What do the families who come into Sleep Clinic have in common? Almost all of them have tried sleep training and failed. There are some common sleep training mistakes that parents make. Knowing about them may make the difference between success and failure.
Parents often feel guilty about sleep training. One of the reasons is that they have tried for a bit and then encountered severe resistance, often in the form of tears and crying all around. Then parents quit.
This always makes me feel terrible– both the parent and the child have suffered without even fixing the problem. Often, if they had persistent, their child would have started falling asleep more easily with just a day or two more of effort.
Many people think that sleep training exclusively implies a “cry it out” approach, which is technically referred to as extinction.
When I say sleep training, I am thinking of a range of behavioral (non-medicine based) methods that parents and physicians may use to help children fall and stay asleep.
If you want to know the best ways to sleep train, I wrote a comprehensive post on the best sleep training techniques here.
Here is my list of the top ten sleep training mistakes:
Avoid these problems and you will be much more successful at fixing your child’s sleep problems.
1. Starting sleep training at the wrong time.
Infants develop the ability to self soothe between 4-6 months of age. To be safe, I usually recommend starting around six months of age, but efforts in the 4-6 month window may be helpful. Before four months, just follow your child’s cues. Lately there have been some articles in the news about training younger infants but I don’t recommend this.
Also, avoid starting around potty training, or learning to walk. These big milestones are associated with lots of sleep disruption.
2. Not changing bedtime.
A well structured bedtime is the key to success. Kids with irregular bedtimes continue to have poor sleep through childhood. Bedtime should be enjoyable, predictable, and last no more than 30 minutes. Additionally, moving bedtime later (called “bedtime fading”) can really help reduce crying. Timing is also critical. If you are really struggling with getting your child to fall asleep at bedtime, you might be in the “forbidden” or “no-fly” zone. Everyone gets a second wind in the evening when they feel more awake. If you put your child down during this period, she will not fall asleep. Here’s how to know if your toddler’s bedtime is in the forbidden zone.
3. Missing the medical causes of sleep difficulties
Children with some medical problems (obstructive sleep apnea, restless leg syndrome, anxiety or severe nocturnal fears, asthma, pain, etc.) won’t necessarily respond to behavioral changes.
It is very common for patients presenting to Sleep Clinic to have more than one sleep problem. If I find multiple sleep issues in a patient, I start with treating the medical problems first before suggesting a behavioral plan. This is why you should discuss your child’s sleep issues with your pediatrician before starting.
4. Being inconsistent
This is probably the biggest problem that I see in clinic– parents who respond differently to their child at night. There are a lots of reasons for this. Exhausted parents have trouble being consistent and may sometimes fall asleep in their child’s bed. Sometimes, one parent handles bedtime or awakenings differently than the other. If the parents are separated, there may be different rules in different homes. Sometimes, a working parent may have the child sleeping at a grandparents’ house until later.
The most powerful form of conditioning is inconsistent positive reinforcement— like pulling the lever in a slot machine. If your child fusses nightly, and is brought into your bed some of the time, that is a very powerful message which validates the fussing.
5. Challenges in the bedroom
Many families live in apartments where the neighbors complain if their child fusses. The child may share a room with a sibling, or live on a noisy street. Sleep training in an apartment may be challenging. If the child shares a room with a sibling, I may recommend that the other child be moved to the parents’ room or another room for a few days to facilitate training.
Also sometimes kids like to sleep in a room with the light on. This is not conducive to great sleep. If it is bright enough to read in your child’s room, it’s too bright for good sleep. Trying putting the light on a dimmer or moving it out of your child’s line of sight. And please, no electronics in the bedroom.
6. Not being ready
When people quit smoking, experts encourage them to have a “quit date” and not start until they are ready. If one parent is ambivalent, it is OK to wait. Also, defer starting until you can allow a few weeks for the new sleep pattern to be established. Don’t do it right before a vacation, or when house guests are staying, or right before your big presentation at work.
For more on this, read When Not To Sleep Train.
7. Moving your child into his or her room at the same time
If your child has never slept in his room successfully, he is going to have a real hard time if you move him into his room and start sleep training. You may need to move with your child into his room for a week until he is ready for you to start sleep training. Here is my article on how to stop cosleeping.
8. Feeding your child all night long
After six to nine months, most children don’t need calories at night. If you are feeding your child multiple times at night, you need to stop it so both you and she can sleep better. I have a guide on stopping night time feeds right here for you.
9. The “Extinction Burst”
This is a behavioral term describing that an undesirable behavior worsens before it improves when you are trying to get rid of it. This is especially common with “cry it out” sleep training.
Here’s what it looks like. Nervously, you decide to let your 9 month old cry himself to sleep. The first night wasn’t too bad. On the second or third night, he’s really screaming. For an hour. Finally, you give him and decide that it wasn’t work.
Sometimes this can get pretty real. Sometimes kids may cry to the point of throwing up. And sometimes little acrobats get creative.
Several years ago I received a frantic call from a friend. Their 18 month old had jumped out of the crib when fussing and had landed on her head. I happened to be nearby and went to check on her– she was fine. However, her parents elected to move her to a big girl bed and it took her issues a while to resolve. If you are sleep training an older toddler, remove things from the crib like bumpers that they can climb.
Unfortunately, if you persist, your child may be done with crying in a few more days. Sleep training usually works in 3-7 days in younger children, and usually the crying is practically done in one to two nights. People imagine that it will take weeks but it should not. If you are trying and you are stuck after this period of time, call your pediatrician.
10. Switching to a bed prematurely
I usually recommend switching kids to a bed around age 2.5-3 years of age, when they are sleeping well. Parents often try switching their kids out of a crib when they are sleeping poorly. Or they may buy an expensive mattress or sheets for their child.
I get it. If you’ve lain down next to your child in a toddler bed or crib, it’s pretty uncomfortable.
Let me tell you though– the problem isn’t the bed or the crib. It’s the behavior. And if your child is sleeping poorly in their crib, it usually gets worse when you make the switch.
The exception is the crib jumping. Then you have to make the switch.
What are the most common sleep training mistakes?
If I had to narrow it down to the two most common reasons why parents struggle and fail with sleep training, I would say that inconsistency and the extinction burst are the most significant.
Parents: what are are the biggest sleep training mistakes you have made?
I am at my wit’s end with my son’s sleeping habits. It seems I’ve tried everything and nothing seems to work. My daughter is almost two and she had a hard time with sleep until she was night weaned around age one. She is very high energy and we had to let her cry it out or else she would just want to play with us ALL THE TIME. She is a great sleeper now.
My son is a whole different ball game and I have to say that after reading tons of online threads, books, etc. I have never seen anyone with a similar issue and I just don’t know what to do. He was 6 weeks premature and spent two months in the hospital, part of that time involved a heart surgery and recovery time. He’s had several health issues but I’ve been assured by his pediatrician and cardiologist that it’s ok for him to cry; he is almost 7 months and about 5 months adjusted (his motor skills are about 3 months adjusted, so I wonder if that has anything to do with it.) Anyway, ever since he came home from the hospital he’s been waking up for 1-2 hours in the night and just sitting there. I used to go be with him and try to get him to sleep or lay down with him but he’s like my daughter and any interaction stimulates him to stay awake longer. I try nursing him to sleep but that rarely works. We decided to let him cry during that time and he usually cries for an hour then falls asleep, but crying then, plus at bedtime and naptime has me on edge all the time and it’s just too much for him. I hate crying but understand it can be useful/necessary with some kids. This just seems like too much!I just don’t know how else to get him to sleep for more than 30 mins at a time during the day. He also has the hardest time with naps. The thing is, he will sleep for hours if he’s in the Ergo, but I just can’t wear him for all his naps anymore. He likes to sleep and is very cuddly, he just has a hard time falling asleep unassisted and me doing anything to help him seems to make him more wired. This is his schedule lately:
Wake around 7:30 am, nap around 9 (he usually cries for 30 mins then sleeps for an hour), nap around 12 (same thing)…I tried doing a third nap but he will cry for longer than an hour for this nap because he’s so tired or mad. I’ve started putting him to bed around 5:30 or 6 (like Weissbluth suggests for an overly tired baby) and he does ok until around 2:30, then it starts all over again with the awake times and the crying. I’ve tried crying, not crying, soothing, nursing, singing, walking around, taking him downstairs, moving bedtime later and earlier, waking him up earlier, more and less naps, etc. I have NO idea what to do!!!! Anything you can suggest would be so helpful. Thank you!
It sounds like things are all over the place. If you are worried about a possible medical cause of his sleep issues (which is understandable) I would consider having your pediatrician order a sleep test. If that is normal I think that you might need to consider either a cry it out method or a “less cry” solution like camping out. Best of luck.
I have another question regarding night wakings. My 5.5 month old goes down really easy. No fussing or crying, but is a restless sleeper. Often wakes up every hour or so, fusses and cries and then back to sleep. Then around ten she is wide awake. I nurse her and put her back down and she throws herself a party in her crib until 1 or 2 in the morning. I tried one time to pat or even rock her to sleep, but it made it worse. She will then sleep until around 5am, nurses, and then goes back down easy. We’re on night 8 of sleep training. I’m not concerned about nursing two times in the night, but it’s upsetting that she is wide awake for two to four hours in the middle of the night. Any advice? (We have a bedtime routine, I don’t nurse to sleep, she takes three naps a day…her first nap being two hours and the other two are a struggle and around thirty to forty minutes. Her wake time between sleep is about 90 minutes and her bed time is down at 630 and usually asleep before 7. She would sleep all morning if I let her, but I have been waking her up at 8 or 830.)
A few thoughts. 1) After six months of age you may need to look at the night nursing if they occur at every awakening or increase in frequency. 2) She has a pretty long sleep opportunity if she is sleeping in in the morning– If she is sleeping for more than 14 hours a day you may want to consistently get her up at 7 am
Hi
I have a 1.5 year old who cries hard at nap time and bedtime. She sleeps through the night most of he time after she finally falls asleep. She started this last June and has not stop. She had stopped in September for a few weeks but then we left town and it started up again. Any suggestions. I most often breast feed her at bedtime and occasionally she will fall asleep but most of the time goes into her crib awake. I have tried rocking her, sleep training her, going. Back in only makes it start all over again. Sometimes she cries for a minute, sometimes 15-30. As she gets older, the crying is harder. I have two older daughters that I sleep trained around 8 months and they never had a problem.
I feel bad listening to the crying as she is the happiest kid during the day. I keep hoping she will realize crying won’t get us back in there as most of the time, we just let her cry.
A later bedtime might help you in the evenings.
Hello DR Canapari,
My daughter is 16 month old. Wakes up every 1.5 hours to feed. We are co-sleeping since her birth. We don’t have a crib for her. Please help me with the following questions:
1) suggest me with the detailed sleep training plan apart from CIO
2) is it necessary to buy a crib in order to sleep train her
3) is it possible is she can sleep train n share our bed
Please help me … I have not had sleep since her birth..
Thank you for ur support
With hopes
Jessu
1. Lots of answers RE different techniques on my Sleep Training methods page.
2. A crib will be helpful. A pack and play is cheaper and will work just as well.
3. It’s pretty difficult and unlikely to get better if you keep doing what you have been doing.
Best of luck
Some great advise here already- thank you.
I am going to try CIO as from tonight, because to be honest I am a very pregnant very grouchy zombie right now!
Bit of background- my son had reflux as a baby and has struggled a little with phlegm/mucous up until recently. At 1 year old he got croup pretty badly and I was so afraid he would stop breathing I felt I had to allow him to sleep propped up next to me. This went on for over a week. From then on, he would be hysterical when I put him in his cot and would get so worked up he would choke and vomit. I couldn’t bear it and so from then until around a month ago he slept in with us.
Around 2 months ago, at 28 months old, we started getting him to sleep in his new toddler bed with bed guard. Prior to this we started spending more time in his room so he was used to the surroundings. We started off laying with him, as he always soothed himself whilst playing with our earlobes before turning over and going to sleep (part of our problem!). We then tried finding an alternative comforter but he just wasn’t interested in anything so we decided after a week or so to start sitting by the door after we put him to bed until he fell asleep.
We are still at this stage, sometimes having to lay with him to get him to stay in bed (especially at 4am after the 4th wake up), but usually sitting by the door until he falls asleep. The trouble we are having, is that in the last week he has gone from waking 3-4 times a night to waking 6-7 times a night (this has happened for the last 3 nights). Would you say it’s time for CIO? I am thinking that training him to self soothe will help him to go back to sleep without waking us when he wakes through the night? I’d really appreciate your help, second baby due in May so we are hoping to crack this before then. Thank you!
If you are stuck you tend to have to switch to CIO. I think you are almost there.
Hi there.. I have just recently started to sleep train my 6m old little girl.. It’s going great but she has just started to teeth and is a lot more sleepy.. My question is if I let her sleep more during the day is it going to mess everything up. Should I stick to the our routine instead? Thank you
The most important thing is making sure that she does not nap for 3-4 hours prior to her bedtime. Otherwise, follow her cues.