig-canapari-b7247350?ref=drcraigcanapari.com) ## In the media ### Articles in Print or Online: - French edition of *It's Never Too Late to Sleep Train* ([*Endormir son enfant sans s'épuiser*](https://www.amazon.fr/Endormir-son-enfant-sans-s%C3%A9puiser/dp/2263194266?ref=drcraigcanapari.com)) featured in ["Les 5 astuces infaillibles d'un pédiatre américain pour endormir son enfant"](https://madame.lefigaro.fr/bien-etre/forme-detente/les-5-astuces-infaillibles-d-un-pediatre-americain-pour-endormir-son-enfant-20260209?ref=drcraigcanapari.com) in *Madame Figaro*, 2/9/26 - Quoted in ["New study links melatonin and heart failure. Don't panic, experts say."](https://www.washingtonpost.com/health/2025/11/03/melatonin-heart-failure-sleep-aid/?ref=drcraigcanapari.com) in *The Washington Post*, 11/3/25 - Quoted extensively in Romper's sleep regression series (2023-2024), including articles on the [4 month](https://www.romper.com/parenting/4-month-sleep-regression?ref=drcraigcanapari.com), [6 month](https://www.romper.com/parenting/6-month-sleep-regression?ref=drcraigcanapari.com), [8-10 month](https://www.romper.com/parenting/8-9-10-month-sleep-regression?ref=drcraigcanapari.com), [12 month](https://www.romper.com/parenting/12-month-sleep-regression?ref=drcraigcanapari.com), [18 month](https://www.romper.com/parenting/18-month-sleep-regression?ref=drcraigcanapari.com), and [teething vs. regression](https://www.romper.com/parenting/sleep-regression-or-teething?ref=drcraigcanapari.com) topics. - Quoted in ["I'm a sleep doctor and a dad. 5 common mistakes parents make with kids and sleep"](https://www.today.com/health/sleep/kids-sleep-expert-tips-rcna73799?ref=drcraigcanapari.com) on *TODAY.com*, 3/13/23 - Quoted in ["Sleep Regression: What they are, why they happen, and survival tips"](https://www.romper.com/parenting/sleep-regression?ref=drcraigcanapari.com) in *Romper*, 2/14/23 - Quoted in "Why little kids' sleep is so wild" by Jessica Grose in *The New York Times*, 5/11/22 - Quoted in ["You might be using melatonin all wrong. Here's what you should know"](https://www.washingtonpost.com/wellness/2022/03/25/melatonin-sleep-insomnia/?ref=drcraigcanapari.com) in *The Washington Post*, 3/25/22 - Quoted in ["Teenagers need more sleep, and permanent Daylight Savings Time won't help"](https://www.washingtonpost.com/parenting/2022/03/22/daylight-saving-time-school-teens/?ref=drcraigcanapari.com) in *The Washington Post*, 3/22/22 - Quoted in ["Daylight-Saving Time Ends Sunday. Yes, You Can Win the Transition"](https://www.wsj.com/articles/daylight-saving-time-ends-sunday-yes-you-can-win-the-transition-11635771600?ref=drcraigcanapari.com) in *The Wall Street Journal*, 11/12/21 - Wrote ["How to Prepare Babies and Kids for the End of Daylight Saving Time"](https://www.nytimes.com/article/daylight-saving-time.html?ref=drcraigcanapari.com) in *The New York Times*, 10/27/21 - Quoted in ["Break the Cycle of Insomnia"](https://www.nytimes.com/2020/11/14/at-home/insomnia-advice.html?ref=drcraigcanapari.com) in *The New York Times*, 11/15/20 - Quoted in ["Is Your Kid Just Refusing Bedtime, Or Is It Insomnia?"](https://www.romper.com/parenting/can-children-have-insomnia?ref=drcraigcanapari.com) in *Romper*, 11/12/20 - Quoted in ["Parents Are Relying on Melatonin to Help Their Kids Sleep. Should They?"](https://www.nytimes.com/2020/05/18/parenting/melatonin-sleep-kids.html?ref=drcraigcanapari.com) in *The New York Times*, 5/18/20 - Wrote ["Some Babies Sleep Better in Car Seats and Swings, but Are They Safe?"](https://www.nytimes.com/2020/04/17/parenting/baby/baby-sleep-car-seat-swing.html?ref=drcraigcanapari.com) in *The New York Times*, 4/17/20 - Wrote ["Bedtime Was Hard Enough. Then Came The Quarantine."](https://www.nytimes.com/2020/04/14/parenting/coronavirus-kids-sleep.html?ref=drcraigcanapari.com) in *The New York Times*, 4/15/20 - Wrote ["Your Kids Refuse to Nap? There's Hope."](https://www.nytimes.com/2020/03/24/parenting/child-stop-napping.html?ref=drcraigcanapari.com) in *The New York Times*, 3/24/20 - Quoted in ["Is your child sleep deprived? Here's how it can affect their development"](https://www.nbcnews.com/better/lifestyle/your-child-sleep-deprived-here-s-how-it-can-affect-ncna1119376?ref=drcraigcanapari.com) on *NBC News* - My book was featured in ["10 Books That Answer Ten Pressing Parenting Questions"](https://better.net/arts-events/books/books-that-answer-pressing-parenting-questions/?ref=drcraigcanapari.com) in *Better Magazine* - Quoted in ["Overcoming sleep disorders"](https://www.bostonglobe.com/lifestyle/health-wellness/2012/06/03/sleep-apnea-children-can-cause-other-health-behavioral-problems/iZzm5Ll0FrxuK5A3kYnxVP/story.html?ref=drcraigcanapari.com) in *The Boston Globe*, 2012 ### Podcast appearances: - [The Matt Walker Podcast episodes 43 & 44: Sleep and Kids](https://podcastnotes.org/the-matt-walker-podcast/44-sleep-and-kids-pt-2-with-dr-craig-canapari-the-matt-walker-podcast/?ref=drcraigcanapari.com) A two-part conversation with UC Berkeley neuroscientist and *Why We Sleep* author Matt Walker on sleep training, infant sleep, and common parenting sleep challenges. - [Balance 365 Life episode 365: Parents, Kids and Sleep: A How-To Guide for Families](https://www.balance365life.com/episode65/?ref=drcraigcanapari.com). I had a wide ranging conversation with the three women who run this podcast and provide great, positive information about health, weight, and body image. - [The Dad Podcast episode 311: Talking Sleep with Dr. Jay and Dr. Craig Canapari of the Yale Sleep Center](https://www.blogtalkradio.com/dadpodcast/2018/03/21/311--talking-sleep-with-dr-jay-and-dr-craig-canapari-of-the-yale-sleep-center?ref=drcraigcanapari.com). This was a fun one-- I got to chat with two stand up comedians Justin Worsham and Dr. Jay Sutay. Fun fact-- when I was a med student I spend one afternoon a week with Dr. Jay for four years-- he taught me a lot about how to be good kid doc. - [Kids Sleep, Parents Sleep - We All Need to Sleep! with Craig Canapari, MD ](https://drcraigcanapari.com/kids-sleep-parents-sleep-we-all-need-to-sleep-on-the-lucas-rockwood-show/)Lucas Rockwood, a yoga teacher and entrepreneur, interviewed me about sleep and health, and what you can and can't control about your child's sleep. - [REDEFINING SLEEP TRAINING (IT’S NOT ALL ABOUT CRY IT OUT) ](https://drcraigcanapari.com/sleep-junkies-podcast/) I was honored to kick off the second season of Sleep Junkies, one of my favorite podcasts on sleep. - [Strollercoaster: Can we get some sleep?](https://open.spotify.com/episode/3Xmk4Z4zI7kpORzg3hjTF4?si=lo6L56XoSrWTU-t%5FEecLAg&dl%5Fbranch=1&ref=drcraigcanapari.com) One of my favorite podcasts that I have been on, and my favorite parenting podcast. ## Do you want to make an appointment with me? I am licensed in New York and Connecticut. I currently see patients in Old Saybrook, New Haven, and Trumbull Connecticut. Additionally I see children residing in CT or NY via telehealth. To book an appointment, either [book an appointment via Yale Medicine online](https://www.yalemedicine.org/specialists/craig-canapari/book-appointment-online?ref=drcraigcanapari.com) or call [1-877-YALEMDS (925-3637)](tel:+1-877-925-3637). ## Do you want to collaborate? If you would like to contact me about speaking engagements or collaboration, please contact me below. Note that I will not respond to individual requests for medical advice. ### Comments Policy URL: https://drcraigcanapari.com/comments-policy/ Last updated: 2013-04-23T02:34:55.000Z All comments on this blog are approved by me prior to posting. I do expect that all commenters be civil and respectful. If I do not feel that a comment is in keeping with the tenor or intent of this blog, I will not approve it. I appreciate that a lot of desperate and sleep deprived parents come to this blog, frequently late at night, for help with their child's sleep difficulties. I started this site with the goal of providing easily accessible and evidence-based guidance for parents. I have made an effort to provide general advice for parents and caregivers. Unfortunately, I cannot provide specific medical advice for parents and will not publish comments asking for specific advice. Thus, please do not make long, detailed comments about your child's difficulties here. Rather, write out your concerns and share them with your pediatrician; this is always a good strategy for [getting the most out of your doctor's visit](https://drcraigcanapari.com/2012/03/29/a-parents-toolkit-for-the-specialist-visit/). Due to the volume of comments I receive (and my inability to keep up with them), I have now limited comments to 30 days after a post is published. Note that comments must be germane to the subject of the post. Thus, if I write about teenage sleep issues, I will not approve sleep training questions/comments. Thanks for your patience and understanding. Best of luck. ### Supporting This Site URL: https://drcraigcanapari.com/supporting-this-site/ Last updated: 2014-11-20T15:34:01.000Z I spend a lot of time writing and editing the content on this site. I also spend about $60 per month on hosting fees, not to mention start-up costs. I would like to make it self-sustaining. **If you have found this helpful, please support it by [shopping in my store on Amazon](https://www.amazon.com/shop/drcanapari?ref=drcraigcanapari.com).** I have curated some of my favorite sleep hygiene products and also some of our favorite books which my wife and I read with our boys. **If you shop through this link, (or any of the Amazon links on my site) you provide me with a 4-6% commission** which will go to developing new content and covering web hosting costs. There is no cost to you. Another great way to support this site is to share the content with your friends-- via Facebook, email, Twitter, smoke signal, or another way you like. Thanks so much for your time, generosity, and attention. . ### Speaking, Consulting, and Media URL: https://drcraigcanapari.com/speaking-and-consulting/ Last updated: 2026-06-22T18:58:06.000Z I work with companies, journalists, and organizations on pediatric sleep — as a product and content advisor, a speaker, an expert source, and an institutional consultant. Recent and ongoing work includes advising consumer brands on sleep-related products and content, speaking to parents and clinicians, and contributing to outlets like the *New York Times*, TODAY, and the Matt Walker Podcast. If you're working on something where pediatric sleep expertise would help, I'd like to hear about it. ## A few things to know **Consulting** is the core of this work. I take on a small number of advisory engagements with companies building products, content, or programs where pediatric sleep matters. Compensation can be cash, equity, or a mix — happy to discuss what fits. **Speaking** is something I genuinely enjoy. I tailor talks to the audience, whether that's parents, clinicians, school administrators, or teens. Evidence-based, practical, occasionally funny. **Media inquiries** are welcome. I'm a working physician, so deadlines on the order of a day or two are usually workable; same-day is hit-or-miss. Short bio, headshot, and recent press are on the [About page](https://drcraigcanapari.com/about/). ## What I don't do here - **Clinical questions about your child's sleep.** For medicolegal reasons, I can't respond to these via the form. If you're looking for help right now, the free [Sleep Training Starter Kit](https://drcraigcanapari.com/welcome-to-the-sleep-training-starter-kit/) is the best place to start. - **In person in CT; telehealth in CT or NY.** If you're in Connecticut or New York and want to be seen as a patient, call my Yale office at [1-877-YALE-MDS (925-3637)](tel:18779253637) - **Guest posts, link exchanges, or sponsored content.** I don't accept these. ## Get in touch ### Scheduling an appointment URL: https://drcraigcanapari.com/scheduling-an-appointment/ Last updated: 2012-03-08T04:25:06.000Z To schedule an appointment, please call 203-785-4081\. Referrals can be faxed to 203-737-7635. I currently see patients in four offices: 1\. [**Yale New Haven Children’s Hospital, 1 Park St, New Haven, CT 06519**](http://www.ynhh.org/yale-new-haven-childrens-hospital/visitor-information/locations,-directions,-parking-and-lodging.aspx?ref=drcraigcanapari.com)2\. [**Yale Specialty Center at Norwalk, 747 Belden Ave., Norwalk, CT 06850**](http://www.ynhh.org/yale-new-haven-childrens-hospital/medical-services/ch%5FPediatric%5FSpecialty%5FCenter%5FNorwalk.aspx?ref=drcraigcanapari.com)3\. [**Yale Specialty Center at Long Wharf, 1 Long Wharf Dr., New Haven, CT 06519**](http://www.ynhh.org/yale-new-haven-childrens-hospital/medical-services/Pediatric%5FSpecialty%5FCenter.aspx?ref=drcraigcanapari.com)4\. [Yale Specialty Center at Trumbull, 5520 Park Avenue, Trumbull, CT 06611](http://www.ynhh.org/yale-new-haven-childrens-hospital/medical-services/ch%5Fspecialty%5Ftrumbull.aspx?ref=drcraigcanapari.com) ### Disclaimer URL: https://drcraigcanapari.com/disclaimer/ Last updated: 2012-03-08T16:16:19.000Z First off: Thanks so much to [Howard J. Luks](http://http//www.howardluksmd.com/?ref=drcraigcanapari.com), who provided much of the information for this endeavor and allowed me to shamelessly use his disclaimer as a template. 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To remain in compliance, CC suggests that you review the Policy, as well as the other website policies, at regular intervals. By continuing to post any content after such new terms are posted, you accept and agree to any and all such modifications to this Policy. Thank you, Craig Canapari MD Theses are further Policies & Disclaimers regarding your use of my Twitter feed, Facebook page, or any blog pages of mine. (NOTE: Credit is due to @hrana and @RayBeckerman) I am not (or may not be) your doctor. Please see your personal doctor for any medical advice. Contact with me in any form is under the explicit understanding that no doctor-patient relationship exists and none will be formed as a result of such contact. A blog post or Twitter status update is not a replacement for a doctor visit in person. If you have a medical emergency, please call 9-1-1 or the emergency services system in your location. My blog posts and Twitter status updates are not medical, legal, ethical, moral, political, or any other form of advice, suggestion, or recommendation. My opinions are fluid and I reserve the right to change my position as my knowledge and experiences dictate. I reserve the right to alter or delete any of my blog posts for any reason. I reserve the right to delete any comments posted on my various social media profiles or blog for any reason. I reserve the right to delete any Twitter status updates for any reason. Most common reasons include but are not limited to: old replies, non-medical related replies, incorrect or unverified articles/links, etc. I reserve the right to ignore any contact attempted through any means (Blog, Twitter, LinkedIn, Email, IM, etc). Most common reasons include but are not limited to: unwanted marketing, SPAM, hostile/aggressive/annoying behavior, unfamiliarity or lack of personal/professional relationship, etc. Following, contacting, or “friending” people on any social media sites, blogs, etc. is not an endorsement by me of the message, opinions, beliefs, or mission of that person, group, or business. ### Privacy Policy URL: https://drcraigcanapari.com/privacy-policy/ Last updated: 2026-03-01T22:05:03.000Z Privacy Policy Effective date: 11/2/2025 Welcome to https://drcraigcanapari.com, a website (the “Site”) owned and operated by EVIDENCE BASED PARENTING, LLC, a limited liability company duly formed and existing under the laws of the State of Connecticut with its principal offices located at at 800 Village Walk #120, Guilford, CT 06437, referred to in this document, by the terms "Provider" or "we" or "us" or "our." The terms "user" or "you" or "your" refers to any and all users and/or viewers of the Site. Your use of the Site constitutes your agreement to the following Privacy Policy which, together with our Terms and Conditions of Use located at this link, govern the relationship between you and us. If you do not agree to this Privacy Policy, please do not use this Site. This page informs you of our policies regarding the collection, use, and disclosure of personal data when you use our Service and the choices you have associated with that data. We use your data to provide and improve the Service. By using the Service, you agree to the collection and use of information in accordance with this policy. Unless otherwise defined in this Privacy Policy, terms used in this Privacy Policy have the same meanings as in our Terms and Conditions, accessible from https://drcraigcanapari.com/ ## Definitions **Service** Service is the https://drcraigcanapari.com/ website operated by Evidence Based Parenting LLC **Personal Data** Personal Data means data about a living individual who can be identified from those data (or from those and other information either in our possession or likely to come into our possession). **Usage Data** Usage Data is data collected automatically either generated by the use of the Service or from the Service infrastructure itself (for example, the duration of a page visit). **Cookies** Cookies are small pieces of data stored on your device (computer or mobile device). **Data Controller** Data Controller means the natural or legal person who (either alone or jointly or in common with other persons) determines the purposes for which and the manner in which any personal information are, or are to be, processed. For the purpose of this Privacy Policy, we are a Data Controller of your Personal Data. **Data Processors (or Service Providers)** Data Processor (or Service Provider) means any natural or legal person who processes the data on behalf of the Data Controller. We may use the services of various Service Providers in order to process your data more effectively. **Data Subject (or User)** Data Subject is any living individual who is using our Service and is the subject of Personal Data. ## Information Collection and Use We collect several different types of information for various purposes to provide and improve our Service to you. ### Types of Data Collected #### Personal Data While using our Service, we may ask you to provide us with certain personally identifiable information that can be used to contact or identify you ("Personal Data"). Personally identifiable information may include, but is not limited to: - Email address - First name and last name - Cookies and Usage Data We may use your Personal Data to contact you with newsletters, marketing or promotional materials and other information that may be of interest to you. You may opt out of receiving any, or all, of these communications from us by following the unsubscribe link or instructions provided in any email we send. #### Usage Data We may also collect information how the Service is accessed and used ("Usage Data"). This Usage Data may include information such as your computer's Internet Protocol address (e.g. IP address), browser type, browser version, the pages of our Service that you visit, the time and date of your visit, the time spent on those pages, unique device identifiers and other diagnostic data. #### Tracking Cookies Data We use cookies and similar tracking technologies to track the activity on our Service and hold certain information. Cookies are files with small amount of data which may include an anonymous unique identifier. Cookies are sent to your browser from a website and stored on your device. Tracking technologies also used are beacons, tags, and scripts to collect and track information and to improve and analyze our Service. You can instruct your browser to refuse all cookies or to indicate when a cookie is being sent. However, if you do not accept cookies, you may not be able to use some portions of our Service. Examples of Cookies we use: - **Session Cookies.**We use Session Cookies to operate our Service. - **Preference Cookies.**We use Preference Cookies to remember your preferences and various settings. - **Security Cookies.**We use Security Cookies for security purposes. ## Use of Data Evidence Based Parenting LLC uses the collected data for various purposes: - To provide and maintain our Service - To notify you about changes to our Service - To allow you to participate in interactive features of our Service when you choose to do so - To provide customer support - To gather and analyze valuable information so that we can improve our Service - To monitor the usage of our Service - To detect, prevent and address technical issues - To provide you with news, special offers and general information about other goods, services and events which we offer that are similar to those that you have already purchased or enquired about unless you have opted not to receive such information ## Legal Basis for Processing Personal Data Under General Data Protection Regulation (GDPR) If you are from the European Economic Area (EEA), the legal basis for collecting and using the personal information described in this Privacy Policy depends on the Personal Data we collect and the specific context in which we collect it. Evidence Based Parenting LLC may process your Personal Data because: - We need to perform a contract with you - You have given us permission to do so - The processing is in our legitimate interests and it's not overridden by your rights - For payment processing purposes - To comply with the law ## Retention of Data Evidence Based Parenting LLC will retain your Personal Data only for as long as is necessary for the purposes set out in this Privacy Policy. We will retain and use your Personal Data to the extent necessary to comply with our legal obligations (for example, if we are required to retain your data to comply with applicable laws), resolve disputes, and enforce our legal agreements and policies. Evidence Based Parenting LLC will also retain Usage Data for internal analysis purposes. Usage Data is generally retained for a shorter period of time, except when this data is used to strengthen the security or to improve the functionality of our Service, or we are legally obligated to retain this data for longer time periods. ## Transfer of Data Your information, including Personal Data, may be transferred to — and maintained on — computers located outside of your state, province, country or other governmental jurisdiction where the data protection laws may differ than those from your jurisdiction. If you are located outside United States and choose to provide information to us, please note that we transfer the data, including Personal Data, to United States and process it there. Your consent to this Privacy Policy followed by your submission of such information represents your agreement to that transfer. Evidence Based Parenting LLC will take all steps reasonably necessary to ensure that your data is treated securely and in accordance with this Privacy Policy and no transfer of your Personal Data will take place to an organization or a country unless there are adequate controls in place including the security of your data and other personal information. ## Disclosure of Data ### Disclosure for Law Enforcement Under certain circumstances, Evidence Based Parenting LLC may be required to disclose your Personal Data if required to do so by law or in response to valid requests by public authorities (e.g. a court or a government agency). ### Legal Requirements Evidence Based Parenting LLC may disclose your Personal Data in the good faith belief that such action is necessary to: - To comply with a legal obligation - To protect and defend the rights or property of Evidence Based Parenting LLC - To prevent or investigate possible wrongdoing in connection with the Service - To protect the personal safety of users of the Service or the public - To protect against legal liability ## Security of Data The security of your data is important to us, but remember that no method of transmission over the Internet, or method of electronic storage is 100% secure. While we strive to use commercially acceptable means to protect your Personal Data, we cannot guarantee its absolute security. ## "Do Not Track" Signals We do not support Do Not Track ("DNT"). Do Not Track is a preference you can set in your web browser to inform websites that you do not want to be tracked. You can enable or disable Do Not Track by visiting the Preferences or Settings page of your web browser. ## Your Data Protection Rights Under General Data Protection Regulation (GDPR) If you are a resident of the European Economic Area (EEA), you have certain data protection rights. Evidence Based Parenting LLC aims to take reasonable steps to allow you to correct, amend, delete, or limit the use of your Personal Data. If you wish to be informed what Personal Data we hold about you and if you want it to be removed from our systems, please contact us. In certain circumstances, you have the following data protection rights: **The right to access, update or to delete the information we have on you.**Whenever made possible, you can access, update or request deletion of your Personal Data directly within your account settings section. If you are unable to perform these actions yourself, please contact us to assist you. **The right of rectification.**You have the right to have your information rectified if that information is inaccurate or incomplete. **The right to object.**You have the right to object to our processing of your Personal Data. **The right of restriction.**You have the right to request that we restrict the processing of your personal information. **The right to data portability.**You have the right to be provided with a copy of the information we have on you in a structured, machine-readable and commonly used format. **The right to withdraw consent.**You also have the right to withdraw your consent at any time where Evidence Based Parenting LLC relied on your consent to process your personal information. Please note that we may ask you to verify your identity before responding to such requests. You have the right to complain to a Data Protection Authority about our collection and use of your Personal Data. For more information, please contact your local data protection authority in the European Economic Area (EEA). ## Service Providers We may employ third party companies and individuals to facilitate our Service ("Service Providers"), to provide the Service on our behalf, to perform Service-related services or to assist us in analyzing how our Service is used. These third parties have access to your Personal Data only to perform these tasks on our behalf and are obligated not to disclose or use it for any other purpose. ### Analytics We may use third-party Service Providers to monitor and analyze the use of our Service. **Google Analytics** Google Analytics is a web analytics service offered by Google that tracks and reports website traffic. Google uses the data collected to track and monitor the use of our Service. This data is shared with other Google services. Google may use the collected data to contextualize and personalize the ads of its own advertising network. You can opt-out of having made your activity on the Service available to Google Analytics by installing the Google Analytics opt-out browser add-on. The add-on prevents the Google Analytics JavaScript (ga.js, analytics.js, and dc.js) from sharing information with Google Analytics about visits activity. For more information on the privacy practices of Google, please visit the Google Privacy Terms web page: [http://www.google.com/intl/en/policies/privacy/](http://www.google.com/intl/en/policies/privacy/?ref=drcraigcanapari.com) ### Payments We may provide paid products and/or services within the Service. In that case, we use third-party services for payment processing (e.g. payment processors). We will not store or collect your payment card details. That information is provided directly to our third-party payment processors whose use of your personal information is governed by their Privacy Policy. These payment processors adhere to the standards set by PCI-DSS as managed by the PCI Security Standards Council, which is a joint effort of brands like Visa, Mastercard, American Express and Discover. PCI-DSS requirements help ensure the secure handling of payment information. The payment processors we work with are: **Stripe** Their Privacy Policy can be viewed at [https://stripe.com/us/privacy](https://stripe.com/us/privacy?ref=drcraigcanapari.com) **PayPal or Braintree** Their Privacy Policy can be viewed at [https://www.paypal.com/webapps/mpp/ua/privacy-full](https://www.paypal.com/webapps/mpp/ua/privacy-full?ref=drcraigcanapari.com) ## Links to Other Sites Our Service may contain links to other sites that are not operated by us. If you click on a third party link, you will be directed to that third party's site. We strongly advise you to review the Privacy Policy of every site you visit. We have no control over and assume no responsibility for the content, privacy policies or practices of any third party sites or services. ## Children's Privacy Our Service does not address anyone under the age of 18 ("Children"). We do not knowingly collect personally identifiable information from anyone under the age of 18\. If you are a parent or guardian and you are aware that your Children has provided us with Personal Data, please contact us. If we become aware that we have collected Personal Data from children without verification of parental consent, we take steps to remove that information from our servers. ## Changes to This Privacy Policy We may update our Privacy Policy from time to time. We will notify you of any changes by posting the new Privacy Policy on this page. We will let you know via email and/or a prominent notice on our Service, prior to the change becoming effective and update the "effective date" at the top of this Privacy Policy. You are advised to review this Privacy Policy periodically for any changes. Changes to this Privacy Policy are effective when they are posted on this page. ## Advertising Previously, CMI Marketing, Inc., d/b/a Raptive (“Raptive”) is a service provider of this Site for the purposes of placing advertising on the Site, and Raptive will collect and use certain data for advertising purposes. Raptive stopped providing service as of 12/23/25\. To learn more about Raptive’s data usage, click here: [https://raptive.com/creator-advertising-privacy-statement](https://raptive.com/creator-advertising-privacy-statement?ref=drcraigcanapari.com) ## Terms of service: Binding Arbitration (“Arbitration Agreement”) a. Applicability of Arbitration Agreement. You agree that any dispute or claim against us, or our vendors or service providers(collectively, “We” or “Us”), related in any way to your access or use of this website, to these Terms, or to any aspect of your relationship with Us, will be resolved by binding arbitration, rather than in court, except that (1) you may assert claims in small claims court if your claims qualify, so long as the matter remains in such court and advances only on an individual (non-class, non-representative) basis; and (2) you or We may seek equitable relief in court for infringement or other misuse of intellectual property rights (such as trademarks, trade dress, domain names, trade secrets, copyrights, and patents). You agree that you must commence any arbitration or other claim within one (1) year after the dispute arises; otherwise, the claim is permanently barred, which means that you will no longer have the right to assert a claim regarding the dispute. This Arbitration Agreement will apply, without limitation, to all claims that arose or were asserted before the effective date of these Terms or any prior version of this Arbitration Agreement. You agree in advance that you will not participate in or seek to recover monetary or other relief in any lawsuit filed against Us, alleging class, collective, and/or representative claims on your behalf. Instead, by agreeing to arbitration, you may bring your claims against any of Us in an individual arbitration proceeding (except for any Batch Arbitration, as described below). If successful on such claims, you could be awarded money or other relief by an arbitrator. You acknowledge that you have been advised that you may consult with an attorney in deciding whether to accept these Terms, including this Arbitration Agreement. The Federal Arbitration Act governs the interpretation and enforcement of this Arbitration Agreement. b. Process. To begin a claim, you must first send a letter describing your claim in detail, including your name and contact information, your legal claim, the specific facts giving rise to your claim (including the date(s) and amount(s) of any relevant transaction or interaction with us), and the requested relief, to 211 Three Corners Road, Guilford, CT 06437\. You and We agree to attempt in good faith to negotiate an informal resolution of your claim. If a resolution is not reached within thirty (30) days, you may commence an arbitration action as set forth herein. The arbitration will be conducted by JAMS, an established alternative dispute resolution provider. Disputes involving claims and counterclaims under $250,000, not inclusive of attorneys' fees and interest, will be subject to JAMS's most current version of the Streamlined Arbitration Rules and procedures available at [http://www.jamsadr.com/rules-streamlined-arbitration/](http://www.jamsadr.com/rules-streamlined-arbitration/?ref=drcraigcanapari.com); all other claims will be subject to JAMS's most current version of the Comprehensive Arbitration Rules and Procedures, available at [http://www.jamsadr.com/rules-comprehensive-arbitration/](http://www.jamsadr.com/rules-comprehensive-arbitration/?ref=drcraigcanapari.com). JAMS's rules are also available at www.jamsadr.com or by calling JAMS at 800-352-5267\. If JAMS is not available to arbitrate, the parties will select an alternative arbitral forum. You may choose to have the arbitration conducted remotely, based on written submissions, or in person at a mutually agreed location. We will be entitled to make an offer of judgment in the arbitration proceeding. If the offer of judgment is not accepted, and the award is not more favorable than the unaccepted offer, you will be solely responsible for all costs incurred by Us after the offer of judgment is made to the extent permitted by applicable law. Any judgment on the award rendered by the arbitrator may be entered in any court of competent jurisdiction. c. Fees. If the arbitrator finds that you cannot afford to pay JAMS's filing, administrative, hearing, and/or other fees, and you cannot obtain a waiver from JAMS, we will pay them for you. If the arbitrator determines the claims are frivolous, you agree to pay Us our attorneys’ fees and costs in the arbitration, to the extent permitted by applicable law. d. Authority of Arbitrator. The arbitrator, and not any federal, state, or local court or agency, will have exclusive authority to resolve any dispute related to the interpretation, applicability, enforceability, or formation of this Arbitration Agreement, including, but not limited to, any claim that all or any part of this Arbitration Agreement is void or voidable. The arbitration will decide the rights and liabilities, if any, of you and Us. The arbitration proceeding will not be consolidated with any other matters or joined with any other cases or parties. The arbitrator will have the authority to grant motions dispositive of all or part of any claim. The arbitrator will have the authority to award monetary damages and to grant any non-monetary remedy or relief available to an individual under applicable law, the arbitral forum's rules, and these Terms (including the Arbitration Agreement). The arbitrator will issue a written award and statement of decision describing the essential findings and conclusions on which the award is based, including the calculation of any damages awarded. The arbitrator has the same authority to award relief on an individual basis that a judge in a court of law would have. The award of the arbitrator is final and binding upon you and Us. e. Waiver of Jury Trial. You and We hereby waive any constitutional and statutory rights to sue in court and have a trial in front of a judge or a jury. You and We are instead electing that all claims and disputes will be resolved by arbitration under this Arbitration Agreement, except as specified in Section (a) above. An arbitrator can award on an individual basis the same damages and relief as a court and must follow this Agreement as a court would. However, there is no judge or jury in arbitration, and court review of an arbitration award is subject to very limited review. f. Waiver of Class or Consolidated Actions. Except with respect to Batch Arbitration (as defined below), all claims and disputes within the scope of this Arbitration Agreement must be arbitrated on an individual basis and not on a class basis, only individual relief is available, and claims of more than one customer or user cannot be arbitrated or consolidated with those of any other customer or user. In the event that this subparagraph is deemed invalid or unenforceable neither you nor We are entitled to arbitration and instead claims and disputes will be resolved in a court as set forth in these Terms. g. Batch Arbitration. You and We agree that, in the event that there are fifty (50) or more individual requests for arbitration of a similar nature filed against Us within an approximately (30) thirty-day period (or otherwise in close proximity) regardless of the state(s) in which such claims are filed, JAMS will administer all such similarly situated arbitration demands on a collective basis as a single, consolidated arbitration (subject to a single set of fees, proceeding schedule, and, if required, hearing) before a single arbitrator in accordance with the requirements outlined elsewhere in this section, provided that – in the event that the arbitrator deems it impracticable or inequitable to administer all such claims collectively in a single arbitration – (s)he may group demands for arbitration into groups of not fewer than twenty (20) matters, plus a remainder group as needed (or as otherwise deemed by the arbitrator to be practicable, equitable, and in best keeping with the spirit of this provision) and arbitrate each group of matters as a single, consolidated arbitration (either structure a “**Batch Arbitration**”). You and We agree (1) to work with JAMS in good faith to facilitate the resolution of disputes on a Batch Arbitration basis and (2) that requests for arbitration are of a “similar nature” if they arise out of the same event, agreement, or factual scenario and raise the same or similar legal issues and seek the same or similar relief. Disagreements over the applicability of this Batch Arbitration process will be settled in a single, consolidated arbitration proceeding that includes all affected parties and is resolved by a single arbitrator subject to the requirements of this section. This Batch Arbitration provision shall in no way be interpreted as authorizing a class or collective arbitration or action of any kind, or any suit or arbitration involving joint or consolidated claims, under any circumstances other than those expressly set forth in this section. h. Severability. If any part or parts of this Arbitration Agreement are found under the law to be invalid or unenforceable, then such specific part or parts will be of no force and effect and will be severed, and the remainder of the Arbitration Agreement will continue in full force and effect. i. Survival. This Arbitration Agreement will survive the termination of your relationship with Us. j. Modification. Notwithstanding any provision in these Terms to the contrary, We agree that if We make any future material change to this Arbitration Agreement, it will not apply to any individual claim(s) for which that you had already provided notice to Us. Consent to Data Collection. These Terms of Service incorporate our Privacy Policy (above), which discloses how we, our vendors, and our service providers collect and use data when you use the Site and/or mobile applications. You hereby consent to the collection and use of data by us, our vendors, and our service providers as described in the Privacy Policy (including any links to other policies therein). You can revoke this consent at any time by following the opt-out instructions in the Privacy Policy or clicking the provided links on the Site. Limitations on Liability. YOU UNDERSTAND AND AGREE THAT, TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, WE, OR OUR VENDORS OR SERVICE PROVIDERS (COLLECTIVELY, “WE” OR “US”), SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL OR PUNITIVE DAMAGES, OR ANY LOSS OF PROFITS OR REVENUES, WHETHER INCURRED DIRECTLY OR INDIRECTLY, OR ANY LOSS OF DATA, USE, GOODWILL, OR OTHER INTANGIBLE LOSSES, RESULTING FROM YOUR ACCESS TO OR USE OF OR INABILITY TO ACCESS OR USE THE WEBSITE. IN NO EVENT SHALL THE AGGREGATE LIABILITY OF ANY OF US EXCEED THE GREATER OF (A) THE TOTAL AMOUNT PAID OR PAYABLE TO RAPTIVE BY YOU FOR THE WEBSITE DURING THE SIX-MONTH PERIOD PRIOR TO THE ACT, OMISSION, OR OCCURRENCE GIVING RISE TO SUCH LIABILITY; OR (B) ONE HUNDRED U.S. DOLLARS ($100). THE LIMITATIONS OF THIS SUBSECTION SHALL APPLY TO ANY THEORY OF LIABILITY, WHETHER BASED ON WARRANTY, CONTRACT, STATUTE, TORT, OR OTHERWISE, AND WHETHER OR NOT THE PARTIES HAVE BEEN INFORMED OF THE POSSIBILITY OF ANY SUCH DAMAGE, AND EVEN IF A REMEDY SET FORTH HEREIN IS FOUND TO HAVE FAILED ITS ESSENTIAL PURPOSE. ## Contact Us If you have any questions about this Privacy Policy, please contact us: - By email: Craig@drcraigcanapari.com ### Welcome Morgan Stanley! URL: https://drcraigcanapari.com/morgan-stanley/ Last updated: 2017-06-26T21:32:22.000Z I hope you guys enjoyed the talk. Obviously, we couldn't cover everything. Here are links to some articles which I've written about the topics we discussed. First off, if you are struggling with your child's sleep, I have a free Sleep Training Mini-Course for parents of children less than six. You can sign up for it here. [Why you fall asleep: Harnessing Sleep Drive for a better bedtime](https://drcraigcanapari.com/harnessing-sleep-drive-for-a-better-bedtime/) [Understanding Your Body Clock](https://drcraigcanapari.com/why-you-fall-asleep-part-2-understanding-the-body-clock/) Here's a post on [whether or not you should consider melatonin for your child.](https://drcraigcanapari.com/should-my-child-take-melatonin-a-guide-for-parents/) Here's my compendium of the [top sleep training mistakes parents make, and how to avoid them.](https://drcraigcanapari.com/sleep-training-mistakes-and-pitfalls/) Here's info on [obstructive sleep apnea](https://drcraigcanapari.com/obstructive-sleep-apnea-a-common-and-serious-problem-in-kids/) and [restless leg syndrome.](https://drcraigcanapari.com/growing-pains-restless-legs-an-under-diagnosed-cause-of-insomnia-in-children/) Finally, here's my [big list of sleep resources for teenagers.](https://drcraigcanapari.com/teen-sleep-info/) ### Thanks so much! URL: https://drcraigcanapari.com/thanks-much/ Last updated: 2017-11-16T16:25:44.000Z I appreciate your readership. I'll keep sending you the best sleep content on the web. [As an added bonus, here is a link to the podcast where John Hodgman calls me a monster for dog-earing library books.](http://www.maximumfun.org/judge-john-hodgman/judge-john-hodgman-episode-251-wrecks-libris?ref=drcraigcanapari.com) ### Thanks so much for signing up! URL: https://drcraigcanapari.com/thanks-much-signing/ Last updated: 2018-06-29T17:15:15.000Z I'm furiously working on your next email! [https://giphy.com/embed/XIqCQx02E1U9W](https://giphy.com/embed/XIqCQx02E1U9W?ref=drcraigcanapari.com) ### Book Resources for It’s Never Too Late to Sleep Train URL: https://drcraigcanapari.com/nevertoolate/ Last updated: 2026-04-30T21:12:24.000Z Hello reader! If you have found this page, you likely have a copy of my book, [It’s Never Too Late to Sleep Train](http://itsnevertoolatetosleeptrain.com/?ref=drcraigcanapari.com). (If not, by all means pick up a copy ;)). The book references several resources — the Sleep Diary, the Double Habit Loop, and the Bedtime Funnel — and you'll find them all here. **Sign up for a free membership to access the workbook.** You'll also get my newsletter with practical sleep guidance for parents. No spam, unsubscribe anytime. Get the workbook Check your inbox — click the confirmation link to access the workbook. Something went wrong. Please try again. _This page is for subscribers only._ ### Resources for pediatricians and pediatric providers URL: https://drcraigcanapari.com/resources-pediatricians/ Last updated: 2019-03-20T21:33:41.000Z Thanks so much for signing up for my list! Here are some of the articles which you might find most useful, and that you may have missed: [Should My Child Take Melatonin?](https://drcraigcanapari.com/should-my-child-take-melatonin-a-guide-for-parents/) [Five Mistakes Doctors Make When Counseling about Sleep](https://drcraigcanapari.com/five-mistakes-doctors-make-when-counseling-parents-about-sleep/) [Restless Leg Syndrome in Children](https://drcraigcanapari.com/growing-pains-restless-legs-an-under-diagnosed-cause-of-insomnia-in-children/) [Sleep Training Tools for the Exhausted Parent](https://drcraigcanapari.com/at-long-last-sleep-training-tools-for-the-exhausted-parent/) [The Top Ten Sleep Training Mistakes](https://drcraigcanapari.com/sleep-training-mistakes-and-pitfalls/) [Teen Sleep Resource Page](https://drcraigcanapari.com/teen-sleep-info/) And remember, you guys are the best. [https://giphy.com/embed/l3V0sNZ0NGomeurCM](https://giphy.com/embed/l3V0sNZ0NGomeurCM?ref=drcraigcanapari.com) [via GIPHY](https://giphy.com/gifs/youre-the-best-you-are-da-l3V0sNZ0NGomeurCM?ref=drcraigcanapari.com) ### Thanks for letting me know who you are! URL: https://drcraigcanapari.com/thanks-for-letting-me-know-who-you-are-consultants/ Last updated: 2019-03-24T19:17:37.000Z I'm a big fan of sleep consultants as you help so many families who are struggling. I'm honored that you have signed up for my list. [https://giphy.com/embed/nXxOjZrbnbRxS](https://giphy.com/embed/nXxOjZrbnbRxS?ref=drcraigcanapari.com) [via GIPHY](https://giphy.com/gifs/win-nXxOjZrbnbRxS?ref=drcraigcanapari.com) ### Thanks for letting me know who you are URL: https://drcraigcanapari.com/thanks-for-letting-me-know-who-you-are-parents/ Last updated: 2019-03-24T19:19:12.000Z I started this list to help tired parents such as yourself navigate the confusing amount of sleep information out there. I am inspired by your comments and emails to keep writing. Thank you.I believe in you. [https://giphy.com/embed/SiViN6pzBpaTu](https://giphy.com/embed/SiViN6pzBpaTu?ref=drcraigcanapari.com) [via GIPHY](https://giphy.com/gifs/you-got-this-finals-week-i-believe-in-SiViN6pzBpaTu?ref=drcraigcanapari.com) ## Posts ### Avoiding Sleep Problems with Falling Back: Your Child and the End of DST URL: https://drcraigcanapari.com/daylight-savings-time-and-your-child-falling-back/ Last updated: 2026-10-23T15:17:05.000Z ![-Falling Back-Avoiding Sleep Problems At the end of daylight savings time](https://drcraigcanapari.com/content/images/wp-content/uploads/2016/10/fallingback-avoidingsleepproblemsattheendofdst.jpg) Ahh, autumn. Halloween costumes, fall foliage, carving Jack-O-Lanterns and enjoying the crisp bite of a fresh apple. Those of use who live in New England often cite this season as the finest of the year, prior to the long nights and cold days of winter. There is one part of it that I don't look forward to as a parent of small children, and a sleep doctor: the end of [Daylight Savings Time](http://en.wikipedia.org/wiki/Daylight%5Fsaving%5Ftime?ref=drcraigcanapari.com) (DST) when the clock falls back by one hour. This year, clocks in the United States will fall back by one hour at 2 AM on Sunday, November 1rst. There is some evidence that DST is associated with adverse health and safety effects, but this is controversial; Brad Plumer [nicely outlined this in the Washington Post](http://www.washingtonpost.com/blogs/ezra-klein/post/daylight-saving-time--still-mostly-a-scam/2012/03/09/gIQATaxP3R%5Fblog.html?ref=drcraigcanapari.com). ## What is Daylight Savings Time? When Does it End I always have to pause and think about these terms because they are pretty confusing. Here's a brief primer: 1. **When is daylight saving time?** "Daylight Saving Time" (or DST) refers to the practice of advancing the clock an hour later for the summer months for an extra hour of daylight. In 2016, it occurs between March 13th and November sixth. 2. **What happens when daylight saving time ends?** The end of DST occurs when the clock is dialed back an hour, which we call "falling back". 3. **Why do you keep calling it daylight SAVING time?** Although it sounds weird, "daylight savings time" is incorrect; **it is correct to say daylight saving time.** But don't be pedantic about correcting people. ## What does "falling back" do to kids' sleep? If you don't have children and don't work nights (medical residents on call that night-- I feel for you as you will be on call for another hour), congratulations! You get an extra hour of sleep. For those of us with little children who get up earlier, however, this can be painful. The reason is that little children tend to get up earlier than their parents would like them to. Thus, a child who is sleeping from 8 PM to 6 AM will now be on a 7 PM to 5 AM schedule. The sleep period has not moved, but the clock has. **In general, early risers DO WORSE with falling back.** There is not much research on this, especially in children, but an abstract from the American Academy of Sleep Medicine meeting[ from 2023 looked at sleep data from 510 infants before and after the sleep change. The authors found:](https://watermark.silverchair.com/zsad077.0764.pdf?token=AQECAHi208BE49Ooan9kkhW%5FErcy7Dm3ZL%5F9Cf3qfKAc485ysgAAA3MwggNvBgkqhkiG9w0BBwagggNgMIIDXAIBADCCA1UGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMpZ4bnqJnVbJBBtHiAgEQgIIDJsjrL9evXHk3bwWwjc9TAGnxXCdaqKFcteH%5FSYm8daPllQKLJPPRiwQS1CQOB31oxwBhCk8eIkLiCKQ5Ea0ZKY8pYAwqaSEfl7E1nRv2aufr6A2IVEu773vhQd6ASLUlWHxKwHXg5KvlrLAaUhtThewkLlKkL9Mi82SfnFHPF3hdLXvfCfGEHYjTDNDNw5pBxmBMn6RhXs7pEoGLwFCII4IR9H-uqQTg5R6OrtCkjFbpM4p1fnqy6MfjyHwC4YX674Q9lKBGECh2jFBLwHIUW%5FrrE14zreX82Xp3zfnvwg9dhYgmhOaivWG2iR3DdzJgNAgTefjN1diB2SDj9ZRtmQcnrrDPZoYhNrxRfOY5i-u5SFYGVFgXVE6xHB9CDdbs3ybtzkXKAkUDKoyyK-KGj%5FLtkimh4Ty3VKvVpdgc7CfqpkKtkH%5FOuqwK8f7LjrL-WaJ7wf5fdp84CRV3AmKTGk1LigCxUdkahHPsO9kEM2lTYmdrLjBFtsBYUdxBiQtUJtGl2QmCAmJrhnEdY7MNgaJY5D1UaIzdMbuCjHBeSBYUFJWlMh36j-keiu5ytLFCoMcN2KAsdq4tgu-D94QSABYMkVZtLEcndEjGJFHd%5F0IaPoba8kkbkLJVhHPIq2Kh8hNvLLnPUa0ijfnFdSVE8fbshZy3Z6A2lVssKegieuxZh3OfhmQyqpkXldUSvWqMaaP2hX4uHkY-r1dE5lDNdAL57hQrhniL3kYI3KRbvagGWHb99WbpffvxDnLnqqO84rVlgHuEjZJfbohLVVqvKPs00DQ8qt7BhwZi5rSPlttlSYc2%5FUPThbHdyYx2B09vvB8TndncjqwrReHkUZ8NJ1DhrwFrdeKgbbDQcOF%5FrUS1SX-V96oDKxi4GVMY-18R%5FxoDJOxoHdXio1ABWf5YmlBqYOiIQQWti9RU8OPGFb0efELKZy5LGHzaYouggumci8w3x6C5m9fNTLAqcfCyiQ-XiukIhh9cTzwJoqddnHwcWWxJEFo%5FkL0DqezusvjAU5hk3GwLwnLKixQr0asu0bs%5FEYa4UUenXEQjB46op14Qoo%5F2q0Le&ref=drcraigcanapari.com) - Infants in the 3-6 month age range had FEWER night time awakenings in the following week - The midpoint of the children's sleep period was about ten minutes earlier for ONE week after the transition. This indicates that children were waking up earlier for at least a week after the transition Teenagers are a different story as they usually have problems with getting up late-- [thus they struggle with the beginning of DST, or "springing ahead.](https://drcraigcanapari.com/2012/03/08/daylight-savings-time-and-your-child-springing-ahead/)" ## Teenagers Benefit from Falling Back Falling back is a great opportunity on reseting your sleep schedule if you struggle to get up in the morning. It is especially helpful for teenagers. Unlike little kids, [teenagers naturally tend to stay up later and struggle to get up in the morning](https://drcraigcanapari.com/the-sleepy-teenager/). Thus, "falling back" tends to feel pretty great for your teenager as the world essentially moves closer to his or her natural sleep schedule. If you want to capitalize on this, I encourage teens to try to stay on the clock time and not use this as an excuse to stay up later. Practically speaking, this means continuing to going to bed a bit earlier based on clock time. For example, if your teen struggles to fall asleep before 11:30 PM, this is a good opportunity to have her go to sleep at 10:30 PM as it will "feel" the same. ## Preparing your child for falling back: tips and strategies First of all, you don't need to do anything! Your child will be fine. **But if your child gets up uncomfortably early, a quick intervention may be helpful.** Fortunately this is pretty easy: Just move your child's sleep period later by 30 minutes for three days before "falling back" and then back to their old schedule on the "new time", effectively moving their sleep period an hour later. ### How to prepare your child for falling back Let's take the example of a child who is on a set 8pm to 6am wake schedule. The day after daylight savings time, this child will be sleeping from 7pm to 5am. Ouch! 5am is pretty earlier. Fortunately, it is pretty easy to address this. I would just move your child's schedule later by 30 minutes for 3 days prior to the transition. In this example, you will have your child go to sleep at 8:30 PM to 6:30 AM (DST-- OLD TIME) for three days (Thursday, Friday, Saturday) before falling back, then move them back to the old clock schedule at the new time (8 PM to 6 AM STANDARD TIME). ![This demonstrates how to adjust the sleep schedule of an early riser prior to falling back. In this example, you will have your child go to sleep at 8:30 PM to 6:30 AM (DST-- OLD TIME) for three days before falling back, then move them back to the old clock schedule at the new time (8 PM to 6 AM STANDARD TIME).](https://drcraigcanapari.com/content/images/wp-content/uploads/2021/10/dst-falling-back.jpg) Not everyone's child will sleep in 30 minutes later but the important thing is to move bedtime. This approach will hopefully cushion the landing from "falling back" and help you get a little more shuteye. I have found this to be useful in my household and my clinic, where the ramifications of DST seem to extend beyond a simple shift; many children seem to have disrupted sleep at night as well around this transitional period. In my experience, these difficulties may be exaggerated in children with autism, so it may be worth a more gradual transition in sleep periods. If early morning awakenings remain an issue, here are some more [strategies for addressing them](https://drcraigcanapari.com/2012/03/20/early-morning-awakenings-what-to-do-about-them/). ## The controversy around DST We all enjoy the extended light period in the summertime with DST. Here's the problem with it-- it does not align correctly with our body clocks. In Standard Time, noon occurs at solar noon-- when the sun is highest in the sky. When we shift to DST, we are changing our biological relationship to time. Many professional organizations, such as the [American Academy of Sleep Medicine, recommend a shift to Standard Time year round. ](https://pubmed.ncbi.nlm.nih.gov/32844740/?ref=drcraigcanapari.com) There are powerful lobbying groups against it-- most prominently golf (DST results in more golfing and more revenue), and Big Candy (there is a reason DST ends after Halloween-- so kids can go trick or treating later. [Here's a great documentary on the role of Big Golf and Big Candy extending DST, and the value of permanent standard time.](https://youtu.be/bQX-rhw41RU?si=-Mmdrmy9oUdLVpes&ref=drcraigcanapari.com) ## Further reading My[ Sleep Edit cohost Arielle Greenleaf ](https://drcraigcanapari.com/podcasts/the-sleep-edit/)has a [nice guide for parents for what to do after the time change if you have issues.](https://expect-to-sleep.kit.com/fall%5Fback?ref=drcraigcanapari.com) [I wrote an article on Daylight Savings Time and children for the New York Times which you can read here.](https://www.nytimes.com/article/daylight-saving-time.html?unlocked%5Farticle%5Fcode=1.wU8.zsRm.PLMDTsLIv63R&smid=url-share&ref=drcraigcanapari.com) [I was also quoted in an article on this issue in the Wall Street Journal.](https://www.wsj.com/articles/daylight-saving-time-ends-sunday-yes-you-can-win-the-transition-11635771600?ref=drcraigcanapari.com) [Why permanent Daylight Saving Time is a terrible idea for kids](https://drcraigcanapari.com/why-permanent-daylight-saving-time-is-a-terrible-idea-for-kids/) [A nice article on Falling Back from McMaster University](https://healthsci.mcmaster.ca/what-this-sleep-expert-wants-you-to-know-about-the-end-of-daylight-time-and-its-impact-on-kids/?ref=drcraigcanapari.com) I'd love to hear about your experiences with this. Has this been a problem for you in the past? ### Toddler Night Wakings: What Causes Them and How to Fix Them URL: https://drcraigcanapari.com/behavioral-sleep-problems-in-children-part-1-inappropriate-sleep-associations/ Last updated: 2026-09-22T13:45:59.000Z **Toddler night wakings** are especially painful as they can cry longer than infants, and are harder to reassure than older children. One of the most common causes of night wakings in infants, toddlers, and even older children is **inappropriate sleep onset associations**. This is a problem which will respond to behavioral management (aka sleep training). Let me paint a picture for you. It's been a long evening in the Smith household. Jimmy is 14 months old. Every night, since he was an infant, his parents have rocked him to sleep every night and then put him in his crib, at around 8 PM. His parents put him to sleep, sit down to watch some television and try to relax, but they are dreading the night ahead. Just when they get into bed, around 11 PM, they hear Jimmy crying out. They rush into his room frantically to try to rub his back so he falls asleep more quickly. These awakenings occur for the rest of the night every hour to an hour and a half. When he gets up for the day at 5:30 AM, Jimmy is quite irritable, and his parents are exhausted. They don't have the luxury of taking two naps today. Jimmy's problem is that he has developed **inappropriate sleep onset associations, the most common cause of frequent night time awakenings in toddlers.** It’s important to note, however, that **many other problems can cause crying and screaming at night in toddlers.** Read on and see which may fit your child the best. Note that some children have more than one issue going on at a time. As always, if you are having trouble teasing out the cause of your child’s crying, check with your child’s pediatrician. Want to learn more? We discussed this in [the Sleep Edit podcast episode on night wakings.](https://drcraigcanapari.com/podcast/episode-13-toddler-night-wakings-early-rising-and-nap-refusal-your-pediatric-sleep-questions-answered/) ## Inappropriate Sleep Onset Associations Cause Frequent Awakenings The typical child with inappropriate sleep onset associations is between 6 and 36 months but may be older or younger. This child needs his parent present to fall asleep and wakes up very frequently during the night. Parents view the awakenings as the problem, but they are a symptom of the primary issue: the child has not learned to fall asleep by himself. **In a nutshell: if your child needs you to fall asleep at bedtime, then needs you there to go back to sleep in the middle of the night, you are likely dealing with a sleep onset association. The fix is teaching your child to fall asleep without you, a process we call *sleep training.*** To understand why this is the case, I've created a few illustrations. First, let's look at a night of normal sleep, on a graph called a hypnogram, which represents the various stages of sleep that a child goes through at night. Notice that the child falls asleep into very deep sleep at the beginning of the night, then has more REM or dream sleep as the night goes on. (REM is highlighted in red.) ![Hypnogram of a normal night for a toddler who falls asleep on his own. After a long stretch of deep Stage 3 sleep early in the night, he cycles between Stage 2 and REM sleep, with two brief awakenings out of REM, and wakes in the morning.](https://drcraigcanapari.com/content/images/2026/09/diagram1-normal-night.png) **A normal night of sleep. The vertical red line is a single brief awakening.* Note that the child briefly awakens after bouts of [REM sleep](https://en.wikipedia.org/wiki/Rapid%5Feye%5Fmovement%5Fsleep?ref=drcraigcanapari.com). However, this child is used to falling asleep on his own. Thus, he does not *signal* to his parents. Compare this with a child who needs her parents present to fall asleep. She may be held and rocked until she falls asleep. She may need his back rubbed or to nurse to fall asleep. She may even fall asleep with a pacifier in her mouth which falls out during the night. In Jimmy's example, his parents rock him to sleep. ![Hypnogram of a toddler who is rocked to sleep. He takes longer to fall asleep, wakes fully five times during the night, each time out of REM sleep, and is up for the day about an hour earlier than a typical wake time.](https://drcraigcanapari.com/content/images/2026/09/diagram2-sleep-association.png) **Kids with inappropriate sleep onset associations take longer to sleep, have multiple times they wake up during the night, and tend to wake up earlier. Note that the first awakening typically occurs 2-3 hours after falling asleep.* This child has not yet learned to fall asleep by herself. Thus, every time she has a normal awakening, she will call out to her parents and need them present to fall back to sleep. **If your child falls asleep under a set of circumstances that are not present during the night (being held, having their back rubbed, nursing, even having a pacifier in their mouth) they will need the same set of circumstances multiple times during the night.** So if they falls asleep in your arms, you are likely going to have to get up multiple times during the night. Often, they wake up earlier as well as exhausted parents bring them into bed with them (thus causing another sleep onset association). Thus, sleep onset associations are a common cause of [early morning awakenings](https://drcraigcanapari.com/early-morning-awakenings-what-to-do-about-them/). Here's a comparison of the two nights of sleep: ![Two hypnograms compared on the same timeline. The child who falls asleep on his own has two brief awakenings and sleeps about 10 hours. The child who is rocked to sleep takes longer to fall asleep, wakes fully five times, sleeps about 8 hours 15 minutes, and is up an hour earlier.](https://drcraigcanapari.com/content/images/2026/09/comparison-both-nights-poster.png) Again, note that the child who is rocked to sleep falls asleep later, gets up multiple times during the night, and gets up earlier. Common sleep on associations include: - Rocking to sleep - Laying down with a parent - Falling asleep in parent’s bed - Feeding or nursing to sleep - A pacifier, blanket, or lovey that gets lost during the night - A music source that turns off after the child falls asleep Dr. Ferber used a great analogy in his [classic book](https://amzn.to/1GDhIwt?ref=drcraigcanapari.com) (affiliate link). Most of us fall asleep with a pillow and blanket. If we woke up and our pillow and blanket were missing, we would get up and go looking for them. We would likely worry about where they had gone **The key to addressing inappropriate sleep onset associations is helping your child to fall asleep on their own. For more advice, please see** [**my post on various sleep training methods**](https://drcraigcanapari.com/at-long-last-sleep-training-tools-for-the-exhausted-parent/)**.** Note that a subset of children may have significant separation anxiety that persists as they get older. The practical way to determine if separation anxiety is a problem is that-- do they need help settling to sleep (with rocking or a pacifier) or is distress about your absence specifically? Often separation anxiety is focused on one parent predominantly. [Often parents make concessions to their child’s anxiety (called accommodations)](https://drcraigcanapari.com/help-kids-with-anxiety-sleep-better/) which can perpetuate the problem. The end result can be persistent cosleeping. Here’s an article on [how to stop co-sleeping](https://drcraigcanapari.com/want-to-stop-cosleeping-heres-how/), even if your child is anxious. ### The technical classification of sleep onset association problems Once upon a time, when I was a wee sleep doctor, we used to classify these sorts of problems as *behavioral insomnia of childhood*, which had two subtypes: sleep onset association disorder (covered above) and [limit setting disorder](https://drcraigcanapari.com/curtain-calls-limit-setting-and-bedtime-battles-behavioral-sleep-problems-in-kids-part-2/) , which is where a child would come out of their room multiple times demanding parental attention, a phenomenon called “curtain calls”. The fact is, curtain calls often occur in children have moved to a bed and also have sleep onset association disorder, so now these issues are grouped under the diagnosis of *chronic insomnia* provided they have happened for three months or more. ## Night terrors: another reason why your toddler wakes up screaming Has your child woken up crying and screaming inconsolably? And nothing you did was able to stop them from crying? If so, they likely are having a night terror. Night terrors are part of a group of disorders called NREM parasomnias. (NREM means they occur out of non-REM sleep stages, and parasomnias are behaviors that occur out of sleep but have features of things you do during wakefulness.) Night terrors are common in toddlers, [occurring in one third of 18 month olds, falling to roughly one in five by age two and a half.](https://jamanetwork.com/journals/jamapediatrics/fullarticle/2281574?ref=drcraigcanapari.com) They really stink! My son used to have one every time we slept at my in-laws and he would wake up the whole house. They are pretty easy to differentiate from sleep onset associations, however. First off, they occur out of NREM sleep. Remember how we discussed the long period of deep sleep at the beginning of the night? That is the most common time for night terrors to occur, although they can occur later in the night. More importantly, you cannot console your child during them. Sleep onset associations? Rocking your child back to sleep works-- that’s the whole trouble; you’ll be doing it again in two hours. Night terrors? Buckle up as they will be screaming and crying no matter what you do. They typically last 10-15 minutes but can last up to 30 or 40 minutes. The upside is that generally, night terrors don’t occur nightly (although they can) and usually only occur once per night. And they are usually benign and resolve on their own. The main thing is to keep your child safe. Generally they stay in the crib or bed (if they leave the bed, it is technically sleepwalking), but they may still thrash about. [Here’s an article I wrote on sleepwalking and night terrors in children.](https://drcraigcanapari.com/night-terrors-sleep-talking-and-sleepwalking-in-children/) ## Did something temporarily disrupt a good sleeper? A few causes of night time awakenings just happen in the course of normal family life and don’t typically need much intervention from parents. But they can still cause a problem if you respond by creating a new sleep onset association. ### Are you dealing with a sleep regression? If your child has been sleeping well then started waking up out of the blue, you may be dealing with what everyone calls a sleep regression. Now, to be clear-- these disruptions are very real. You know: you were up at 3 a. m.for no obvious reason after 3 months of solid sleep with a fussy 18-month-old. I’m just not a believer in the purported age based predictable regressions that are all over social media. When researchers track night wakings over time, they decline steadily-- there is no bump at 12 months, 18 months, or 2 years. What I do know is that big-ticket developmental milestones (most famously walking and potty training) may be associated with short night wakings. And look how many happen during toddlerhood, as well as how they line up with purported age based sleep regressions. | Age | What parents call it | What's actually going on | | ---------------- | ----------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | **12–15 months** | "the 12-month regression" | Independent walking (typical 12–15 months, normal range 9–18). Pulling up and cruising just before. Often still on two naps and starting to fight the second. | | **15–18 months** | "the 15- or 16-month regression" | The 2-to-1 nap transition — most common in this window (range 12–24 months). Separation awareness sharpens. First molars erupting (13–19 months). | | **18–24 months** | "the 18-month or 2-year regression" | Autonomy and limit-testing arrive. Canines erupt (16–23 months). Climbing out of the crib becomes physically possible. | | **2–3 years** | "the 2-year or 2.5-year regression" | Crib-to-bed transition (often forced by climbing out, or by a new sibling). Potty training. Second molars erupt (23–33 months) — the last teeth, and the most blamed. Imagination and night fears begin. | | **3–3.5 years** | "the 3-year regression" | Dropping the nap (commonly 3–5 years). Total sleep need falls to roughly 10–13 hours. Night fears more prominent. Preschool starts — new schedule, new separations. | Plenty of what disrupts toddler sleep isn't pegged to an age at all: illness, travel or a schedule change, a new sibling, a house move, a new caregiver. The problem with the age-based framing is that it makes parents worry about things that may never happen. So before some scaremongering post about the Halloween sleep regression or the Mercury in retrograde sleep regression, take a breath and recognize the exciting developmental work your child is doing (which may have the cost of a few nights of disrupted sleep). If you do nothing, these events tend to resolve on their own. But if you respond to them by, say, getting in the habit of rocking your child back to sleep, you may generate a new sleep onset association and cause the night wakings to persist. I have a comprehensive post on the problems with age-based sleep regressions, as well as [recognizing and addressing sleep regressions.](https://drcraigcanapari.com/how-to-deal-with-a-sleep-regression/) ### Is your toddler sick right now? This isn’t rocket science. If your child has a cold or fever, sleep disruption is common. Nasal congestion and ear pain are both worse when lying down. If your child is sick, just soothe them and take care of them. Obviously call your pediatrician if you are worried. This too shall pass (until the next cold). Just be a bit wary-- if you take your child into your bed for a week when they have a cold, you run the risk of creating another sleep onset association you may need to unpack later. ### Is it teething? Teething is commonly blamed for sleep problems. However, it generally only causes [local, mild and brief symptoms of irritability around tooth eruption.](https://publications.aap.org/pediatrics/article-abstract/137/3/e20153501/81436/Signs-and-Symptoms-of-Primary-Tooth-Eruption-A?redirectedFrom=fulltext&ref=drcraigcanapari.com) Think maybe a night or two. And, importantly, teething does not cause fevers although it can nudge the temperature up slightly. If your child is having fevers or seems unwell, don’t just attribute it to teething; call your pediatrician. ### Is there a new baby in the home? Some parents struggle with their toddler's sleep when a new baby comes into the home. If the children share a room, this can be especially challenging. (Of course in early infancy, [your infant should likely sleep in your room, provided that you can do so safely](https://drcraigcanapari.com/room-sharing-infancy-isnt-necessary-for-safe-sleep/)). If you have a small home, a crying infant in another room can wake up your toddler, so using a sound machine can be helpful. [Just mind the volume and where you place it.](https://drcraigcanapari.com/is-your-sound-machine-harming-your-childs-hearing/) Sometimes, just the stress of welcoming a new baby to the home can disrupt your child's sleep. Usually, these disruptions are brief and last less than a week. If you can spend some time during the day with your toddler (and without the baby), that can help your child feel secure and calm as she goes through the exciting process of welcoming a baby brother or sister to the home. ## Is a medical disorder waking your child? Many common and chronic medical problems are overlooked as a cause of sleep disruption. I’m not talking about things that last for a night or two. I’m talking about problems that either occur multiple times per week, or in the context of a known chronic medical problem. You may be aware of the condition, or the night time symptoms may be your first clue that you need to chat with your child’s pediatrician. For example, if your child coughs frequently at night they may have [asthma which needs to be treated.](https://drcraigcanapari.com/sleep-training-in-a-coughing-child/) Acid reflux can be associated with belly pain and vomiting at night. [Obstructive sleep apnea is a very common problem](https://drcraigcanapari.com/obstructive-sleep-apnea-a-common-and-serious-problem-in-kids/) associated with snoring which can disrupt sleep. ## Is the schedule or the environment the problem? Sometimes, there are some structural issues that you can address to help your child sleep better. ### Is your toddler waking up hungry? Toddlers should not need to eat during the night unless there is a medical reason for them to eat. (If you are concerned about your child's growth, please talk to your pediatrician about this). If you are giving your child a bottle of milk or breast feeding your child during the night, weaning these feeds will likely help improve your child's sleep rapidly. [Here is my comprehensive post on dealing with night feeds.](https://drcraigcanapari.com/learned-hunger-nighttime-feeding-stop-night-feeding/) Still feeding at night? Night feeds are one of the most common reasons night wakings persist. My weaning guide has the exact bottle taper I use in clinic, plus approaches for breastfeeding families. Free for members. [Get the weaning guide →](https://drcraigcanapari.com/how-to-wean-night-feedings-bottles-and-breastfeeding/) ### Is your child in bed for too long? Some kids suffer from "too much time in bed syndrome". (I’m shamelessly borrowing this phrase from [Brett Kuhn](https://www.childrensnebraska.org/provider/3216124/brett-r-kuhn-phd?ref=drcraigcanapari.com), whom I heard use it in a talk many years ago). This happens when parents keep the same schedule their toddler had at twelve months, even though the child now needs less sleep. Imagine a child who was sleeping from 6 PM to 6 AM at age 1\. At age 3, this is likely too long a sleep opportunity, especially if the child is still napping. This child's sleep needs may have decreased from 13 to 11 hours per 24 hour period. Thus, if you keep the same nocturnal sleep period, your child may be awake for an hour or two at night. Usually in this scenario, your child is happy when she wakes up at night and is well rested in the morning. This may be the right time to get rid of a nap or consider a later bedtime. For more information, here's my post on [how much sleep kids need.](https://drcraigcanapari.com/how-much-sleep-do-kids-need-with-bonus-grown-up-info/) ### Is the environment waking up your child? Environmental cause tend to be obvious. [Is there a or other electronic device on in the room? If so, please take it out of there.](https://drcraigcanapari.com/get-that-television-out-of-your-kids-room-now/) Is there loud noise from neighbors or the road outside? Does your child share the room with a sibling or parent who makes a lot of noise? Room sharing with siblings can make it particularly challenging to manage toddler night wakings. If one child wakes up, frequently the other does too. [Here's more information on how to navigate the tricky waters of room sharing.](https://drcraigcanapari.com/agony-ecstasy-room-sharing-siblings/) Not sure which sleep training method fits your child? My free quiz matches your child's age and temperament to the right approach — and free membership includes the full 8-lesson Sleep Training Starter Kit to walk you through it. [Find your method →](https://drcraigcanapari.com/find-your-childs-perfect-sleep-training-method-take-the-quiz/) ## In summary Night wakings in toddlers are painful and common. If your child needs your help to fall asleep at bedtime, teaching them to fall asleep via sleep training will help them sleep through the night in a matter of weeks. So you can sleep through the night as well. If they fall asleep independently, there are other causes you can address. If you found this article helpful, please share with your friends and family. ### New Podcast: You're Not Doing it Wrong, with Dr. Lauren Hughes URL: https://drcraigcanapari.com/new-podcast-youre-not-doing-it-wrong-with-dr-lauren-hughes/ Last updated: 2026-09-08T13:59:45.000Z I'm a pediatric sleep doctor, but that didn't mean I knew what I was doing when we brought our first baby home. Breastfeeding was harder than my wife and I expected, and we needed help. That is one reason I was so glad to have Dr. Lauren Hughes join Arielle and me. Lauren is both a pediatrician and a lactation consultant, and she understands how tangled feeding advice and sleep advice can get. We talked about bottles, protecting milk supply, sharing the overnight work, and a distinction I wish more parents heard: sleep training and night weaning are separate decisions. We also talked about what happens when parents are too exhausted, or too worried about being judged, to tell their pediatrician how nights are actually going. Her closing line is the one I keep coming back to: you are not doing it wrong if your kids aren't sleeping through the night, and the only people who get an opinion are the ones waking up with that child overnight. ## Key Takeaways - Sleep training and night weaning are two separate decisions. Lauren sleep trained her twins at eight months and did not night wean them until eighteen — a baby can learn to fall asleep without help and still get every overnight feed they need. - Six hours counts as sleeping through the night. It may not be the six hours you wanted — 8 p.m. to 2 a.m. qualifies — and reframing the target is sometimes the entire intervention. - Milk storage capacity runs from roughly two to twelve ounces per breast and has nothing to do with breast size, which is why dropping a night feed is a non-event for one parent and tanks supply for another. How long you can go before engorgement is roughly your own ceiling, since engorgement is what tells the body to make less. - "Normal" is far wider than parents are told: in the newborn weeks three hours is a maximum, not a minimum — babies can eat sooner, and three hours is when you wake them. Breastfed babies average about 24 ounces in 24 hours, range 19 to 32. - It isn't nipple confusion, it's flow preference — babies take the path of least resistance, so a fast bottle beats the work of the breast, and paced feeding is the fix. Offering a bottle once a week from about a month old heads off the refusal that surfaces the week daycare starts. - The research on feeding method and sleep genuinely conflicts, and we don't pick a side. Under six months exclusively breastfed babies wake more often, though most studies find no difference in total sleep; after six months most find breastfed infants sleeping less — and much of the older literature simply asked parents, whereas Rudzik's actigraphy study found no difference in measured sleep even as formula-feeding mothers reported more. ### **Listen and watch** - The Sleep Edit episode page: [https://sleepedit.show/episodes/youre-not-doing-it-wrong-breastfeeding-and-sleep-with-dr-lauren-hughes](https://sleepedit.show/episodes/youre-not-doing-it-wrong-breastfeeding-and-sleep-with-dr-lauren-hughes?ref=drcraigcanapari.com) - Or find us on Apple Podcasts, Spotify, Overcast — wherever you get your podcasts Full medical disclaimer: [https://sleepedit.show/disclaimer](https://sleepedit.show/disclaimer?ref=drcraigcanapari.com) [Submit Listener Feedback and Questions Here](mailto:thesleepeditshow@gmail.com) ## ### Meta Just Agreed to Stop Waking Your Teenager Up. Don't Wait for It. URL: https://drcraigcanapari.com/meta-just-agreed-to-stop-waking-your-teenager-up-dont-wait-for-it/ Last updated: 2026-08-31T20:44:56.000Z On August 26th, Meta reached a settlement with **47 states, the District of Columbia, and three U.S. territories** regarding allegations that its products have harmed children and teenagers. Meta will pay **at least $12.1 billion and potentially up to $17.1 billion** over the next decade, depending in part on whether other major social media companies agree to similar restrictions. That is a lot of money for most of us, but not particularly a lot for Meta. Meta continues to deny wrongdoing, but the settlement resolves allegations that Facebook and Instagram were deliberately designed to keep young people engaged and that Meta misled the public about the risks of those products. For a summary I would recommend [this article by Casey Newton at Platformer](https://www.platformer.news/meta-child-safety-settlement-instagram-facebook-youtube-tiktok/?ref=drcraigcanapari.com), who really goes in depth. Meta also agreed to change how its products behave for teenage users. There are two changes specifically relevant to sleep health. The first is a **nighttime block restricting access to feeds between midnight and 6 AM**. The second is **turning off notifications between 10 PM and 7 AM**. They are also going to implement a two-hour daily cap, with pauses at 15, 60, and 90 minutes. This can be disabled with parental permission. [Here is the D.C. Attorney General’s summary of the settlement.](https://oag.dc.gov/release/attorney-general-schwalb-announces-meta-will-pay?ref=drcraigcanapari.com) ## The problems with the settlement Although I think this is a step in the right direction, I really would not recommend that parents or teens rely on the goodwill of tech companies and their oligarch owners to keep them safe or help them sleep well. First, the proposed changes are not in effect yet and it's unclear when they will be. It is also reliant on Meta knowing the correct age of users; as of now it's pretty easy to circumvent verification on Meta platforms. As part of the settlement, Meta does have to build an age assurance framework for children under 13, teenagers, and adults, but they have a year to do so. It is also unclear how effective this will be. Finally, teenagers need a sleep opportunity that allows for the **recommended 8–10 hours of sleep per night**. There is no reason this couldn't be, say, a 10 PM–7 AM blackout period nightly, or at least on school nights. The [American Academy of Sleep Medicine recommends that teenagers ages 13–18 regularly obtain 8–10 hours of sleep](https://aasm.org/advocacy/position-statements/teen-sleep-duration-health-advisory/?ref=drcraigcanapari.com). If the blackout is only midnight–6 AM (as it is under the current settlement), that allows only six hours of sleep. ## You need to have control of the phone at night **I would not rely on your teen's willpower to keep them from using their cell phones at night.** You need to have custody of the phones, either having them in a central charging area with associated consequences if they're not there, or keeping them someplace safe. I've had parents who've really struggled with their teens' social media use who've actually gotten safes or locked their kid's phone in their car. Hopefully that does not need to be the case in your home, but we're not relying on anyone's willpower to not use their phone. How good are you at not picking up your phone when it's in your pocket or sitting on your desk? Honestly, I struggle with it. Your teenagers may struggle even more. And there is evidence supporting this approach: **bedroom access to phones and other portable media devices is associated with shorter sleep, poorer sleep quality, and greater daytime sleepiness.** A large [JAMA Pediatrics systematic review and meta-analysis](https://jamanetwork.com/journals/jamapediatrics/fullarticle/2571467?ref=drcraigcanapari.com) found associations not only with bedtime device use, but even with simply having access to a device at bedtime. I've been beating the drum on the issues with electronics in kids' bedrooms. One of the earliest posts I wrote on this site (back in 2014) was called ["Get That Television Out of Your Kid's Room. Now."](https://drcraigcanapari.com/get-that-television-out-of-your-kids-room-now/), written back when the biggest technology worry we had was bedroom TVs. I've also written about [how and why to implement a light diet with your devices](https://drcraigcanapari.com/light-is-like-caffeine-avoid-insomnia-by-managing-your-screens/). And, finally, here's my guide [to keeping technology out of your child's bedroom.](https://drcraigcanapari.com/prevent-sleep-problems-in-kids-keep-technology-out-of-the-bedroom/) This includes a guide to dealing with smartphone excuses and arguments. ## The most cynical part Perhaps the most breathtakingly cynical part of the settlement is this: Meta has agreed that the nighttime feed blackout will expand from **midnight–6 AM to 10 PM–7 AM—**[**but only if major competitors including Snapchat, TikTok, and YouTube**](https://www.reuters.com/legal/government/what-meta-agreed-us-teen-safety-settlement-2026-08-26/?ref=drcraigcanapari.com) **agree to comparable protections**. In other words, apparently 10 PM–7 AM is a reasonable time to protect teenagers' sleep, as long as everybody else has to do it too. ### How Much Sleep Do Kids Need? (With Bonus Grown-Up Info) URL: https://drcraigcanapari.com/how-much-sleep-do-kids-need-with-bonus-grown-up-info/ Last updated: 2026-08-09T20:33:45.000Z As a sleep expert, I understand how important it is for parents and caregivers to ensure their children get enough sleep for optimal health and development. That's why I created a comprehensive guide on how much sleep kids really need. In this guide, parents will discover the optimal sleep duration for children of all ages and learn essential tips for making sure their child gets the rest they need to thrive. I also provide bonus advice on how grown-ups can improve their own sleep quality, making this guide a valuable resource for anyone looking to improve their family's sleep habits. I get asked all the time, "Is my child getting enough sleep? How much sleep do kids need?". There are a couple of ways to answer this question. Here's one way of answering the question. - **Does your child wake up in the morning without complaint?** - **Does she pay attention in school without difficulty?** - **Does she stay awake on short car trips around town?** If the answer to all of these questions is yes in a school age or older child, the answer is likely yes. However, **sleep quality matters too**\-- your child could be getting twelve hours of sleep a night and still wake up exhausted if he has a sleep disorder like [obstructive sleep apnea](https://drcraigcanapari.com/obstructive-sleep-apnea-a-common-and-serious-problem-in-kids/), or if [the TV is on in her room all night long](https://drcraigcanapari.com/get-that-television-out-of-your-kids-room-now/). It can be harder to judge in younger children who nap routinely. That is why it is important to know what the normal range of sleep duration is by age. In 2016, the American Academy of Sleep Medicine published new guidelines. [These numbers were recently validated in a study published in 2026.](https://www.sleephealthjournal.org/article/S2352-7218%2826%2900106-3/fulltext?ref=drcraigcanapari.com) | Age | Recommended sleep per 24 hours | | ---------------------- | ------------------------------ | | Infants 4–12 months | 12–16 hours (including naps) | | Toddlers 1–2 years | 11–14 hours (including naps) | | Preschoolers 3–5 years | 10–13 hours (including naps) | | School age 6–12 years | 9–12 hours | | Teenagers 13–18 years | 8–10 hours | *Recommended sleep durations from the* [*American Academy of Sleep Medicine consensus statement*](https://pmc.ncbi.nlm.nih.gov/articles/PMC5078711/?ref=drcraigcanapari.com)*, endorsed by the AAP.* (Full citation: Paruthi S, et al. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine. *J Clin Sleep Med.* 2016;12(6):785–786.) ## If you need a lot of sleep as a baby, you will need a lot when you are older. One thing I would add- if your child is on the high end of sleep needs in early childhood, they will likely continue to be in the high end of the range when they are older. If you have a high sleep needs baby, you often don't end up needing to sleep train or have any struggle with early morning awakenings. You feel like a parenting genius, and your friends are secretly jealous. But your child may struggle a bit as a teen. Likewise, kids who need less sleep are challenging to parents– they get up early, give up naps early, and may be challenging. But as teens they tend to have an easier time of it. Figuring out how much sleep your child needs (and designing a schedule around it) is one of the best tricks to ensure that everyone is sleeping well at night. ![CTA Image](https://canapari.mymagic.page/content/images/2026/04/rocket.png) Struggling with your child's sleep? I have a short [8 lesson Starter Kit](https://canapari.mymagic.page/sleep-training-starter-kit/?ref=drcraigcanapari.com) that will get you going on your journey to better sleep for your family. Need advice getting more sleep? Here are posts on how you can: - [Get 30 more minutes of sleep per night](https://drcraigcanapari.com/sample-post/) - Address [early morning awakenings](https://drcraigcanapari.com/early-morning-awakenings-what-to-do-about-them/) in your child - Effectively [sleep train your children](https://drcraigcanapari.com/at-long-last-sleep-training-tools-for-the-exhausted-parent/) - Help teenagers get more sleep by advocating for [later school start times](https://drcraigcanapari.com/aap-school-start-times/) ### The Back to School Sleep Tune-Up (Plus Summer Sleep Rules) URL: https://drcraigcanapari.com/the-back-to-school-sleep-tune-up/ Last updated: 2026-08-09T19:56:20.000Z Summer vacation means freedom for most kids. However, sleep schedules tend to fall by the wayside during the summer months. Many parents worry about teen summer sleep. Learn how you can help your child and teen develop healthy sleep habits during the summer months. ## Sleep schedule changes in the summer months Younger children (think from birth through elementary school) tend to be early risers. Thus, even if they are in school during the year and off for the summer, they tend to get up about the same time, or perhaps a little later. However, they are often up with the light, which can actually be earlier with the longer days of summer. However, as children enter puberty, [their sleep schedule gets later by about three hours.](https://drcraigcanapari.com/why-you-fall-asleep-part-2-understanding-the-body-clock/) Thus, during the summer when schedules are more relaxed, many teens will start staying up and getting up later unless they have to get up in the morning for camp or work. In a study of children in early adolescence (ages 12-14), [the average shift in the timing of their sleep schedule was later by about 41 minutes](https://pubmed.ncbi.nlm.nih.gov/28922020/?ref=drcraigcanapari.com) when compared to how they slept during the school year. Interestingly, data on older teens is somewhat limited. ### Can you be more relaxed about sleep in the summer? Most teenagers are [chronically sleep deprived during the school year.](https://drcraigcanapari.com/less-than-10-of-high-school-students-get-enough-sleep-at-night/) Some catch up sleep, and synchronization with their natural, later body clock schedule is to be expected. **I don't think that teens need to stay on their school sleep schedule.** However, there are a few caveats you should be aware of. #### Many children, especially obese children, tend to gain weight in the summertime. Sleep is likely a factor Many children in the US struggle with maintaining a healthy weight. Obesity researchers have explained this using something called the [Structured Days Hypothesis](https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-017-0555-2?ref=drcraigcanapari.com). Essentially, the idea is that children have less structure during the summer. They can eat when and what they want to, they are less physically active, and their sleep schedule shifts later and is less consistent. All of these behaviors are obesogenic-- they predispose children to gaining weight. #### Summertime schedules are not a guarantee that children are getting more sleep. A study of 7 year olds in New Zealand showed that the children were actually getting less sleep on weekends and summer days when compared to weekdays during the school year. Other studies have shown that teens, especially urban minority girls, [are likely to continue to be sleep deprived during the summer.](https://academic.oup.com/jpepsy/article/41/6/692/2579905?ref=drcraigcanapari.com) #### Later sleep schedules are associated with less sleep and worse dietary choices. An interesting study [surveyed over a hundred to 9-15 year olds in a gifted program in Mississippi](https://pubmed.ncbi.nlm.nih.gov/28709514/?ref=drcraigcanapari.com). They split the study participants into groups with early and late sleep periods. (They used a marker known as "midsleep time"-- essentially the midpoint of a night of sleep.) The earlier group's midsleep time was 2:11 am and the late group was 6:14 am during the summer. Assuming 9 hours of sleep, the early group was sleeping from 9:40pm to 7:50am; the late group was sleeping from 1:45 am to 10:45 am. The researchers found that children in the late group were more likely to make poor dietary choices-- specifically to consume more sugary, caffeinated beverages, and select other foods with high energy density and poor nutritional content. This adds to the [literature suggesting that short sleep and late sleep are associated with obesity in children.](https://drcraigcanapari.com/lack-of-sleep-may-make-kids-obese/) #### Should parents expect kids to take ownership of getting enough sleep in the summer? In the study above, children in the early sleep group were much more likely to have a parent set bedtime. Thus, **parents can influence their child's sleep time, even in adolescence.** Although it may not feel that way, the way you talk about sleep and the expectations you set matter. #### Should kids have a bedtime during summer break? I would recommend one through age fourteen. After this I would set a wake time for weekdays. More on this below. #### Is it OK to let your teenager sleep all day? I wouldn't let it become a habit as it will make it difficult to adjust to school in the fall. #### How much sleep is too much for a teenager? Teenagers who are consistently needing more than 10-11 hours per night could have a sleep disorder. You should talk about this with your pediatrician. In my experience, however, most kids who are sleeping all day just have an inappropriately late bedtime. ### Here's what you should do about your child's sleep schedule in the summer. **First, I think it is important that your child still have a set bedtime**, up through ages 12-14\. It's ok if it is later. For my patients, I recommend a 1+ schedule for children in elementary school and younger (one hour later to bed and one hour later to rise), and a 2-3+ schedule (two to three hours later to bed and rise) on average days during the summer. Especially for older teens, you will have more luck if you negotiate this with them. **For older teens agreeing upon a wake time and letting them set the bedtime is appropriate.** **Second, it's important for your children to have some structure during the day.** Camp or jobs are ideal, but not everyone has access to them. I do think that every child should get out of the house every day and get some physical activity and sunshine. Give them chores. Help them make plans with friends, especially in the morning. **Third, don't let electronic use get out of control over the summer.** I get being a little more lax in the summer. But many of the children in my clinic seem to spend all day and much of the night on their devices. **At a bare minimum, I would encourage you to keep electronics out of the bedroom at night and place screen time limits during the sleeping hours.** **Finally, and most important, check and see if your child getting enough sleep during the summer.** You can't take this for granted. (For more on the appropriate amount of sleep, read on!) Now, all these rules apply to an average day. Don't freak out if your child sleeps in to 2pm on one occasion after a sleepover with friends. ## What to think about a month before school **As a parent, you may want to start thinking now about how you will adjust your child's schedule to get them back on their school schedule.** It can be a rocky landing if teens need to adjust to a new school year and are used to staying up late and sleeping late-- a [condition known as social jet lag](https://drcraigcanapari.com/social-jet-lag-and-the-teenager/). To me, professionally, what this means is that it is **time for a sleep tune-up** for my patients who have trouble sleeping. I usually see my patients in July, especially those with [body clock or circadian problems](https://drcraigcanapari.com/why-you-fall-asleep-part-2-understanding-the-body-clock/), to make sure that they are on the right trajectory to re-enter school successfully. **The beginning of school sets the tone for the year** and kids who are having trouble sleeping may struggle. I would advise parents to think about the sleep habits of their children, and how they may need to be readjusted prior to restarting school. If you are wondering about whether or not your child could use some sleep adjustment, I would recommend answering two questions: 1. Does your child's bedtime routine need adjustment? 2. Does your child's sleep schedule need adjustment? (By the way, here's a video I shot back in the pandemic when many kids were heading back to full time school– on how to adjust back to a typical school sleep schedule). Many of these tips are still valid. ## Does your child's bedtime routine need adjustment? It’s ok to be a LITTLE more relaxed about routines and rules in the summer. I would argue, however, that you should not normalize screen use at night in the bedroom. If your teens have gotten used to using screens at night before bed, it’s critical that you start putting the brakes on screen time use in the evening and ensure that there are clear rules about keeping the [cell phone](https://drcraigcanapari.com/prevent-sleep-problems-in-kids-keep-technology-out-of-the-bedroom/), [tablet](https://drcraigcanapari.com/light-is-like-caffeine-avoid-insomnia-by-managing-your-screens/), or [television](https://drcraigcanapari.com/get-that-television-out-of-your-kids-room-now/) out of your kid's room at night. I would also try to pick a bedtime which will allow your child an adequate opportunity to get enough sleep at night. Here are [the recommended sleep requirements by age.](https://drcraigcanapari.com/how-much-sleep-do-kids-need-with-bonus-grown-up-info/) | Age | Recommended sleep per 24 hours | | ---------------------- | ------------------------------ | | Infants 4–12 months | 12–16 hours (including naps) | | Toddlers 1–2 years | 11–14 hours (including naps) | | Preschoolers 3–5 years | 10–13 hours (including naps) | | School age 6–12 years | 9–12 hours | | Teenagers 13–18 years | 8–10 hours | *Recommended sleep durations from the* [*American Academy of Sleep Medicine consensus statement*](https://pmc.ncbi.nlm.nih.gov/articles/PMC5078711/?ref=drcraigcanapari.com)*, endorsed by the AAP.* (Full citation: Paruthi S, et al. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine. *J Clin Sleep Med.* 2016;12(6):785–786.) Recommended hours of sleep by age Some children fall outside of this age range and are doing great. If your child routinely falls outside of this range, it would be worth talking with your child's doctor to make sure they are getting enough sleep (if they are on the low end) or that they don't have a sleep disorder (if their sleep requirements are at the high end). ## Does your child's sleep schedule need adjustment? This is a pretty easy question to answer. Look at when your child is waking up on a day where they don't have any activities. If your child is consistently waking up more than two hours later than the school wake up time (for teens) or one hour (for preteens and younger), I would recommend that you work together to get their schedule on track. **This tends to be a much more common problem in teenagers.** In general, getting your child up at 8am for a week before school starts and taking them out for a walk in the sunshine will help their body clock adjust to an earlier schedule. If your child is sleeping in VERY late (think noon or later), you may need to roll the clock back slowly as described below. Want kids' sleep advice that shows up when you need it? I send one or two emails a month — seasonal schedule resets like this one, plus what's actually worth knowing in pediatric sleep. Free, and you can unsubscribe anytime. [Join the list →](#/portal/signup) ## How to adjust your child's sleep at the end of the summer vacation Here are the best practices for prepping your child's sleep for school: - **For elementary school age children,** their schedule tends not to deviate too much during the summer. (Even if you want them to when you are on vacation, [they don't sleep in](https://drcraigcanapari.com/vacation-sleep/)). However, you may have relaxed your routine a little bit. Here's what I would recommend: - Mark one week prior to the beginning of school and plan on establishing more rigorous bedtime routines about a week prior to the first day of school. - If you have been a bit lax about electronics in the bedroom, I would encourage you to [take them out right now](https://drcraigcanapari.com/prevent-sleep-problems-in-kids-keep-technology-out-of-the-bedroom/). - **Teenagers tend to have more difficulty with this**. Teenagers have a natural predisposition to go to bed later and stay up later. If they have time shifted later by more than an hour, and they probably have, you can anticipate some difficulty in the first week of school. This is due to their [natural body clock predisposition](https://drcraigcanapari.com/social-jet-lag-and-the-teenager/) to stay up later and go to bed later, which can become exaggerated over the summer. - **Roll the clock back, slowly.** It is always harder to go to bed earlier than to stay up later. You can only move the schedule back by about 10-15 minutes a day. So if your teenager is sleeping from 1-10 AM and your target sleep period is 10 PM-7 AM, you will need at least 12 days to make the move. Ideally, you will make a move every other day, so a three-hour shift can take about a month. **The most important variable to move is wake time** as bedtime will slowly adjust. - **Open those blinds.** Early morning exposure to light will help to shift your child's sleep schedule earlier. Conversely, late-night light exposure (usually from TVs, iPads, phones, gaming consoles) will move your child's sleep schedule later. - **Enlist your child**. If there is one thing I have learned as a sleep doctor is that a parent's (or doctor's) best laid plans are doomed to fail if the child is not on board. Discuss your concerns with your child in terms that they get. - **Recognize when things are a bit out of control**. Some teens with a condition called [delayed sleep wake phase disorder](https://drcraigcanapari.com/the-sleepy-teenager/) may have a severe, marked delay where their day/night schedules become reversed. If a teenager has become nocturnal by the beginning of August, I would meet with your pediatrician now. [Medication like melatonin](https://drcraigcanapari.com/should-my-child-take-melatonin-a-guide-for-parents/) may be necessary but please discuss with your physician. I also want to share some related links: - Here's a great article on [social jet lag from the Guardian.](https://www.theguardian.com/lifeandstyle/2019/jan/21/social-jetlag-are-late-nights-and-chaotic-sleep-patterns-making-you-ill?ref=drcraigcanapari.com) - Here’s an article from the AP on [how to get kids back to sleep in time for school.](https://apnews.com/article/back-to-school-sleep-schedule-5a3269b20512d9e00802e5571bf14e4f?ref=drcraigcanapari.com) - Here's some [great information on this topic from Johns Hopkins](https://www.hopkinsmedicine.org/health/wellness-and-prevention/teenagers-and-sleep-how-much-sleep-is-enough?ref=drcraigcanapari.com) - [Summer Sleep Schedules: Does Your Teen Need One?](https://yourteenmag.com/health/physical-health/summer-sleep-schedules?ref=drcraigcanapari.com) I remember always having marked difficulty sleeping before the first day of school perhaps due to my [undiagnosed restless leg syndrome.](https://drcraigcanapari.com/growing-pains-restless-legs-an-under-diagnosed-cause-of-insomnia-in-children/) Or maybe it was just because I was a super nerd who was excited about my meticulously ordered folders and pens and all the math I was going to be doing in the fall. In any case, I hope these tips help your kid have a great time going back to school. ### How to Wean Night Feedings: Bottles and Breastfeeding URL: https://drcraigcanapari.com/how-to-wean-night-feedings-bottles-and-breastfeeding/ Last updated: 2026-07-04T18:07:34.000Z How to wean night feeds: the exact night-by-night bottle taper I use in clinic, plus approaches for breastfeeding families. _This post is for subscribers only._ ### How to Deal with Early Risers: The Morning Light Protocol URL: https://drcraigcanapari.com/how-to-deal-with-early-risers-the-morning-light-protocol/ Last updated: 2026-07-04T18:02:29.000Z A step-by-step plan for kids waking before 5:30–6 AM — including the Morning Light protocol I use in my sleep clinic. _This post is for subscribers only._ ### Sleep Training Techniques Compared: Which One Fits Your Child? URL: https://drcraigcanapari.com/sleep-training-technique-comparison/ Last updated: 2026-07-04T18:03:23.000Z Nine sleep training methods side by side — what each involves, who it's for, pros, cons, and my clinical notes on choosing the right one for your child. _This post is for subscribers only._ ### Bonus Episode: Summer and Back to School Sleep URL: https://drcraigcanapari.com/bonus-episode-summer-and-back-to-school-sleep/ Last updated: 2026-06-29T15:38:04.000Z We taped this one in late July of last year, with summer in full swing and the back-to-school reckoning closer than anyone wants to admit. Arielle and I talk through what actually happens to kids' sleep over the summer — why relaxed routines can quietly cost sleep rather than add it, how heat becomes a genuine safety issue for babies, and what to do when travel blows up the schedule. We go age by age, from infants napping on the go to teenagers sleeping until noon, and finish with a practical plan for easing everyone back onto a school schedule before the first day. If your household runs looser in July and August, this is the episode for getting back on track without making the whole summer joyless. ## Key Takeaways - Summer's relaxed routines can quietly cost kids sleep. Later bedtimes plus early-brightening rooms often mean less total sleep, not more — so let the schedule slide a little, but keep an eye on the total. - The "structured days" effect is real: school imposes wake times, activity, and meal and screen structure. Losing it in summer shifts sleep later and loosens eating and screen habits, which research links to higher BMI. - Heat is a safety issue for infants. Overheating is a SIDS risk factor — keep the room cool with fans or a window AC, dress babies lightly, and draw the shades during the day. - When you travel, aim to keep schedules within about 30 to 60 minutes and protect the main nap. Don't be afraid to deviate: a child who has slept well can usually get back on track within a day or two at home. - Teens drift the latest. Camp, summer jobs, and especially camping — natural light, no screens — are powerful resets. Before school starts, move wake time earlier by 10 to 15 minutes a day and get morning light. - Keep a bedtime through roughly ages 12 to 14, hold the same screen rules as the school year, and keep devices out of the bedroom at night. And remember parental satisfaction counts — if a relaxed change is working for everyone, it's fine. **Listen and watch** - Watch on YouTube: We taped this one in late July, with summer in full swing and the back-to-school reckoning closer than anyone wants to admit. Arielle and I talk through what actually happens to kids' sleep over the summer — why relaxed routines can quietly cost sleep rather than add it, how heat becomes a genuine safety issue for babies, and what to do when travel blows up the schedule. We go age by age, from infants napping on the go to teenagers sleeping until noon, and finish with a practical plan for easing everyone back onto a school schedule before the first day. If your household runs looser in July and August, this is the episode for getting back on track without making the whole summer joyless. ## Key Takeaways - Summer's relaxed routines can quietly cost kids sleep. Later bedtimes plus early-brightening rooms often mean less total sleep, not more — so let the schedule slide a little, but keep an eye on the total. - The "structured days" effect is real: school imposes wake times, activity, and meal and screen structure. Losing it in summer shifts sleep later and loosens eating and screen habits, which research links to higher BMI. - Heat is a safety issue for infants. Overheating is a SIDS risk factor — keep the room cool with fans or a window AC, dress babies lightly, and draw the shades during the day. - When you travel, aim to keep schedules within about 30 to 60 minutes and protect the main nap. Don't be afraid to deviate: a child who has slept well can usually get back on track within a day or two at home. - Teens drift the latest. Camp, summer jobs, and especially camping — natural light, no screens — are powerful resets. Before school starts, move wake time earlier by 10 to 15 minutes a day and get morning light. - Keep a bedtime through roughly ages 12 to 14, hold the same screen rules as the school year, and keep devices out of the bedroom at night. And remember parental satisfaction counts — if a relaxed change is working for everyone, it's fine. **Listen and watch** - Watch on YouTube: Full medical disclaimer: [https://sleepedit.show/disclaimer](https://sleepedit.show/disclaimer?ref=drcraigcanapari.com) Submit Listener Feedback and Questions Here - Or find us on Apple Podcasts, Spotify, Overcast — wherever you get your podcasts Full medical disclaimer: [https://sleepedit.show/disclaimer](https://sleepedit.show/disclaimer?ref=drcraigcanapari.com) Submit Listener Feedback and Questions Here ### The Cognitive Shuffle: The anti-insomnia tool I use when I can’t sleep URL: https://drcraigcanapari.com/the-cognitive-shuffle/ Last updated: 2026-06-29T15:12:31.000Z I’ve struggled with insomnia intermittently since I was a child. Partly due to [undiagnosed restless leg syndrome ](https://drcraigcanapari.com/growing-pains-restless-legs-an-under-diagnosed-cause-of-insomnia-in-children/)coupled with caffeine (turns out the 1980s practice of having Coke with dinner is not useful). I just spent a few days in Barcelona with some friends and my sleep is always worse when I travel. When this happens, I reach for my favorite tool in my arsenal: the cognitive shuffle. I was first introduced to this technique by [Brendan Duffy](https://www.linkedin.com/in/brendan-duffy-08622049/?ref=drcraigcanapari.com) at a conference and I find it super useful. [This technique was originally created by Luc Beaudoin, a cognitive scientist and insomnia sufferer; here is a nice summary from CNN.](https://www.cnn.com/2025/04/08/health/cognitive-shuffling-sleep-technique-benefits-wellness?ref=drcraigcanapari.com). [Dr. Beaudoin is an academic, writer, and software developer based in Canada.](https://cogzest.com/about/founder/?ref=drcraigcanapari.com) Here's a complete video on the topic, btw: ## How to perform the cognitive shuffle This is really simple. In a nutshell, you pick a word, and come up with as many words starting with each letter of the word. Rinse and repeat. Let’s go through this in a bit more detail. Let’s say you pick the word “bedtime.” Begin with the first letter "b" and think of a word that starts with the letter "b". For example "broom". Bring up the mental image of a broom. Then think of another word that begins with the letter "b" and visualize that word. Don’t stress about the word choice. “Booger” works as well as “beautiful” Keep going until you run out of words that begin with the letter "b". Go to the next letter in "bedtime" - "e", and think of words that begin with "e". Visualize the words as you think of them. Continue at your own pace, but just keep going until you fall asleep. Dr Beaudoin recommends if stressful thoughts come your way, just acknowledge them and go back to shuffling your thoughts instead. ### Other tips 1. It’s useful to pick a word without repeating letters (like SLEEP) but don’t agonize over word choice. You can just finish your word then go on to the next one 2. Don’t keep score. It’s easy to stress yourself if you can’t come up with a lot of words if you are an anxious person (like me). [You aren’t trying to get Queen Bee on the NYT Spelling Bee game.](https://www.nytimes.com/puzzles/spelling-bee?ref=drcraigcanapari.com) 3. Sometimes words with a negative or stressful connotation will come up. Just acknowledge them and move on. 4. Go slow! Take the time to picture the image associated with the word before you move on. 5. You can try matching this with breathing. Breathe in as you come up with the word. Breathe out as you visualize the word. This will slow down your tempo further. Plus, slow exhales activate the parasympathetic system, which helps to calm you down [(Magnon et al., 2021)](https://www.nature.com/articles/s41598-021-98736-9?ref=drcraigcanapari.com) *Some people found this helpful, but personally I found it stressful to try to sync up breathing with finding and visualization.* 6. If you find yourself getting frustrated, take a break. ## Why this works Dr. Beaudoin and his colleagues published [a review article in 2020 looking at the thought processes](https://www.sciencedirect.com/science/article/pii/S1087079219302217?via%3Dihub&ref=drcraigcanapari.com) prior to sleep in normal adults and in patients with insomnia. In general, the transition from wakefulness to sleep was characterized by hallucinatory, disconnected imagery. In the review, they cite [an article by Wicklow et al analyzing the thought content of insomnia sufferers prior to sleep.](https://www.sciencedirect.com/science/article/pii/S0005796799001369?via%3Dihub&ref=drcraigcanapari.com) Insomnia sufferers had more unpleasant and less random thoughts. Instead of images, they focused on planning, problem solving, sleep and consequences, arousal status (“I’m wide awake!”), and external noise. To me, this sounds like what I experience when I can’t sleep—I’m worrying about problems I have, the bad day I will have if I can’t sleep, and bedroom factors (feeling too hot, noticing noises in the house, etc.) In the CNN article above, the author quotes Dr. Beaudoin: > In addition to taking the mind off one’s worries, cognitive shuffling “resembles in critical respects natural sleep onset,” Beaudoin said. > In the natural transition into sleep, people tend to have “microdreams” and fragmented, nonlinear thought patterns, Beaudoin and Kaylor said. Intentionally engaging in random, disconnected thinking may replicate this cognitive pre-sleep state. Personally, I have found that using the technique does mimic that feeling I have when I fall asleep more easily—I have disconnected thoughts and dreamlike imagery as I am drifting off. Research on this technique is limited. [Beaudoin et al published an abstract of research studying an analogous method he calls Serial Diverse Imagining Task (SDIT)](https://summit.sfu.ca/item/16196?ref=drcraigcanapari.com) where external neutral words were given to 154 college students suffering from insomnia, reporting decreased pre-sleep arousal and effort, and improved sleep quality. [He also created an app called MySleepButton which replicates this process.](https://mysleepbutton.com/en/home/?ref=drcraigcanapari.com) ## Conclusions The cognitive shuffle is one of my go-to techniques when I can’t sleep. If you have intermittent insomnia like me, it’s definitely worth trying out. Obviously, this is not a treatment for an underlying sleep disorder. If you are really struggling, check in with your physician. ## Sources 1. Beaudoin LP, Digdon N, O’Neill K, Racour G. Serial diverse imagining task: A new remedy for bedtime complaints of worrying and other sleep-disruptive mental activity. the American Academy of Sleep Medicine and the Sleep Research Society. Published online March 17, 2016\. Accessed June 17, 2026\. [https://summit.sfu.ca/item/16196](https://summit.sfu.ca/item/16196?ref=drcraigcanapari.com) 2. Lemyre A, Belzile F, Landry M, Bastien CH, Beaudoin LP. Pre-sleep cognitive activity in adults: A systematic review. Sleep Medicine Reviews. 2020;50:101253\. doi:10.1016/j.smrv.2019.101253 3. Magnon V, Dutheil F, Vallet GT. Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults. Sci Rep. 2021;11(1):19267\. doi:10.1038/s41598-021-98736-9 4. Rogers K. Cognitive shuffling: A mental trick to help you quiet racing thoughts and fall asleep. CNN. April 8, 2025\. Accessed June 17, 2026\. [https://www.cnn.com/2025/04/08/health/cognitive-shuffling-sleep-technique-benefits-wellness](https://www.cnn.com/2025/04/08/health/cognitive-shuffling-sleep-technique-benefits-wellness?ref=drcraigcanapari.com) 5. Wamsley EJ. Constructive episodic simulation in dreams. PLOS ONE. 2022;17(3):e0264574\. doi:10.1371/journal.pone.0264574 6. Wicklow A, Espie CA. Intrusive thoughts and their relationship to actigraphic measurement of sleep: towards a cognitive model of insomnia. Behaviour Research and Therapy. 2000;38(7):679-693\. doi:10.1016/S0005-7967(99)00136-9 ### The Sleep Edit #19: Debunking Bad Online Sleep Advice URL: https://drcraigcanapari.com/the-sleep-edit-19-debunking-bad-online-sleep-advice/ Last updated: 2026-05-31T13:14:00.000Z This week on The Sleep Edit, Arielle and I take on the sleep advice that spreads fastest online — and holds up worst. We start with the big one: the idea that an "overtired" child floods with cortisol and spirals into worse sleep. I walk through where that story actually comes from, why the study behind it doesn't say what social media thinks it does, and what the better-controlled research really shows. From there we get into wake windows, the 3-6-9 rule and the Wonder Weeks, magnesium lotions and melatonin, and the stubborn myth that bedtime has to be exactly 7 p.m. We close on a question I get asked constantly: in a field anyone can enter, how do you tell a trustworthy sleep expert from a confident voice with a big following? ## Key Takeaways - The "overtired child floods with cortisol and can't sleep" claim gets the science backwards. Poor sleep can nudge cortisol up, but cortisol is a marker of inadequate sleep, not its cause — and it is not something you need to manage at home. - The Middlemiss (2012) study used to argue that sleep training is harmful had no control group and studied infants in an unfamiliar inpatient setting, nothing like sleep training at home. Better-controlled work, including Gradisar's randomized trial, found infant cortisol did not rise after sleep training. A few hard nights are brief, harmless stress — not the chronic toxic stress that genuinely affects development. - [Wake windows ](https://drcraigcanapari.com/do-wake-windows-help-kids-nap-better/)describe something real — sleep drive builds the longer a child is awake — but the rigid, age-based formulas online are not research-based. Watch the child in front of you and their 24-hour sleep totals, not a chart. "Average" sleep needs span wide ranges and were never meant as individual targets. - [Magnesium lotions have no evidence they do anything](https://drcraigcanapari.com/magnesium-sprays-and-lotions/); melatonin is a hormone, not a routine fix for healthy children, and should follow behavioral changes and a conversation with your pediatrician. [Melatonin is now the most common substance U.S. children](https://drcraigcanapari.com/melatonin-overdoses-are-on-the-rise-why-parents-should-worry/) accidentally ingest — store it like medication. - For most children before puberty, a bedtime roughly between 7:30 and 8:30 works well; an artificially early bedtime mostly manufactures bedtime battles. And the pediatrician is the first stop for sleep questions — "evidence-based" has become a marketing phrase, so ask any consultant how they actually make decisions. **Listen and watch** - The Sleep Edit episode page: [https://sleepedit.show/episodes/debunking-bad-online-sleep-advice](https://sleepedit.show/episodes/debunking-bad-online-sleep-advice?ref=drcraigcanapari.com) - Watch on YouTube: [https://youtu.be/7O8cut6xD5c](https://youtu.be/7O8cut6xD5c?ref=drcraigcanapari.com) - Or find us on Apple Podcasts, Spotify, Overcast — wherever you get your podcasts [Submit Listener Feedback and Questions Here](mailto:thesleepeditshow@gmail.com) ### How not to ruin a perfectly good walk URL: https://drcraigcanapari.com/how-not-to-ruin-a-perfectly-good-walk/ Last updated: 2026-05-24T11:42:14.000Z Recently, I went for a hike with my dog. I'm fortunate in that some days of the week I'm able to take her out first thing in the morning and go for a long hike in the Westwoods, which is a local network of hiking trails where we seldom see any other people, houses, or cars. Lately, I've been on a quest to get a new mattress. Our current mattress is about 13 years old and is showing signs of aging-- and so am I. My shoulders feel crammed into my sides some nights. So I have been obsessively researching mattresses. While on this hike, I had an extended dialogue with Gemini where I sussed out my mattress thoughts, feelings, and then did research about the mattresses I was considering. The result was that I had a fairly comprehensive document about mattresses. And I had ruined a perfectly good walk. One of the challenges of being a human being, and especially a parent, today is that you can always learn more. You can research more about your child-- their development, challenges you're having, or sleep training techniques. The problem is, it's hard to turn this off. It's always tempting to just go click one more link and go a little bit deeper in the internet rabbit hole. This can be especially pernicious when you're worried about something or you're just trying to go to bed at night. To me, the rise of large language models has put this impulse on steroids. You can sit and chat with Claude or Gemini or ChatGPT and feel like you are actually being productive or learning something, and sometimes you are, but on other occasions, it's just like picking an itchy scab. It feels good, but you might also be hurting yourself a tiny bit. The extreme version of this is what [*The Verge’s* Nilay Patel calls "software brain"](https://www.theverge.com/podcast/917029/software-brain-ai-backlash-databases-automation?ref=drcraigcanapari.com)\-- the idea that all of human existence can be flattened into data that can be processed and optimized by AI. This idea can be especially tempting if you are tracking your child's sleep with a device like a Nanit or Owlet. > "I'm not saying regular people don't use Excel or Airtable to plan their weddings or have fun throwing PowerPoint parties, or even that AI won't be useful to regular people over time. I think a lot of people enjoy data and tracking different parts of their lives. I'm wearing a Whoop band as I write this. I'm just saying these things aren't everything. Not everything about our lives can be measured and automated and optimized, and shouldn't be." So what's the antidote? The fact is there is no perfect solution. You can feel that if you just had enough information and you fed it into Claude, you would find the ONE TRUE SOLUTION for your problem. There is no perfect answer to your mattress search, your parenting conundrum, or what you're going to have for lunch today. Having a pocket supercomputer that knows the answer to literally everything is an invitation to feed your anxiety. Henry Shukman is a Zen and meditation teacher. I heard him on the Waking Up app and decided to make my way through his own meditation program ([called "The Way"](https://www.thewayapp.com/?ref=drcraigcanapari.com)). One of the sessions really struck me. Henry asked the question, "What if you decided you didn't need to know right now?" Very simple. But I think about this often, especially when I'm anxious or spending too much time on my phone. Sometimes you don't need to know every answer. Sometimes you have to let it go and live with the ambiguity. It's okay to just put the question aside, put down your phone, and go for a walk with your dog in the sunshine. ![Hound dog resting on a plush ottoman with a pitbull friend in the background](https://drcraigcanapari.com/content/images/2026/05/55D1F70D-5B11-43F8-8639-3B6B4074662D_1_105_c.jpeg) Restful afternoon with a friend ### Welcome to my new site! URL: https://drcraigcanapari.com/welcome_to_my_new_site/ Last updated: 2026-04-30T18:40:25.000Z Long-time readers should mostly notice cosmetic changes for the time being, but there are big changes under the hood. I've switched from Wordpress (for the site) and Kit (for email) to a unified platform called Ghost. You don't need to do anything — your subscription carried over. If you see the following message, just click "Sign in" and put your email address in. ![Image demonstrating the sign in where people can subscribe or log in](https://drcraigcanapari.com/content/images/2026/04/Cursor_and_Notification_Center-1.jpg) Don't be scared! You have access. ## What's new for you Ghost is built around a simple idea: instead of an anonymous blog with a separate email list bolted on, the website and the subscriber list are the same thing. If you got this email, you're a free member. There's nothing to set up and no password to remember. When you want to read members-only content or access your account, you'll get a one-time sign-in link by email. Everything I publish goes both to the site and to your inbox, the way it always has. If you signed up recently (or you just want to check it out), take a look at my new [Sleep Training Starter Kit ](https://drcraigcanapari.com/sleep-training-starter-kit/). It's an updated and expanded version of my old free sleep training email course. Just enter your email and you'll have access. ### How I got here I've been writing for parents since 2012, a few years after I finished my training. I stayed on Wordpress that whole time and cycled through several email providers along the way. In 2017 I created an online course called the Sleep Training Toolkit. I was proud of it, but I didn't want to keep updating it indefinitely. So I took the lessons I'd learned and turned them into my book, [*It's Never Too Late to Sleep Train*](https://amzn.to/2PfthnX?ref=drcraigcanapari.com), which came out in 2019. In 2022, after writing a guest post for another blog, the owners suggested I sign up for an ad network. Initially it was great — ad density was low, and for the first few years the ads made a fair amount of money. It was the first time my online work had ever broken even. Then in 2023, my traffic started to fall. I spent a lot of time and money trying to optimize for Google and speed up the site, and traffic kept dropping. I didn't realize at the time that this was largely a result of Google's algorithm changes (the so-called "[helpful content update](https://medium.com/the-bald-writer/googles-helpful-update-is-destroying-blogs-here-s-what-i-m-doing-3fe751a014f2?ref=drcraigcanapari.com)"). I'd gotten so caught up in the mechanics of running a website and an email list — endless theme tweaks, SEO settings, optimization — that I wasn't actually writing very much. I was also disturbed by how aggressive online ad platforms had become, and worried I was part of the problem — part of what was making the web a worse place. So last year I removed the ads and rejiggered things. But I still felt like Wordpress and Kit were robbing me of joy. ### What's different now In the era of algorithmic social media, there are only a few things you can really own: your own website, a podcast, and an email list. That's where I'm going to put my energy. Ghost lets me run all three from one place, with a fraction of the maintenance overhead. (It's also proudly open source, and was [just named a Digital Public Good](https://ghost.org/changelog/digital-public-good/?ref=drcraigcanapari.com) by the United Nations.) I also like writing — way more than making videos. And the written word is much easier to reference when you're trying to solve a problem at 2am than, say, a funny Instagram Reel. Although I also do like occasionally dropping a video like this one. [Craig Canapari M.D. on Instagram: “Arielle and I had @thatsleepdoc on the latest episode of #TheSleepEdit to talk about parasomnias and restless leg syndrome. The rest of the episode is slightly more evidence based. #dreams #nightmares #parasomnias”217 likes, 20 comments - drcanapari on July 12, 2024: “Arielle and I had @thatsleepdoc on the latest episode of #TheSleepEdit to talk about parasomnias and restless leg syndrome. The rest of the episode is slightly more evidence based. #dreams #nightmares #parasomnias”.![](https://drcraigcanapari.com/content/images/icon/icwX0xAk0pz.webp)Instagram![](https://drcraigcanapari.com/content/images/thumbnail/503291251_1353193329310251_5865966590142685925_n.jpg)](https://www.instagram.com/drcanapari/reel/C9V7M8IBr0-/?ref=drcraigcanapari.com) ## What's coming I'm looking forward to getting back to writing instead of tweaking site settings. Expect more opinionated pieces alongside the longer reference guides, which I'll keep updating as the research evolves. Honestly, running a website and a podcast costs money, and long-term this needs to be self-sustaining. I have some ideas about how to do that, and there will be a survey in a month or two — I want to make sure whatever I build actually meets your needs. My core commitment isn't changing: free, high-quality, evidence-based sleep information for parents and providers. Everything I've published so far, and most of what I'm going to make going forward, will remain free. ### New content I've been working on While I've been working on the technical transfer, I've also been creating and updating work for you: - A new article on the evidence for [theanine use in children](https://drcraigcanapari.com/should-you-give-your-child-l-theanine-for-sleep/) (TLDR: there isn't much) - A major update to [my melatonin guide](https://drcraigcanapari.com/should-my-child-take-melatonin-a-guide-for-parents/), plus the separate guide to [melatonin risks and safety.](https://drcraigcanapari.com/melatonin-overdoses-are-on-the-rise-why-parents-should-worry/) - Two new podcast episodes: 1. [**Our sleep stacks and routines in 2026** ](https://drcraigcanapari.com/the-sleep-edit-17-our-sleep-stacks/)— our own sleep routines, supplements, and technology (or lack thereof) 2. [**Another reader mailbag episode**](https://drcraigcanapari.com/the-sleep-edit-18-your-questions-answered/)featuring some of your questions. - [The **Sleep Training Starter Kit**](https://drcraigcanapari.com/sleep-training-starter-kit/) — an updated, expanded version of my old free email course ## Thanks, and an ask If you've read this far, thank you. Going forward, I'd love to know what you want to see. Hit reply and tell me what you want more of. And if you know someone struggling with sleep, send them my way. (And if there are any major technical issues, also LMK). Thanks for joining me in this new chapter. Craig Canapari, MD ### The Sleep Edit #17: Our Sleep Stacks and Routines in 2026 URL: https://drcraigcanapari.com/the-sleep-edit-17-our-sleep-stacks/ Last updated: 2026-04-30T16:03:03.000Z We take a turn in the hot seat this week — sharing our own sleep habits, gear, and personal struggles. From frigid bedrooms and weighted blankets to trazodone, magnesium, and light therapy glasses, this episode is part confessional, part practical guide. We also dig into CBT-I for insomnia, the phenomenon of orthosomnia (when sleep tracking makes your sleep worse), what melatonin actually does at a low dose, and how to think about supplements when the evidence is thin but the risk is low. ### The Sleep Edit #18: Your questions, answered URL: https://drcraigcanapari.com/the-sleep-edit-18-your-questions-answered/ Last updated: 2026-04-26T19:13:11.000Z This week we opened the mailbag. You sent in a lot of questions, so Craig and Arielle grouped them by theme and worked through them in order: infant sleep and the baby who "can't" lie flat, whether to wean the SNOO and the night feed at the same time, inconsistent night wakings on an identical schedule, the right order for night weaning versus room transition versus sleep training, 4 AM wake-ups in toddlers and infants, a 30-month-old who fights bedtime but naps easily, the classic "I had a bad dream" that somehow isn't scary, managing toddler sleep through a cold, floor beds, containing a 2-year-old who won't stay put, and whether there's any real evidence that outdoor naps at daycare actually help. Plus a rapid-fire round on crib-to-bed transitions, SNOO versus traditional bassinets, and whether you have to sleep train at all (short answer: no). ### Melatonin For Children? A Guide for Parents URL: https://drcraigcanapari.com/should-my-child-take-melatonin-a-guide-for-parents/ Last updated: 2026-04-09T18:30:09.000Z A common thread I find in children coming to Sleep Clinic is that many or all of them have been on melatonin at some point, or are taking it currently. Melatonin is an important tool in the treatment of sleep disorders in children, and because it is naturally derived, there is a widespread perception that it is safe. However, I have become concerned by the frequency of its use, especially in an unsupervised way. (In recent years magnesium has also become common– here is a full article on the [limited evidence for magnesium supplementation for sleep in children)](https://drcraigcanapari.com/magnesium-for-kids-sleep/). It's hard to know exactly how many children are taking melatonin. A study in JAMA in 2022 [estimated that use in adults had tripled between 2005 and 2018, and that adults were using higher doses.](https://jamanetwork.com/journals/jama/fullarticle/2788539?guestAccessKey=c85385a8-83d2-4319-b33b-21acf8daad72&utm%5Fsource=For%5FThe%5FMedia&utm%5Fmedium=referral&utm%5Fcampaign=ftm%5Flinks&utm%5Fcontent=tfl&utm%5Fterm=020122) **Melatonin for children products are being marketed aggressively.** I worry that the widespread availability of melatonin has led to some parents using it as a shortcut to good sleep practices.[ An article in the Wall Street Journal](http://www.wsj.com/articles/SB10001424127887324637504578567670426190246?ref=drcraigcanapari.com) (which also provided the sales figures above), quoted a father’s review on Amazon: > OK, yes, as parents my wife and I should do a better job starting the bedtime routine earlier, turning off the TV earlier, limiting sweets, etc., etc. Well, for whatever reason, this is not our strong suit. This 1 mg light dosage of melatonin is very helpful winding our kids down and getting them ready for bed. Short on time? Here's a quick video which should answer most of your questions: ## How often are children using melatonin? It's hard to know for sure. An article the New York Times, ["Parents Are Relying on Melatonin to Help Their Kids Sleep. Should They?"](https://www.nytimes.com/2020/05/18/parenting/melatonin-sleep-kids.html?ref=drcraigcanapari.com), noted that melatonin sales overall had increased by 87% in the year prior to March 2020\. The Times conducted a survey of 933 parents with children under age 18\. One third had a history of sleep difficulties in the past year. Over half the parents reported giving melatonin to their children at one time. More recent data has shown that there is an [almost 500% increase in melatonin prescriptions in Scandinavia](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2843284?ref=drcraigcanapari.com). Additionally, melatonin has become the [most common overdose in pediatric emergency rooms](https://drcraigcanapari.com/melatonin-overdoses-are-on-the-rise-why-parents-should-worry/) and calls to poison control centers in the US. This seems to be a worldwide issue. ## What is melatonin? What does melatonin do? Melatonin is a hormone which is naturally produced by the pineal gland in your brain. It is both a **chronobiotic** agent, meaning that it regulates your circadian or body clock; and a **hypnotic**, meaning that at higher doses it may induce sleep. **Melatonin is usually used for its hypnotic effect, but it does not have this effect in everyone. Only the chronobiotic effect occurs in all individuals.** The natural rise of melatonin levels in the body 1-3 hours before sleep onset is known as the “dim light melatonin onset” (DLMO). This is the signal involved in body clock scheduling of sleep and corresponds to the end of the “wakefulness” signal produced by the circadian system. Children with insomnia may be given melatonin after their scheduled bedtime passes; what this means is that their bodies are not yet ready for sleep. This is one reason why [bedtime fading can be so effective for some children](https://drcraigcanapari.com/bedtime-fading-the-secret-sauce-in-sleep-training/). The doses used clinically (0.5–10 mg or higher) greatly exceeds the amount secreted in the body. There are a few things to be aware of: - Blue-white light exposure in the evenings shift the DLMO later. This is why bright light exposure in the evenings can worsen insomnia. I highly recommend eliminating ANY screen time for preschool through elementary school children for an hour prior to bedtime. That means [**no light emitting Kindles, iPads, smartphones, computers**](https://drcraigcanapari.com/prevent-sleep-problems-in-kids-keep-technology-out-of-the-bedroom/)**,** [**or (God forbid) television in the bedroom**](https://drcraigcanapari.com/2014/11/24/get-that-television-out-of-your-kids-room-now/) For students in junior high and beyond who need to use computers to complete school work, I highly recommend lowering brightness settings and using software to reduce the blue light frequencies. ([For more on this read my post about going on a “light diet” here](https://drcraigcanapari.com/light-is-like-caffeine-avoid-insomnia-by-managing-your-screens/)). - The effect of dosing melatonin (and light therapy for that matter) are *phase dependent*. What that means is that the timing of giving melatonin determines both the magnitude and direction of effect. Many people do not realize that **the optimal time to dose melatonin for shifting sleep period is actually a few hours before bedtime**– that is to say, before the DLMO. The other facet of this is that in teenagers with severely shifted sleep schedule (delayed sleep phase syndrome) may actually have a later shift in their sleep schedule if this is not dosed correctly. Thus I would leave the timing of this to a sleep physician. Jet lag is a similar case[\[1\]](#fn-1). - "All natural" melatonin is from cow or pig brains and should be avoided. Most preparations around now are synthetic, which is preferable. - The half life of melatonin is about 40 minutes. Thus it is much more likely to help with falling asleep (as opposed to with night wakings). Here's a short video I put together to explain how when you give the melatonin dose really matters. (Maybe just for the supernerds out there like myself). ## How effective is melatonin for sleep problems in children? The overall effects of melatonin for children include falling asleep more quickly and an increase in sleep time. Like all medicines used to help children fall asleep, there is fairly limited information available. This means that most studies have small groups followed for short periods of time. Furthermore, melatonin not regulated as a pharmaceutical in the U.S. Thus, there is no large pharmaceutical company bankrolling larger and long-term studies (more on this below) . Rather it is regulated as a food supplement by the FDA. [(I have more on the 1994 legislation which resulted in this here). ](https://drcraigcanapari.com/sleep-supplements/)For a terrific review, including dosing recommendations, [I highly recommend the melatonin material from the International Pediatric Sleep Association](https://ipsapedsleep.wildapricot.org/Melatonin-TaskForce?ref=drcraigcanapari.com), which includes parent guides in multiple langauage as well as literature revies of the use of melatonin in typically developing children, and children with autism. **Here is the big picture, however. Melatonin seems to result in about 30 minutes more of sleep at night, predominantly due to shortening time to fall asleep. This seems to be fairly consistent across trials in children. Like all sleep medications– it's not magic.** When breaking down the research in this group, I'm going to try to use meta-analyses– articles which combine multiple studies which often contain assessment of the quality of different studies– when available. ### **Chronic sleep onset insomnia and melatonin in typically developing children** Problems with falling asleep are common in children, just like in adults. Chronic insomnia is defined as difficulty falling or staying a sleep for at least three times per week for three months or more, resulting in dissatisfaction with sleep or daytime issues. [A meta-analysis by Edemann-Calleson in 2023 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC10339185/?ref=drcraigcanapari.com)combined data from 419 children and demonstrated about a 30 minute increase in sleep overnight, with 18 minutes coming from falling asleep more quickly (a reduction in *sleep latency*). Importantly, there was no improvement in daytime functioning AND there was an increase in adverse events in the treatment group when compared with placebo. The [2025 IPSA position paper on melatonin for typically developing children ](https://cdn.wildapricot.com/284366/resources/Melatonin/Melatonin%20use%20in%20typically%20developing%20children%20-%20IPSA%20expert%20consensus%20recommendations%20for%20healthcare%20providers.pdf?version=1741927395000&Policy=eyJTdGF0ZW1lbnQiOiBbeyJSZXNvdXJjZSI6Imh0dHBzOi8vY2RuLndpbGRhcHJpY290LmNvbS8yODQzNjYvcmVzb3VyY2VzL01lbGF0b25pbi9NZWxhdG9uaW4lMjB1c2UlMjBpbiUyMHR5cGljYWxseSUyMGRldmVsb3BpbmclMjBjaGlsZHJlbiUyMC0lMjBJUFNBJTIwZXhwZXJ0JTIwY29uc2Vuc3VzJTIwcmVjb21tZW5kYXRpb25zJTIwZm9yJTIwaGVhbHRoY2FyZSUyMHByb3ZpZGVycy5wZGY~dmVyc2lvbj0xNzQxOTI3Mzk1MDAwIiwiQ29uZGl0aW9uIjp7IkRhdGVMZXNzVGhhbiI6eyJBV1M6RXBvY2hUaW1lIjoxNzc1NzU0MjY3fSwiSXBBZGRyZXNzIjp7IkFXUzpTb3VyY2VJcCI6IjAuMC4wLjAvMCJ9fX1dfQ%5F%5F&Signature=XSwcaahwf5o8pJoCkViNL918iZME9Td~OIGwSQysHDjVLu7K2r5PQ6nJLwn7Px9k84MLGSlrHVKN2HtkIxodZI2hl0pdXA6uQJCGuR81NtLpIkUO89i2RfkkJ3axx0of2V9KHREjTEJdPnApAm5lQtI4GDvD4xsxbMOULFR0jUNn8ttLS061XKVqCX6koX9fBqYbmnjGQWn2FRx51mrPIhk2RLVPSu8~GpdhMxeGHzQIBv22WFV8i8RGvlXhUYBjFN9y4pL54JGzedUNJdcPtF0hqIeLHTgVFVyeP4LJMd-P5WACPmsq4eqc8Yck~dwJOpCelLIJHHXSzKcY-PQV4Q%5F%5F&Key-Pair-Id=K27MGQSHTHAGGF&ref=drcraigcanapari.com)offered some important recommendations for this age group: 1. There should be a thorough medical and sleep evaluation before starting melatonin, including a detailed sleep history. 2. A thorough clinical sleep evaluation should include current schedule, duration, sleep onset latency, and use of electronic devices. 3. Melatonin should only be used when supervised by a medical. provider. 4. Behavioral approaches should be used first. 5. Melatonin should not be administered to children less than age 2 except in very rare circumstances. 6. Melatonin is only indicated for insomnia or circadian disorders. 7. Melatonin should not be used to “make sleep better” in children without sleep-related complaints. 8. Melatonin should not be recommended to force adolescents (i.e., who do not have a circadian rhythm sleep-wake disorder) to fall asleep earlier to accommodate early school start times ### **Autism and melatonin** Sleep problems are common in children with autism spectrum disorder (ASD). Multiple types of problems occur, including prolonged time to fall asleep, less sleep during the night, and problems with nocturnal and early morning awakenings. Some children with autism have decreased levels of melatonin as well as decreased variation in melatonin secretion throughout the day. Because of this, melatonin has commonly been used in autistic children, which seems to result in less difficulty falling asleep and more sleep at night. Some studies used immediate release preparations, whereas others use long acting forms of melatonin. The majority of studies involved melatonin dosing 30–60 minutes prior to bedtime. [A 2025 meta-analysis by Yang et al ](https://pubmed.ncbi.nlm.nih.gov/40768003/?ref=drcraigcanapari.com)showed that the most significant effect was on sleep efficiency (which is essentially time asleep divided by time in bed) and total sleep time, as opposed to sleep latency. The benefit of melatonin was greater for older children (kids >10 benefited more than kids from 6-10 who benefited more than kids < 6 years of age). The effectiveness of melatonin sometimes lessenned with time. Higher doses seemed to be more effective than lower doses. [A 2017 trial looked at a time released melatonin preparation called PedPRM at doses of 2-5 mg.](http://www.sciencedirect.com/science/article/pii/S0890856717316726?via%3Dihub&ref=drcraigcanapari.com) The children in this trial slept 57.5 minutes more (compared with the children who did not receive the medication, who slept 9 minutes more). Most of the benefit seemed to be due to improvement in falling asleep– on average, treated children fell asleep 39 minutes faster. [This medication is available in Europe under the brand name Slenyto](https://www.slenyto.com/?ref=drcraigcanapari.com) but is unlikely to be approved by the FDA in the USA, unfortunately. The [2024 IPSA recommendations on melatonin use in ASD](https://cdn.wildapricot.com/284366/resources/Melatonin/Melatonin%20use%20in%20managing%20insomnia%20in%20children%20with%20autism%20and%20other%20neurogenetic%20disorders%20-%20as%20assessment%20by%20IPSA.pdf?version=1741927395000&Policy=eyJTdGF0ZW1lbnQiOiBbeyJSZXNvdXJjZSI6Imh0dHBzOi8vY2RuLndpbGRhcHJpY290LmNvbS8yODQzNjYvcmVzb3VyY2VzL01lbGF0b25pbi9NZWxhdG9uaW4lMjB1c2UlMjBpbiUyMG1hbmFnaW5nJTIwaW5zb21uaWElMjBpbiUyMGNoaWxkcmVuJTIwd2l0aCUyMGF1dGlzbSUyMGFuZCUyMG90aGVyJTIwbmV1cm9nZW5ldGljJTIwZGlzb3JkZXJzJTIwLSUyMGFzJTIwYXNzZXNzbWVudCUyMGJ5JTIwSVBTQS5wZGY~dmVyc2lvbj0xNzQxOTI3Mzk1MDAwIiwiQ29uZGl0aW9uIjp7IkRhdGVMZXNzVGhhbiI6eyJBV1M6RXBvY2hUaW1lIjoxNzc1NzU1NjE4fSwiSXBBZGRyZXNzIjp7IkFXUzpTb3VyY2VJcCI6IjAuMC4wLjAvMCJ9fX1dfQ%5F%5F&Signature=oP4BuKxVcVlSRGz~hJ95KgbjwH6opgXw1Nfob3juRggqAmWjHSomSbi0Sp4CqxbZt0cxvjJhlKlFSJCqNnHh6BkMnefHSlFLXSy4TTSxUhSeRPpFZGcqERm5HF8d7aWyTOUGP1qBswSLFOUaCPFg53HdF6EVCH0kRfv70KO-zkOjDETtFguytGeF8BBP7n0jkD7~HLNrmOs8eTEljEFxHiGAhilCrPAWyKFfiVKKV8vW2~1PXzbnfPG9V95LTLMkKNLKaRtIwvKswd4RBiU28n1ojApJwGpJKiT4~ZjUGXo~SV~SbGOjVOck6Knct7ImLHRWoNm7TwJOqWvqPiEBBw%5F%5F&Key-Pair-Id=K27MGQSHTHAGGF&ref=drcraigcanapari.com) included: 1. A trial of behavioral strategies first 2. Ruling out other sleep disorders such as [restless leg syndrome,](https://drcraigcanapari.com/growing-pains-restless-legs-an-under-diagnosed-cause-of-insomnia-in-children/) [obstructive sleep apnea](https://drcraigcanapari.com/obstructive-sleep-apnea-a-common-and-serious-problem-in-kids/), and restless sleep disorder first 3. Starting a low dose and titrating up with a maximum dose of 10 mg, under the supervision of a specialist. 4. Dosing 30-60 minutes prior to bedtime 5. Periodically checking in to see if the medication is still necessary. [Buckley et al have a 2020 American Academy of Neurology guideline ](https://pmc.ncbi.nlm.nih.gov/articles/PMC7238942/?ref=drcraigcanapari.com)which also recommends addressing other issues first, then trying melatonnin, then trying long acting melatonin (10 mg) or short acting melatonin– starting at 2 mg and working up to a maximum of 10 mg. (True story– I worked with Ashura Buckley when I was a fellow and so was she). As in other children, melatonin should be added to a behavioral management plan. For pediatricians, there is [a great practice pathway which suggests the addition of medication](http://pediatrics.aappublications.org/content/130/Supplement%5F2/S106.long?ref=drcraigcanapari.com) only after a behavioral intervention has failed. Two great resources for families are the [Autism Speaks Sleep Toolkit](https://www.autismspeaks.org/science/resources-programs/autism-treatment-network/tools-you-can-use/sleep-tool-kit?ref=drcraigcanapari.com), and the book [Solving Sleep Problems in Children with Autism Spectrum Disorders: A Guide for Frazzled Families](http://www.amazon.com/gp/product/1606131958/ref=as%5Fli%5Ftl?ie=UTF8&camp=1789&creative=390957&creativeASIN=1606131958&linkCode=as2&tag=drcraigcanapa-20&linkId=7TIGMC24ENFMIKXP&ref=drcraigcanapari.com)(affiliate link). ### **ADHD and melatonin** Attention deficit hyperactivity (ADHD) is [commonly associated with sleep problems](https://drcraigcanapari.com/adhd-and-sleep-unraveling-the-connections/), just as sleep problems can cause attentional issues. Interestingly, the authors one of the early papers describing ADHD (referred to as "hyperkinetic disorder") wrote this: > Generally, the parents of hyperkinetic children \[who would currently be referred to as children with ADHD\] are so desperate over the night problems that the daytime ones pale in significance. (Laufer MW, Denhoff E. Hyperkinetic behavior syndrome in children. J Pediatr. 1957;50(4):463–474\. doi: 10.1016/S0022-3476(57)80257-1) As many as 70% of children with ADHD may have sleep problems. Sleep problems include difficulty falling asleep, abnormalities in sleep architecture (e.g. the proportions of different stages of sleep), and daytime sleepiness. [A 2024 review article by Cortese on the management of sleep issues in ADHD ](https://www.tandfonline.com/doi/10.1080/14737175.2024.2353692?url%5Fver=Z39.88-2003&rfr%5Fid=ori:rid:crossref.org&rfr%5Fdat=cr%5Fpub%20%200pubmed&ref=drcraigcanapari.com)noted that there were two positive randomized controlled trials showing benefit. [A systematic review by Larsson in 2024](https://www.sciencedirect.com/science/article/pii/S1389945722012709?via%3Dihub&ref=drcraigcanapari.com) showed a 30 minute decrease in sleep latency, improved sleep efficiency, but no evidence of improvement in quality of life or ADHD daytime symptoms [One small trial did demonstrate that melatonin helped with insomnia on children with ADHD on stimulants](https://pmc.ncbi.nlm.nih.gov/articles/PMC6410756/?ref=drcraigcanapari.com), but this was limited to chart review. ### **Delayed Sleep Phase Syndrome and Melatonin** Delayed sleep phase syndrome (DSPS) is a common disorder in teens, where their natural sleep period is shifted significantly later than the schedule which their commitments (usually school) mandates. Thus, teens with this disorder an unable to fall asleep by 1–2 AM in the morning or even later. I have seen kids who are routinely falling asleep between 4–5 AM. Melatonin has a clear role in this disorder, as small doses 3–4 hours earlier than sleep onset (along with light exposure limitation, sleep hygiene measures, and gradual changes in schedule \[chronotherapy\]) can be effective in managing this disorder. The reason for the delay is a marked delay in the DLMO, so melatonin dosing can move sleep periods earlier. For children with DSPS, giving a dose 4–6 hours prior to the current time of sleep onset, then moving it earlier every 4–5 days, is recommended, with low dose preparations. **Of all the conditions mentioned here, this has the clearest benefit from melatonin.** Here is [a terrific review article](https://www.mja.com.au/journal/2013/199/8/circadian-rhythm-disorders-among-adolescents-assessment-and-treatment-options?ref=drcraigcanapari.com). ### **Children With Neurodevelopmental Delay and Melatonin** Children with various causes of neurodevelopmental delay may have significant insomnia and melatonin may help. However, in some children melatonin use caused persistently high daytime blood levels of melatonin (and daytime sleepiness). [A different review article by Edemann-Callesen in 2023 looked at melatonin in a mixture of conditions ](https://pmc.ncbi.nlm.nih.gov/articles/PMC10339185/?ref=drcraigcanapari.com)(including atopic dermatitis, epilepsy, mental retardation, Angelman, Dravet, Rett, cystic fibrosis, post-concussion. Total sleep time was increased by 19 min (mostly via reducing latency), but no evidence of subjective sleep improvement or daytime improvement. ### **Blindness and Melatonin** Some children with blindness may have issues with sleep wake time as they do not have light regulating their circadian clock and may thus develop sleep disorders. Very small trials in adults have shown benefit ([here’s one](http://www.ncbi.nlm.nih.gov/pubmed/25678831?ref=drcraigcanapari.com)) but the data is [very limited](http://www.cochrane.org/CD008473/BEHAV%5Fmelatonin-for-sleep-disorders-in-visually-impaired-children?ref=drcraigcanapari.com). ### Eczema and Melatonin Eczema is associated with dry, itchy skin and kids with it can have problems with insomnia and non-restorative sleep. Some research has suggested that children with eczema may have low melatonin levels, and [a recent trial suggest that melatonin may be helpful](http://health.usnews.com/health-news/articles/2015/11/24/melatonin-might-help-sleepless-kids-with-eczema-study-finds?ref=drcraigcanapari.com). ## **It sounds great. Why should I worry about melatonin?** There are several areas for concern, specifically known and theoretical side effects, and problems with preparations. - **There is a risk of overdose.** A June 2022 study showed that the rate of melatonin overdoses in children had risen by 530% in the last ten years. [Here's an article on how you can avoid overdose and safely use melatonin.](https://drcraigcanapari.com/melatonin-overdoses-are-on-the-rise-why-parents-should-worry/) - **Side effects (known):** In the short-term, melatonin seems to be quite safe. Unlike many other sleep inducing agents, “no serious safety concerns have been raised” (from a review by [Bruni ](http://linkinghub.elsevier.com/retrieve/pii/S1090379814002086?ref=drcraigcanapari.com)). The most common side effects include morning drowsiness, bedwetting, headache, dizziness, nausea, and diarrhea. These effects are generally mild, and in my practice only the morning drowsiness seems to be significant. It can also interact with other medications (oral contraceptives, fluvoxamine, carbemazepine, omeprazole, and esomeprazole, to name a few). - **Problems with preparations-- poor labeling:**Melatonin preparations have been shown have to variable concentrations from preparation to preparation. Moreover, [the amount that a child’s body absorbs may vary. ](https://www.sciencebasedmedicine.org/melatonin-for-sleep-disorders-safe-and-effective/?ref=drcraigcanapari.com) Remember how I told you that melatonin was treated as a food supplement by the FDA? - **Long term safety is limited.** [As pointed out in a 2026 analysis,](https://jamanetwork.com/journals/jama/article-abstract/2844458?ref=drcraigcanapari.com) only two studies have looked at long term safety data. - **Problems with preparations-- inaccurate dosing:** A recent study showed [that the amount of melatonin can vary anywhere from -83% to +478% from the labeled dose](https://www.ncbi.nlm.nih.gov/pubmed/27855744?ref=drcraigcanapari.com). This means that if you are giving your child a dose of 3 mg, the actual dose may actually be anywhere from 0.5 mg to 14 mg. Moreover, the lot to lot variability was as high as 465%– meaning that you may buy a different bottle of medicine, from the same manufacturer, and still one bottle may have more than four times as much as melatonin as another, Finally, the researchers found serotonin (a medicine used in other conditions, and also a neurotransmitter) in 71% of samples. [Furthermore, another study looked specifically at gummy preparations:](https://jamanetwork.com/journals/jama/fullarticle/2804077?ref=drcraigcanapari.com)the actual preparations contained an amount of melatonin differenting from 74 to 347% of the labeled dose. **To me, this is the most concerning issue with melatonin– you don't know what you are getting.** **Side effects (theoretical):** Melatonin given to children may lead to persistently elevated blood melatonin levels throughout the day. This can be associated with persistent sleepiness, but the other effects are unclear. It is important to know that melatonin has NOT been tested as closely as a pharmaceutical as the FDA regulates it as a food supplement. The studies following children who have been using melatonin long-term have relied mostly on parental reports as opposed to biochemical testing. A physician in Australia named David Kennaway has published two editorials pointing out the inadequacy of information on long-term use in children. (You can read this [here](http://onlinelibrary.wiley.com/doi/10.1111/jpc.12840/full?ref=drcraigcanapari.com)). He states his point of view in a pithy fashion\]" > …parents should always be informed that (1) melatonin is not registered for use in children, (2) no rigorous long-term safety studies have been conducted in children and by the way (3) melatonin is also a registered veterinary drug used to alter the reproduction of sheep and goats ." ![melatonin for children](https://drcraigcanapari.com/content/images/wp-content/uploads/2015/05/natrol_melatonin_1mg_liquid_drugstore_com.jpg) This is a common preparation. . . ![Confusing dosing chart for melatonin](https://drcraigcanapari.com/content/images/wp-content/uploads/2015/05/natrol_melatonin_1mg_liquid_drugstore_com_1.png) . . .but the label is not clear that it is 0.25 mg in each dropperful. Many parents think it is 1 mg / dropperful. This means there is [substantially less regulatory oversight in terms of safety and efficacy.](https://www.sciencebasedmedicine.org/whats-in-your-supplement/?ref=drcraigcanapari.com) I also find that the labelling of preparations is frequently misleading. Take the example of this liquid preparation, which many of my patients have tried. It is labeled as “1 mg” but each dropperful contains 0.25 mg. You need to go to the web to get this information as it is not on the bottle. (It may be in the package insert, but I suspect few people read these). A 2020 study of the PedPRM long acting melatonin formulation followed 80 children for 2 years, and [did not show any evidence of effects on weight, height, body mass index, or Tanner staging (a measure of sexual development).](https://www.sciencedirect.com/science/article/pii/S0890856720300344?ref=drcraigcanapari.com#bib14) **This is the best long term study of melatonin safety and is quite reassuring– but I wish there were more long term studies.** ## My child is already on melatonin. Do I need to freak out? I don’t think so, as there is little concrete evidence of significant harm. However, **if you started melatonin on your own I beg you to discuss it with your child’s physician to see if it is really necessary**. If your child has been using it long-term and sleeping well, you can consider slowly reducing the dose and seeing if it is still really necessary. Try to use it as needed as opposed to nightly. Also, I would take a hard look at sleep hygiene and ensure that you are ensuring good bedtime processes such as a [high quality bedtime routine](https://drcraigcanapari.com/what-makes-a-great-bedtime/) and avoidance of screen time for at least an hour prior to bedtime. I would try to reduce the dose, and potentially only use it as needed as opposed to nightly. Finally, as per the 2025 IPSA recommendations, I would limit use of melatonin to 3-6 months and try your child off of it periodically. Please do take measures to keep melatonin in a safe place and dose it appropriately. [For more on melatonin safety, including reducing overdose risk and avoiding interactions with other medications, read this article.](https://drcraigcanapari.com/melatonin-overdoses-are-on-the-rise-why-parents-should-worry/) ## My doctor and I have talked about it. What should we consider regarding how and when to give melatonin? Melatonin can be a tricky medication to dose. Effects change depending on when you give it compared to your child’s usual sleep schedule. Thus, a small dose a few hours before bedtime can have more of an effect than a large dose given at bedtime. Generally 30-60 minutes before your child's bedtime is the sweet spot. Sometimes, earlier may work better. As per the 2025 IPSA guidelines: - Melatonin should only be used for for chronic insomnia disorder and circadian rhythm sleep-wake disorders - NOT for sleepwalking, restless sleep, etc. - NOT to force earlier sleep in adolescents with normal circadian timing - Minimum evaluation before starting: detailed sleep history + 14-day sleep diary - Behavioral interventions must precede and accompany melatonin - Treat as medication requiring provider recommendation and supervision - Immediate-release for sleep onset delay only; prolonged-release may help night wakings (in children with autism) ### What is the dose of melatonin for children? As per the 2025 IPSA guidelines, the dose ceilings are age based. You should start at 0.5 mg and increase weekly by 0.5 mg to improvement, or when you hit the maximum dose: [Here is a direct link to the parental information sheet from IPSA in English. ](https://cdn.wildapricot.com/284366/resources/Melatonin/IPSA%5FMelatonin%20-%20English%5F13032025.pdf?version=1741910305000&Policy=eyJTdGF0ZW1lbnQiOiBbeyJSZXNvdXJjZSI6Imh0dHBzOi8vY2RuLndpbGRhcHJpY290LmNvbS8yODQzNjYvcmVzb3VyY2VzL01lbGF0b25pbi9JUFNBX01lbGF0b25pbiUyMC0lMjBFbmdsaXNoXzEzMDMyMDI1LnBkZj92ZXJzaW9uPTE3NDE5MTAzMDUwMDAiLCJDb25kaXRpb24iOnsiRGF0ZUxlc3NUaGFuIjp7IkFXUzpFcG9jaFRpbWUiOjE3NzU3NTk2MTJ9LCJJcEFkZHJlc3MiOnsiQVdTOlNvdXJjZUlwIjoiMC4wLjAuMC8wIn19fV19&Signature=dEAdbfJXEQvXZVRP9B1XqdsgkxoA7s72pZO2JxgOxJyFMYlzxp1DhIXeNYLlXk1w3A2h1EJnRe-~dfyQ4TZPv8EQVf7vdIycTkQ-wodg8aEJkLoiM7VqbqGUBkzVur23CEXGWBqNe13qJzObwCha2S28BLmw87Hp~cJmPrRt-xETsJ5vmz8kcZ4nApALIYe9Pps26F6MHKNHOFoNTGD~pOG1iDL0dkhcJA9lDs~Q0cNkFIeDj8PS~gFTqidu8zGjrDrTOCtiT7Rq~wBLUmyYm6H5ZUQdAp7WRbLtdPiXLWFf4q29xVWcUn-vjNbYuwPBKgnlRGjwcJIpSghOmLFzbQ%5F%5F&Key-Pair-Id=K27MGQSHTHAGGF&ref=drcraigcanapari.com) #### Age based dosing recommendations. - Under 2: not recommended - 2–3 yr: max 1 mg - 4–5 yr: max 2 mg - 6–10 yr: max 3 mg - Older school-age/adolescents: max 5 mg - Note that you may go higher in children with autism as noted above. I've surveyed the latest guidelines and put together a [melatonin dosing calculator that will help you select the safest dose for your child. ](https://drcraigcanapari.com/melatonin-dosing-calculator-for-children/) Here's the critical part. **Melatonin is not a substitute for good sleep hygiene practices and should only be used in concert with a** [**high quality bedtime**](https://drcraigcanapari.com/what-makes-a-great-bedtime/)**,** [**limitation on light exposure**](https://drcraigcanapari.com/light-is-like-caffeine-avoid-insomnia-by-managing-your-screens/)**, and an appropriate sleep schedule.** **When possible, purchasing a USP Verified preparation** may indicate that [the product is manufactured to the requirements of the U.S. Pharmacopeial Convention](http://www.aasmnet.org/articles.aspx?id=6743&ref=drcraigcanapari.com), which could mean that the quality controllers are tighter. **Please** [**read my article on the safety risks of melatonin.** ](https://drcraigcanapari.com/melatonin-overdoses-are-on-the-rise-why-parents-should-worry/) ## What is the take home? Should my child take melatonin? I have not met a parent who is eager to medicate their child. Such decisions are made with a lot of soul-searching, and frequently after unsuccessful attempts to address sleep problems via behavioral changes. Treatment options are limited. There are no FDA-approved insomnia medications for children except for chloral hydrate which is no longer available. Personally, I use melatonin for children commonly in my practice. It is very helpful for some children and families. I appreciate Dr. Kennaway’s concerns but I have seen first hand the consequences of poor sleep on children and families. I always investigate to make sure that I am not missing other causes of insomnia (such as restless leg syndrome). **My end goal is always to help a child sleep with a minimum of medications. I know that this is the goal of parents as well.** Some children, especially those with autism of developmental issues, will not be able to sleep without medication. So, melatonin may be a good option for your child if: - ***Behavioral changes alone have been ineffective*** - **Other medical causes of insomnia have been ruled out** - **Your child has chronic insomnia or a circadian disorder, not just "bad sleep" or difficulty with an early school start time** - **Your physician thinks that melatonin is a safe option for your child and is willing to follow his or her insomnia over time** - **You have a plan for when to stop. It should not be open ended for most children.** [One other thing- if your child's sleep difficulties came out of the blue, perhaps you are dealing with a sleep regression. Here's what you can do.](https://drcraigcanapari.com/how-to-deal-with-a-sleep-regression/) *A special thanks to Bob Young R.Ph (aka the legendary "Bob from Pharmacy") for his assistance with the initial version ofthis article.* ### Melatonin Safety for Children: What Parents Need to Know About Overdoses, Dosing, and Drug Interactions URL: https://drcraigcanapari.com/melatonin-overdoses-are-on-the-rise-why-parents-should-worry/ Last updated: 2026-05-02T21:37:05.000Z A recent study shows that melatonin overdoses have risen a whopping 530% in the last ten years, with a more rapid rise since the COVID-19 pandemic began. As a parent and a sleep physician, this is concerning to me. Parent who give their children melatonin need to be aware of the risks. Here’s what parents need to know. Melatonin has become one of the most common causes of emergency room visits for children under five. **A study of emergency visits estimated that 7% of all visits for accidental ingestions were** [**due to melatonin in children less than age 5**](https://www.cdc.gov/mmwr/volumes/73/wr/mm7309a5.htm?ref=drcraigcanapari.com)**, with about half of those coming from ingestions of melatonin gummies.** [A recent systematic review by Kracht et al in 2026](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2843284?ref=drcraigcanapari.com) confirms that the increase in usage in children is global, and points out that there is no good efficacy data for children under age 6, and only two trials looking at melatonin use in children. Thus, young children are more likely to overdose on melatonin than receive any proven benefit. ## **How melatonin overdoses took over the emergency room** ## The first warning signs of this came from a study by Lelak published in 2022\. The study, [*Pediatric Melatonin Ingestions— United States, 2012-2021*](https://doi.org/10.15585/mmwr.mm7122a1?ref=drcraigcanapari.com) (Lelak, K., 2022\. Pediatric Melatonin Ingestions — United States, 2012–2021\. MMWR Morb Mortal Wkly Rep 71\. https://doi.org/10.15585/mmwr.mm7122a1) In it, the authors reviewed poison control center data from the last ten years. ### **Who is overdosing on melatonin?** Risk factors included male gender and being less than <5 years of age. The vast majority of the ingestions occurred and were managed at home. [A follow up study published in 2024](https://www.cdc.gov/mmwr/volumes/73/wr/mm7309a5.htm?ref=drcraigcanapari.com) showed that 7% of ALL emergency room visits were for children <5; 47% of those ingestions were associated with gummy preparations. It turns out, if you make medicine look and taste like candy, young children will treat it as such. In the Lelak study, 10.7% of ingestions were managed at health care facilities (hospitals, doctor's offices, etc.). Of this group, 14.7% were hospitalized, with 1% requiring an ICU stay. (To put this in perspective, 1.5% of cases were hospitalized and 0.1% ended up in the ICU). Most hospitalized patients were teenagers with intentional ingestions. It's important to note that, generally, a teenager who is suicidal and intentionally ingestions anything will be hospitalized for safety and assessment, so "hospitalization" does not necessarily reflect the danger posed by melatonin, but more the presence of suicidal intent. The largest increase in hospitalizations, however, was in children less than age 5. ### Melatonin ingestion frequency has increased by 530% in the last ten years, with a marked increase since 2020. A total of 260,435 reported ingestions occurred in the last ten years. These represent 2.25% of all ingestions reported during the same period. In 2012, melatonin accounted for 0.6% of reported ingestions, whereas it accounted for 4.9% of reported ingestions in 2021. ![Graph from Lelak, K., 2022. Pediatric Melatonin Ingestions — United States, 2012–2021. MMWR Morb Mortal Wkly Rep 71. https://doi.org/10.15585/mmwr.mm7122a1 demonstrating linear increase in melatonin overdoses reported to Poison Control Centers 2012-2022. The x axis is year; the y axcis is # of ingestions per 100,000 US population](https://drcraigcanapari.com/content/images/wp-content/uploads/2022/06/pediatric_melatonin_ingestions_e2_80_94_united_states_2012_e2_80_932021_-_lelak_-_2022_-_zotero-1.jpg) Trend line showing marked increased in melatonin ingestions from 2012 to 2022\. (Source: Lelak, K., 2022\. Pediatric Melatonin Ingestions — United States, 2012–2021\. MMWR Morb Mortal Wkly Rep 71\. https://doi.org/10.15585/mmwr.mm7122a1) More serious ingestions were also noted. ![This shows an increase in more serious outcomes and hospitalizations from melatonin use. The red vertical line around the beginning of 2022 indicates the start of the pandemic. The x access is years and ranges from 2012-2022. The Y axis shows the number of ingestions and ranges from 0 to 1400. A dotted line shows more serious outcomes. A solid line below it shows hospitalizations. Source:

https://doi.org/10.15585/mmwr.mm7122a1Lelak, K., 2022. Pediatric Melatonin Ingestions — United States, 2012–2021. MMWR Morb Mortal Wkly Rep 71. https://doi.org/10.15585/mmwr.mm7122a1" class="wp-image-235801">