How To Deal With A Sleep Regression

Sleep regressions are a common concern for parents. If your child has been sleeping well, and then starts

• Waking up at night
• Fighting at bedtime
• Refusing naps
• Waking up painfully early in the morning

You may be in the the middle of a sleep regression.

(I have some concerns about the term. You can read more about my concerns in this post, Are sleep regressions real?).

What do I do if my child has a sleep regression?

Although I’m not that fond of the term, there is no doubt that many parents struggle with these unpredictable events. A few bad nights is unfortunately sometimes just the cost of doing business as a parent. Many parents who have been enjoying the hard-won fruits of a sleep training battle are justifiably freaked out when their sleeping angel becomes a little devil again.

The first step is not to panic. In my experience, anywhere from 1-3 nights of sleep difficulties happen periodically without a clear cause. I would wait and keep doing what you are doing– keep the same schedule, comfort your child, and just try to wait it out. Sometimes kids just do annoying things.

But if it persists for longer than that, it runs the risk of being a bad habit. This is especially true if your reaction makes things worse. One example of this is starting to take your toddler into bed with you if they start waking up at night. Guess what? Your toddler really likes spending time with you. And they will likely start waking up to come into bed with you.

If you are a video person, here is a quick video on this material, taken from Episode 4 of the Sleep Edit Podcast:

So, if your child’s sleep behavior is disruptive and last for a few days, you might want to deal with it.

Here’s how to handle a sleep regression, regardless of your child’s age

1. Rule out a medical cause. Is your child cutting a tooth? Does she have a cold or signs of an ear infection? Is she constipated? (Constipated kids don’t sleep well. I’m not sure why. As I tell my patients, I’m an “above the waist” doctor). Symptoms like snoring or complaining about leg pain at night can suggest medical causes of sleep problems. If in doubt, call or visit your friendly neighborhood pediatrician.
2. Take inventory of your sleep practices. Have you gotten a bit lazy in your bedtime routine– are you varying the time and sequence of events? Are you lying down with your child to fall asleep at bedtime when he used to fall asleep independently? Are you bringing him into your bed at night? If so, you need to go back to basics. Have a set bedtime routine every night at the same time and leave before your child falls asleep. If this is difficult, there is a whole host of techniques you can use. Specifically, if you’ve started co-sleeping, here’s how you can stop.
3. Look at your child’s sleep duration at night. Maybe you read Weissbluth’s book and your child goes to bed at 6pm every night and you expect her to sleep until 6 AM and take two two hour naps. Maybe this worked in infancy, but your two year old won’t sleep for sixteen hours a day no matter how much you want her to. Track your child’s sleep for a few nights and consider adjusting her time in bed. Check your expectations versus the actual sleep requirements expected of a child that age. You may need to drop a nap (terrifying, I know) or move bedtime later.
4. Consider how you are responding in the middle of the night. If you are bringing your child into your bed you need to stop. You could consider the bedtime pass, where you give your child a pass to leave her room 1-2 times per night. After this you return her to her room without contact. Weissbluth also talks about the silent return– if your child shows up to your room, bring her back to her room without comment. You may need to do this 20-30 times for a night or two. It feels crazy but it will work quickly if you are consistent. Here’s a review of my favorite sleep training techniques.
5. Be patient. Generally these issues DO improve if you do nothing.
6. Consider bringing in a pro. A sleep consultant or sleep physician may be helpful if none of this work. I hate to toot my own horn, but check out my book as well— if you followed the steps in my book, I suspect your child will be falling asleep and staying asleep fairly quickly.

FAQ and tips on sleep regressions

What is the first thing parents should do if their child is now having sleep issues?

Check and see if your sleep habits have slipped a bit. Is bedtime later or more variable? Are you being lax with your bedtime routine?

How long can we expect sleep regression to last?

Usually they are pretty brief— say, less than a week.

If your child’s sleep regression is so disruptive and doing nothing is just not working, what can we do to make it come to an end?

It’s time to go back to basics and make sure that you have a high quality bedtime routine and that you do the minimum you need to to soothe your child. I would also check in with your child’s pediatrician.

Can they be prevented? For example, when you’re about to potty train your child, can you prepare for a possible sleep regression and stop it from happening?

I would double down on your high quality bedtime routine and also make sure that you going to be extra careful about respect your child’s bedtime and sleep schedule.

What can we avoid doing so we don’t make sleep regression worse or last longer than it needs to?

Make sure that you are not inadvertently causing the regression by giving too much attention. For example, if your baby starts crying at night and you then start giving him a bottle every night, you will likely cause the problem behavior to continue.

Are kids going to go through a sleep regression? Are some more likely than others?

There’s very little research on sleep regressions— as noted above, the term is poorly defined. As a parent, I can tell you that children frequently regress in many domains, just when you think you have things figured out.

What are medical causes we should be on the lookout for?

Often the common cold may present with a sleep problem first. I’ve asked myself on many occasions, “why is my kid doing this weird thing?” and then a day or two later he will get a cold.

Snoring and complaints about legs can represent medical causes of sleep disruption and should be discussed with your pediatrician.

How do you tell the difference between “regression” and an issue like teething or a fever that might cause interruption in sleep patterns?

Often, it’s not obvious until a day or two later, as noted above.

What are good sleep practices for kids that we should make sure to faithfully implement so we all get a good night’s sleep?

Further reading

Here is a nice article in Romper about sleep regressions. 

Have you experienced a sleep regression? Tell us about it– what happened and how did you fix it? Write it out in the comments below.