Sleep is serious business. If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial, from the point of view of the United States of America Department of the Army. A major point, emphasized by the Army, is that more sleep produces more benefits for Soldiers. Also, more sleep produces more benefits for children. Even small amounts of extra sleep help (Blog Post 6). At every age!
Another point made by the army is “The extent to which sleep is undisturbed by arousals and awakenings-sleep continuity [or Sleep Consolidation]-is important because this influences both the duration and depth of sleep, with deeper sleep being more restorative.” and “The restorative value of sleep is determined not only by the duration of the sleep period. But also by the continuity of the sleep period-that is, the extent to which the sleep period is continuous and uninterrupted [Sleep Consolidation]. When sleep is interrupted, the beneficial effects of sleep are reduced.”
The Army is clear about who is in charge: “Planning for sleep is a leader [Parent] competency”
Consolidated sleep means uninterrupted sleep, sleep that is continuous and not disrupted by night awakenings. Slumber broken by awakenings or complete arousals is known as disrupted sleep or sleep fragmentation. Seven hours of consolidated sleep is not the same as seven hours of fragmented sleep. Parents of newborns or sick children who have their sleep interrupted frequently know this very well. The effects of sleep of sleep fragmentation are similar to the effects of reduce total sleep: daytime sleepiness increases and performance measurable decreases. Getting up four times at night, over an eight-hour time in bed, to care for your baby has the same effect as getting only four hours of consolidated sleep.
We all cycle through the night between deep sleep and light sleep. Babies often vocalize with quiet sounds during the light sleep period and then return to a deeper sleep by themselves. In the middle of the night, when your baby quietly vocalizes and you suspect he is not hungry or in distress, consider delaying your response several seconds or minimally soothe in the baby’s crib without always using feeding as a soothing technique. Then your baby learns to fall asleep unassisted in the middle of the night after a normal occurring arousal. For your baby, the ability to return to sleep unassisted is called self-soothing.
To repeat, after your child has fallen asleep at night, your child, while asleep, or after waking, may make non-distress sounds. What are non-distress sounds and why do they occur? I am talking about harmless sounds that all babies make, that do not indicate distress and, if you feel comfortable, can usually be safely ignored. You will hear sounds creating the false impression that your healthy baby has a cold (mucousy, gurgling, nasal congestion) because, for all babies, the nasal passage is narrow and a little fluid their vibrates when breathing through the nose. You will hear quiet wheezing, whistling, and noisy breathing sounds because, for all babies, the muscles lining the airway are not well developed so during inhalation, the airway slightly narrows. You will hear coughing because, for all babies, saliva pools at the back of the mouth and stomach contents normally reflux a little up the esophagus and the cough protects the lungs by clearing the back of the throat. Sneezing, snorting, and rattling sounds are common. Also, there may be some low or feeble sounds that sound like a whimper, or a quiet moan or groan which may or may not indicate distress.
If you go to your baby because you hear a quiet whimper, moan, or groan, and it appears that she is not having difficulty breathing and she appears to be calm without signs of distress such as grimacing, vomiting, or diarrhea, and her forehead does not feel warm or hot, and she showed no signs of illness during the day, it is probably safe to practice watchful waiting. That is, closely watch but do not intervene, even if she appears to be partially or completely awake.
So do you delay your response or respond immediately? In one study, using video cameras in the child’s bedroom, it was observed that often the infants’ self-soothed back to sleep unassisted. At 3 months of age, the average number for parental checks was one or two times each night, but the range was wide (zero to twelve). The average parental delay time was about three minutes. “The children of parents who waited longer to respond to their awakenings at 3 months were more likely to be self-soothers by 12 months of age.”
Hello Dr. Weissbluth – I am the mother of a soon-to-be 6 month old boy who was born 5 weeks preterm. He began sleeping though the night at 3 months. (We have a 7-year old and already closely followed your sleep prescription with great success). We begin the baby’s sleep ritual at 5:00pm and he is asleep in his crib by 5:30/45pm.
His naps are still fragmented throughout the day. Can I do anything more to help him to consolidate his naps? Morning wake up is usually 6:00am. He goes down for an hour nap one hour after waking up. He is usually drowsy again after feeding and playtime about an hour and a half. From there it is a crap shoot as to when and for how long he will nap. Some days he is awake for an hour and then sleeps for an hour. Other days he sleeps in bigger blocks. He is taking about 4 – 5 naps per day. It varies.
Should I be doing something differently to help him organize his naps sooner than later?
Thank you, by the way, for sharing your incredible expertise. Our family is in your debt for the gift of sleep health you have taught us. I made sleep one of the essential keystones to my parenting and chose the absolute best educator with the best approach to follow. We are thankful for you!
Thank you for your kind words. Because your baby was born early, and naps get organized around 4-6 months after the due date, please be patient regarding day sleep. Be optimistic because his night sleep is great, soon his naps will become more regular and perhaps longer. Maybe a pitch black room and/or a whit noise machine will help. On the week-end when your husband is around to care for your older son, focus on your baby’s drowsy signs and ask if the current nap irregularity is due to natural distraction from your older son. Maybe you will see a better nap routine for your baby. Let me know how it goes.
Dear Dr. Weissbluth,
My son is now 14 months old and has been sleeping through the night and had been taking one 2 hour nap a day. He generally went to bed around 6 and woke up at 5am. For the past 2 weeks he has been waking up at 4am and has been taking shorter naps. We tried doing a few days of 5:30 bedtime but he still was waking up before 5am and we also tried a later bedtime at 6:30 but he woke up at 3:45. What can we do to help him sleep later? 5am wake up is doable for us but before 5am feels like night time still. Thank you.
When does he usually take his single nap? Please describe his mood and behavior between 4-5pm when he is alone with toys (no screens or parental interaction). When younger, and taking 2 naps, what was his usual falling asleep time? When did he transition to a single nap?
Hi Dr. weissbluth,
His single nap is usually at 10am. I put him down drowsy but awake and he usually sleeps 1.5 – 2.5 hours (1.5 if sleep is poor overall, 2.5 when it’s good). He is usually eating his dinner between 4-5 so that we can get him to bed early. He is often fussy before then and wants a lot of parental attention. When we were on 2 naps we still did early bedtime around 5:30 or 6. We stopped 2 naps because the second nap was becoming a struggle and he really would only take it in the car. He seems to get easily over tired and we found the 5:30 bedtime helpful. We only recently tried a later bedtime closer to 6 and it had been working. He had also been having one wake up and night feed until about a month ago when I decided to cut it because getting up in the night was affecting my sleep negatively. We had a few glorious weeks of sleeping through the night until 5 or 5:30, and 2 -3 hour naps and then all of a sudden he will only sleep until 4am and it feels like the hard won sleep has fallen apart.
Based on his age, your goal is to slowly delay the single nap in small increments (maybe 10-20 minutes a day) until it settles in the midday range and during this transition be very strict with a 5:30pm falling asleep time plus extinction at night plus not going to him before 5-5:30am. Once the nap is settled at midday, maybe the bedtime will be moved to a little later time based on drowsy signs. Read about the ‘5:30 rut’ in my book to appreciate why this might not work so well. Does this help?
Sorry I forgot to add my name to the above comment
Yes that does help. I will work on delaying the nap. Thank you!
Hi Dr. Weissbluth,
I have a 7 month old who consistently wakes up once to twice a night. I just started being strict about feeding her once and then not going in again. She has now developed a cold, I’m just wondering how this should change my approach?
I cannot answer your question because there are too many variables to consider. Perhaps your pediatrician or my book will help.
Hello Dr. Weissbluth,
I have a 7 month old who naps very well, however, he still wakes up frequently throughout the night. He is breastfed and has been on solids for the last month. He usually will go down for night sleep anywhere between 6 and 7 pm depending on his last nap. He will self soothe and doesn’t have long crying spells when falling asleep for naps or night sleep. His first wake up is usually around 11-1130 pm. I used to go to him at this time and feed him, however, for the last week and a half, I have let him cry it out at this time to cut back on the night feedings (in hopes that it would lengthen his nighttime sleep). His crying during this time has gotten shorter and shorter and there was one night where he slept from 630pm-130am, although that has happened only once and he still is waking up around 11-1130pm, 1-2am, sometimes around 4-5am. I have been only feeling him when he wakes up between 1-2am and then around the 5am mark. Sometimes he will go to sleep after the 5am feed and sometimes he’s up for the day, although I do not encourage him to get up this early.
On top of this, we share a room because of limited space in the home. I am reaching out to see what I can do to maximize/lengthen his night sleep. Any insight you can share is greatly appreciated, thank you!
Kindly,
Megan R.
Please describe his mood and behavior when alone with toys (no screens or parental interaction) during the hour preceding his bedtime.
Please describe a common nap schedule.
He has a wonderful mood and temperament all day, everyday. He started crawling a week ago so he has been much more active during the day. We also try to get him outside, whether that is taking him for a walk in the stroller or just sitting outside.
His nap times are typically as follows:
Nap 1: between 830-9am (depending on how early he wakes up/wake window usually 2-3 hrs). He will nap anywhere between 50min to 2.5 hrs.
Nap 2: between 12-130pm (depending on wake up time from morning nap/wake window is typically the same). This nap is sometimes 45 min to 2hrs. He occasionally will have a long nap of three hours but that is not very common.
If he wakes up at 2pm or later, I will not put him down for a third nap and will make his bedtime sleep between 530-630pm.
If he wakes up before 2pm, I play it by ear for a third nap, depending on how cranky/tired he seems.
If he is truly hungry at night, please feed him.
Because he might not be truly hungry at night, would you like to try extinction?
If so, because you share a room, it might be a little complicated for 3-4 nights.
Let me know and I’ll advise you.
So I have been trying extinction for when I hear him at 11pm. The first night he cried for an hour and a half. The second night it was about 45 minutes. Several nights after that it was only 30ish minutes. There was a night where he made a little bit of noise and immediately went back to sleep. But for the last few nights he is crying between 15-30min. He will go back to sleep and then he wakes back up around 1-2am and at that time I change and feed him. Then he is up again around anytime between 4 amd 530am. If it is close to 4am, I attempt extinction again and sometimes he goes back to sleep and sometimes not so easily so then I get him and feed him. I’m trying not to instill a night waking/night feeding habit but i am not sure what to do. I am open to anything at this point.
Please try to to be certain that he is hungry at night by offering a test bottle and observe how quickly and how much he takes or pay close attention to his sucking strength and rapidity compared to swallows. If truly hungry it will be suck/swallow repeatedly but if not, it will be suck/suck/ suck/ swallow etc.
Consider camping out in your living room for only 3-4 nights, do extinction, feed him only if you think he truly is hungry or if unsure, don’t feed him. Your expectation is that you will reduce crying and habit feeding (if present) and after a few nights you then go back to your bedroom.
How does this sound?
Yes, thank you so much!
One more question, if he goes to sleep between 6-7pm and I am doing extinction, at what time should I go to him?
Please read carefully the Blog Posts on Drowsy Signs and base your bedtime on drowsy signs (7pm is too late). The failure to have an early bedtime will cause extinction to fail.
” I am doing extinction, at what time should I go to him?” : Please read the section on ‘Extinction’ in my book.
Thank you for your response. I have read that chapter.
Lately, he is in bed between 6-620pm. I have been consistent with extinction and last night he slept from 615pm-355am. When he woke at this time, he was gently vocalizing for about 10min until it started getting progressively louder. At that point, I went in, changed his diaper, breastfed him and he was back to sleep by 430am and then woke for the day around 620am.
I will continue to put him down for bedtime around 6pm and will continue extinction throughout the night. If he continues to wake around 4am (this has been a seemingly consistent pattern with him since I’ve started extinction), do you recommend that I continue extinction until a later wake up time like 6am or is it okay that I go in around 4am, change and feed him, and allow him to go back to sleep?
I am unsure if I should drop all feedings (i.e. the 4 am feeding) or if I should keep it?
Understood.
Please continue to feed him and change him when he is hungry around 4am. Because about 80% of breast milk is consumed in about 10 minutes, I gently suggest that you try to shorten the time that you are with him, for example, maybe 15-20 minutes instead of 35 minutes.
I think you are on the right track for success!
Thank you so much for your guidance!
Hello Dr. Weissbluth,
I have been trying extinction for over a week and a half now and my son is still continuing to wake up around 11pm, 1-2am, 4am, then around 6am for the day. I was doing extinction for the 11 and 2am wake up but he is persistent at waking up at these times and at 11am he has been crying for at least an hour. I myself am so sleep deprived and all nightly duties are on me because my partner works thirds shift, I don’t know if I should abandon extinction temporarily or if I should continue. It’s been more than 3-4 nights of extinction and he still is not sleeping through the night.
Here is my suggestion for the next 3-4 nights only, and then re-evaluate:
A strict 5:30pm bedtime (you have bathed, changed, fed, and soothed him and are leaving the room when he is drowsy but awake at 5:30pm)
Do not go to him before 5:00am unless you are absolutely certain that he is hungry. If so, make the feeding/changing very quickly.
Do not wake him in the morning.
Nap times are based on drowsy signs mid-morning and mid-day. No 3rd nap is allowed.
Thoughts?
I am willing to try anything. Thank you!
Dr. Weissbluth,
Just an update, last Monday I started your most recent suggestion and by night four, he slept from 530pm-440pm without waking at all! I then got him, changed and fed him, and he slept from about 5am-7am! This has been occuring for the last four nights. Thank you so so much! It worked!!
Kindly,
Megan R.
Congratulations! Please consider writing a narrative report of your sleep adventure that I would post as a Blog Post. Mothers would be more attuned to your voice than mine. if so, please include the role of the father (either + or -). Thank you.
Hello Dr. Weissbluth,
My son is 4.5 months now, and I thought we were getting into a good routine following your suggestions from your book. However, the last week has seen a regression.
He was moving towards only waking up twice at night to feed at about 11pm and 3am. His bed time was 6pm and he would wake up to start the day at about 7:30am.
In the last week, he has consistently woken up every two hours wanting to feed. He still goes to sleep at 6pm and wakes up at 7:30am.
I’m at a loss on what to do. He wakes up crying and I wait a couple of minutes before going to him. I believe it to be a hunger cry so I start breast feeding. He will feed between 15-40 mins and I then I put him back in the cot. Once in the cot he’ll fall asleep after 10-20 mins.
How do I get him back to sleeping for 4-6 hours before needing a feed at night?
Please describe his mood and behavior when alone (no screens or parental interaction) between 5-6pm.
Does he get expressed breast milk or formula?
Do you have any concern regarding your breast milk supply?
We observed him while alone for a couple of minutes (no interaction, no toys). He was calm and mostly still and looked around the room.
We do top him up with formula when we think he might still be hungry. Sometimes he rejects the bottle, sometimes he will drink 2-3 ounces.
I did originally think I was having a dip in supply, but I pumped for 15 mins after each feeding for a day, and I was producing 1-2 ounces per pump. So I didn’t think that was the reason and stopped pumping.
Last night he slept for slightly longer. We started our bed time routine at 5:30, but he cried until he fell asleep at 7pm (which he doesn’t normally do). He fed at 5:30pm, 6:30pm, 8:30pm, 12:15am, 3:30am and then started the day and fed at 7:20am.
If your breast milk supply is adequate and/or you offer him formula (instead of or after breast feeding), then at 4.5 months, do you acknowledge that he cannot be hungry 1-2 hours after a feeding?
What are you thoughts regarding extinction or graduated extinction?
Yes, I suppose he can’t be hungry that often. We can try extinction. How would we follow that method for night sleep? Do I still feed him at 11pm and 3am?
I originally used extinction during the day for naps with a 20 minute cap to teach him to self sooth. It took about a week for him to fall sleep without crying. He’s a very good napper during the day now and wakes up happy. But at night he’ll go to sleep quietly and wake up crying hysterically, hence why I thought he was waking up because he was hungry.
We’re also about to travel, so when would be the best time to start?
Please describe in detail his usual nap schedule and your travel plans.
Dr Weissbluth,
I have no idea what is going on with my son. Last night he slept through like he used to do with only two feeds. He was back to his routine and I didn’t do anything differently.
Yesterday, he fell asleep at 6:30pm. Woke up to feed at 10:45pm, slept until 3am when he woke up to feed again. Then slept until 6:45am. He fed every 3 hours during the day. Nap 1 started at 8:30 for 40 mins, Nap 2 at 10:45 for 1.5 hours, Nap 3 at 1:45 for 1.5 hours, Nap 4 at 4:40 for 30 mins. He fell asleep for the night at 6:45pm.
We live in America and will be travelling to Australia tomorrow for 5 weeks. I already have your advice for how to handle jet lag and will be applying it.
Night sleep begins to develop around 6 weeks of age, so at 4.5 months, please be strict about early bedtimes based on drowsy signs and feed overnight only when hungry, not more then twice at night.
Day sleep begins to develop around 3-4 months of age and is very regular by 6 months of age, do at 4.5 months, please be more flexible regarding the timing of naps and focus on keeping the intervals of wakefulness between naps brief. Sometimes there is a third nap but don’t let it start after 3pm to protect an early bedtime. A 4th nap will mess up his sleep by making the bedtime too late.
Does this help?
Yes, it does help. But, I would like to clarify:
1) My son’s drowsy sign is becoming very still. This tends to happen after being awake for 50 mins. When he becomes still, I commence the bed time routine- change diaper, put in sleep suit, rock for 30 secs and then put in crib. He then rolls about in the crib, or stares at his hands. He typically falls asleep after being awake for 1 hour 15 mins. How do I shorten his awake time?
This morning we tried to put him to sleep for his first nap after 40 mins being awake and he rolled about in his cot for 45 mins. We had to end the nap there cause it was time to leave for the airport.
2) If we don’t have a 4th nap, does this mean we have to keep him up, and then put him to bed at 5pm?
I think you need to be flexible during travels and maybe while on vacation.
Balancing having a fun vacation and keeping him well rested, a reasonable goal is a 5:30 falling asleep time; the earlier bedtime will allow for longer intervals of wakefulness during the day.
A 4th nap is incompatible with and early bedtime, so yes, keep him up and he might need more soothing and/or a longer soothing to sleep time at bedtime.
Until he is better rested, a shorter interval of wakefulness might be needed, perhaps 60 minutes will work well but maybe 40 minutes is too short.
But, please don’t be a slave to a sleep schedule and try to enjoy your holiday.
Your thoughts?
Hello Dr W,
We’re back from holidays and had a lovely time. Yes, completely agree with your advice. The first few days after we arrived was reserved for recovering. We were all so exhausted from travelling and we had a massive delay with our connecting flight which didn’t help. The early bed time worked so well. Once my son was better rested he naturally wanted to stay up a little later and his bed time moved from 5pm to 6pm. However, we seem to be unable to get rid of the 4th nap completely. He seems to want to sleep a lot.
Some days (like twice a week) he’ll have 4 shorter (45 mins) naps during the day. And even though we try to extend him out, he won’t co-operate – he’ll start to get upset and cry if we don’t let him go to sleep. We didn’t have any problems during the night. He still slept really well, require two feeds, and would wake up at 7am
Mostly he would have 3 longer naps (1-2 hours), so it was easier to not let him nap again after 3pm and have a 5-5:30pm bed time. On the days where he napped 3 times, he would treat the start of his bed time as a catnap, and only sleep for 30 mins before waking up. So I felt like he was trying to get that 4th nap in. I feed him and then put him back to bed and he would sleep well during the night with only two feeds and a 7am wake up.
I guess the question that I have for you, is that my son is now 6 months old and is still sleeping a lot and wants 4 naps. He’s happy and engaged during the day and doesn’t fuss or cry (unless overtired). I’m I doing something wrong?
Because he “wants 4 naps”, I think you ae on a path towards more sleep problems.
Based on his age, past history of sleep issues, and the recent travel:
A. As described in my book, simultaneously:
1. Control the wake-up time at 6-7am.
2. Nap drill at 9am and 12-2pm (depends on duration of 1st nap). No nap allowed at any other time. Father does nap duty starting on Saturday and Sunday. Mother leaves the house.
3 Falling asleep time is temporarily 5:30pm (You are leaving the room at 5:30pm). Start on a Friday night.
4 Overnight: Extinction
Do not attempt this unless both of you can strictly commit to 5 days. There might be a lot of crying per day for just a few days. Keep a written record.
OR
B. Contact The Family Sleep Institute (familysleep@gmail.com) for a referral to a Community Sleep Consultant. There might be less crying per day but for more days.
Let me know your decision.
We’re going to attempt option A. In your book it says that we should encourage the nap to last at least an hour. Is there a maximum time when the nap should end we should wake him up?
I don’t think I can cut him down to only two naps straight away if he’s not willing. I’ll see how I go. I’d like to take a gentler approach even if it takes a bit longer to achieve the results. I will definitely only allow the third nap if it starts before 3 pm to preserve the early bed time.
We can’t commit to overnight extinction. Also, my son is only waking up twice now during the night and I do believe he is hungry, so I don’t want to ignore his hunger cries. He feeds (I can hear a suck, swallow, suck, swallow pattern and he pops off when done) and then goes straight back to sleep.
I understand that what I describe above will take longer. I’ll keep records.
“Is there a maximum time when the nap should end we should wake him up?” To maintain an age appropriate sleep schedule when attempting to help a child sleep better, maybe limit a nap to no more than 2 hours so that the morning nap does not interfere with a timely mid-day nap and the mid-day nap does not interfere with an early bedtime.
Please re-read the section on extinction in my book; always feed a baby at night when the baby is hungry and always attend to your baby when he requires attention. The key to quick and complete success is an early bedtime based on drowsy signs.
Let me know how it goes.
Hello Dr Weissbluth,
This morning my son woke at 355am after going to sleep at 705pm (8hr50min). This is not something that occurs often with him. He went back to sleep at 604am to 745am.
His nap the day before was 1207pm-205pm. And night sleep the day before was 749pm to 628am (10h40m) which is a little shorter than usual for him.
Over the past 30 days he averages 11h12m night sleep and 2h2m nap. His naps have ranged from 1h25m to 2h51m. Roughly 5 hours awake before and after the nap each day.
For context, my son is 18 months old in two days. He’s a pretty good sleeper. Has been on one nap consistently for almost two months now. The transition was a bit rough with a few night wakings, but we got through it. His nap always starts at 12pm +/- 10min now
His bedtime ranges from 630pm to 8pm, depending on his nap length. (I’ve been considering capping naps at 2hours to maintain a bedtime closer to 7pm). We really do not like it getting close to 8pm because his wake up time is generally between 6-7am, usually closer to 615-630am. However, we have had a 545am wakeup before and a 445am wakeup where he went back to sleep 610am to 744am. Also, I’ll mention he usually goes to sleep within 20 minutes of being put down but sometimes it takes an hour for him to go to sleep at night.
Do you have any ideas on what is happening and why he woke at 355am today? I don’t think he is overtired because he does get a good amount of sleep and I think the timing is age appropriate. Is my schedule off? I am pretty confused and I work very hard to help him get healthy sleep.
What percentage of the time is the bedtime close to 6:30pm and same for 8pm?
When the bedtime is around 6:30pm, please describe his mood and behavior when alone with toys (no screens or parental involvement) during the hour before his bedtime routine begins.
When the bedtime is around 8:00pm, please describe his mood and behavior when alone with toys (no screens or parental involvement) during the hour before his bedtime routine begins.
Over past 30 days the bedtime is:
Close to 630-7 PM about 55%
Closer to 730-8 PM about 45%
Mood when put to bed earlier (615-630 in crib): He always has a good amount of energy. Seems to do better. But when a nap is from 12-2pm he ends up staying awake for an hour in the crib before falling asleep close to 730-8. If nap ends early after 1.5 hours or so around 130pm he will fall asleep by 7-715.
Mood when put to bed later (7-730 in crib): Generally good especially if it was a long nap from 12-215 or 230. We put him to bed later because he won’t go to sleep at 630 or 7 as described above. Naps are usually about 2 hours and don’t go to 2.5 hours often. If a nap is 1.5 hours or so he can be a bit crankier during leadup to bedtime.
In both cases he will play alone for the most part but does come looking for attention and fuss if he wants to play/have attention. The hour before bedtime we feed dinner, a short walk, bath, milk, bed. Usually during that hour routine he enjoys his walk and bath.
I have a lot of data but it is hard to describe a lot of this. Let me know if I can be more clear.
About half the time: “If nap ends early after 1.5 hours or so around 130pm he will fall asleep by 7-715…If a nap is 1.5 hours or so he can be a bit crankier during leadup to bedtime.”
Please carefully read Blog. Posts 83 and 115X to understand why pre-sleep arousal (Blog Post 159) is making him “cranky” and also makes him have difficulty returning to sleep unassisted during the light sleep in the early morning.
Also read the section on “Regularity” of sleep schedules in my book to understand why he needs a more regular schedule.
Tell me specifically what you plan to do to fix his sleep issue and I will help you.
Dr. Weissbluth,
I have read the regularity sections and looked at the blog posts and videos.
I have still been following drowsy signs for the most part and my understanding is while those are important, at 18 months I should be more clock based for regularity. Is that correct?
My plan is to institute a more regular bedtime. Wakeup time (6-7am) and nap time start (12pm) are already regular. I also think I should cap the nap at 2 hours (2pm), so that an earlier and regular bedtime can happen. I plan to have him in his crib by 615pm from now on.
If you agree, I have some questions.
If the nap ends early (130pm), do I move bedtime up slightly to 6pm?
I am also thinking about nap time shifting to start at 1130 or 1145am. But I understand this may be out of sync with an age-appropriate naptime of 12pm?
Please let me know if I should rethink this plan. Thanks.
“I plan to have him in his crib by 615pm from now on.” Excellent! The earlier bedtime will, over time, automatically shorten the nap to about 1-2 hours and to help achieve the earlier bedtime, go ahead and cap the naps for now.
Going forward, there will be some variability in the onset and duration of nap so drowsy signs are still your bet guide for the bedtime instead of clock time. But the earlier bedtime will promote more regularity anyway. Note that a bedtime that is just 10-15 minutes too late all the time will eventually create a sleep debt leading to pre-sleep arousal causing messed up sleep.
Similarly, there will be some variability in the wake-up time and variability in morning activities, so here again, base the onset of his nap on drowsy signs, not clock time.
Soon, you will see that the nap starts anytime between 11:30-12:30 and bedtime between 5:30-6:30pm. The better well-rested he is, the more he can still sleep well even if you are off in your timing a little bit.
How does this sound?
Sounds good. Today he started his nap at 1135am. For capping it do I cap the length or the end time? In other words cap it at 2 hours long (130pm) or at 2pm?
Cap the nap after 2 hours to help get an early bedtime.
Hi Dr Marc,
You have helped us a great deal so far with our son who will be 8 months old in about a week’s time.
With your help we managed to get him onto an age appropriate nap schedule at six months and managed to get longer stretches of sleep at night by ignoring him. Thankfully he does not cry when we do extinction. This has been a great help, as our older daughter was very dramatic during extinction.
All has been going well since we implemented your advice for about two months now.
However, the past three nights our son has been waking up a lot in the night, sometimes he plays for an hour in his cot at around 9pm. His bedtime is early, between 4-5pm.
He then also started waking more in the early hours of the morning, between 4-6am, but does often go back to sleep. He does not cry when he wakes up, he mostly just makes sounds in his cot for quite a long time. Sometimes he will fuss a bit, but not really.
He is not yet crawling, or very mobile at all.
I am still doing one feeding at night, around midnight or 1am. He then sleeps til about 6 or 6.30am.
I am wondering if I should stop feeding him in the evenings and if this is perhaps causing him to suddenly wake up more?
My daughter who is now 2 and a half slept very well at night as a baby, but around 9 months she started waking every hour. At that point we went cold turkey and stopped the one feeding I was doing with her, and that solved the problem within a few nights.
However, I tend to have a lot of doubt and confusion about whether or not my son is capable of sleeping the entire night without a feeding. Perhaps I should continue for another month or so, unless you think this could be contributing to the night wakings? Sometimes I further doubt myself and wonder if I should be doing two feedings and not have dropped to only one. (I dropped to one about two weeks ago).
He is an extremely tall baby and his weight is very good. During the day he has about 4 bottles of expressed breastmilk. He eats very few solids at the moment as we have been giving him finger foods and not purées.
While I have NOT consulted a local paediatrician, I tend to struggle with advice given from the paediatricians on the matter in general. They tend to all say different things with regards to night feedings and a common advice that is given is to reduce the amount of milk given per feeding or to increase feedings when a baby is teething. I do not agree with this.
A big question I have is, if he stops feeding at night, is it necessary to ensure he is drinking enough milk and solids during the day to make up for stopping the night feed, or does it not matter if he does not make up for the lost feed during the day? I think if I gain some confidence on how much he should and shouldn’t be feeding, I would feel more equipped to make a suitable decision regarding his night feeds.
Another element adding to my doubt, is his early bedtime. I’m often concerned that because his bedtime is so early, he will need a feed during the night to make it to a reasonable morning wake up time. Do you think this is something that should be considered when deciding on how many feeds to do and when?
I hope my questions above make sense and are not too all over the place.
Thanks in advance.
Lorraine
For 2-3 nights only, have your husband offer a bottle of expressed breast milk and monitor the suck-swallow pattern. As long as every suck is followed by a swallow, your baby is thirsty or hungry and continue feeding. As soon as it becomes suck-suck-suck-swallow, stop the feeding and father gently puts him down to sleep with a kiss but no soothing. Record the duration of feeding, volume consumed, and time of night. The entire feeding encounter should be less than 10-15 minutes. Let me know the results and then I can give you some suggestions regarding sleep and feeding.
Perfect thank you Dr Marc, I will report back with the results. Appreciate the help!
Hi Dr. Marc,
I feel so silly, it seems both our children are currently sick, I suspect the previous night wakings were caused by a sore throat and now the sickness has fully emerged in our son and daughter. The same has happened to other friends children who we encountered multiple times throughout the past week.
However, I still plan to report back to you on the night feedings once he is back to his normal self as I would still like to know if he is ready to be weaned or requires a night feeding still going forward.
Will let you know as soon as I have some reliable findings.
Hello Dr Weissbluth,
I am responding again to my last message in the comments about capping naps at 2 hours and having my son in the crib at 615pm for regularity purposes. He ended up getting sick during that, so I am just now getting back to this after a few weeks.
Over the past two weeks or so his mood and behavior have been awful. I know it is due to poor sleep. The past 4-5 days are listed below. I have been trying so hard to get him back to normal. I am stuck in this cycle of trying to be regular with his sleep times but then running into being overtired. So, I am not sure how to fix it. I follow all your book advice and the blog responses you make to others. I just cannot figure it out. He is almost 19 months. Transition to 1 nap about 15 months was rough but stabilized until these past few weeks.
I think I messed him up by letting bedtime get too late (630ish) during the time and he wouldn’t fall asleep until 715-745pm. So, I attempted to fix it with 6-615pm bedtime. Now as naps deteriorate and waketime gets earlier, I’ve had to bring in super early bedtimes of 5-530pm. Of course, this is against the regularity idea, but I don’t know what else to do. I even forced him to stay up from 5am to 1130am on day 4 because I didn’t think a 10ish am nap time would be helpful. And I try not to do a bedtime before 5pm.
Do you notice any errors in my thoughts and approach? I must be doing something wrong, but I can’t figure it out. Appears he is getting an appropriate amount of total sleep but its poor sleep and mistimed, I think.
Day Night Crib time Asleep Awake Night duration Nap crib time Asleep Awake Duration
1 5:30 PM 6:43 PM 6:56 AM 12h13m 11:32 AM 12:08 PM 1:29 PM 1h21m
2 5:38 PM 6:30 PM 6:22 AM 11h52m 11:28 AM 11:37 AM 1:05 PM 1h35m
3 5:25 PM 6:43 PM 5:49 AM 11h06m 11:14 AM 11:16 AM 12:14 PM 58m
4 5:06 PM 5:30 PM 5:00 AM 11h30m 11:16 AM 11:19 AM 2:19 PM 3h00m
5 5:31 PM 6:57 PM
On day 2 nap he went back to sleep from 115 to 122 for 7 minutes
On day 4 nap he woke at 48 minutes. Sat there for 1 minute then back to sleep. Woke again at 1h30m. Sat for a minute, laid down went back to sleep after about 5-7 minutes. Then napped until 3 hour mark.
I let him keep sleeping because of how bad his mood has been since this disastrous sleep stretch.
There are many ‘Anonymous’ comments so please provide the history of your baby’s sleep issue.
Please read pages 219-233 and tell me whether any of these issues are present. In particular, why did you allow his bedtime “get too late (630ish) during the time and he wouldn’t fall asleep until 715-745pm.”
Please describe in detail the role of the father (+ or -) regarding sleep.
Do you wish to fix his sleep issue quickly or slowly?
Sorry I didn’t pay attention to name adding. From now on I’ll add my name Rebecca.
The history for his sleep is as follows. At 15 months in March we transitioned to 1 nap. It was rough for about 2 months (some 1 nap days and some 2 nap days) Then in May, 1 nap was consistent starting around 1130am-12pm. Range in length from 1.5 to 2 hours. Bedtime was usually around 630pm. Wakeup usually 630am with some later wakeups towards 7am and some earlier about 6am. There were a few days (3-4) of random night wakings over the past few months. The last night waking was June 20 for 1.5 hours at 150am.
Allowing his bedtime to drift later was because when we put him in bed 615pm range he would not go to sleep until about 7-730pm. but was generally in good moods, so we thought he was able to handle longer wake times from after the naps that ended around 145-215pm. Looks like we were wrong and cause this problem. Of note I have seen in your comments before about 4-5pm behavior he was playing happily. He would go in and out of his playroom on his own without us giving him attention when we were in the family room.
In response to the pages to read. No, we do not have any of those issues if I read the right section in the fifth addition. No marriage problems, no depression. He has soothing skills, never cries when put to bed or when he wakes unless he was sick. We have had your book from the beginning and followed sleep training with extinction. We do not have any thoughts of needing to run to him in his crib and don’t interfere with his sleep in any way I can think of. We have a bedtime routine established since a few months old: after dinner it is bath, bottle, brush teeth, book, bed.
My husband’s role is extremely positive. He basically does the bedtime routine since we have another son that is 5 months old (slept thru the night since 9 weeks) that I handle. My husband does great, and he read your book and we share all the same thoughts and agree on everything we do regarding their sleep. I consider us obsessive over our kids getting quality sleep. We never miss naps or delay bedtime for social reasons.
I want to fix this quickly.
Thank you, Rebecca. Please be optimistic.
Please correct me if I misunderstand your history: It appears that after May 1 when he went to a single nap, cumulative sleepiness slowly developed (please read Blog Posts 84-86) from a bedtime that was too late but only during the past few weeks has it become obvious.
I think that there will be some trial and error to find out what his best sleep pattern is because currently he is overtired; so please be patient.
The first step is to arbitrarily and rigidly impose an age-appropriate sleep schedule with a focus on an early expected falling asleep time (in order to repay his sleep debt).
The second step is to allow more flexibility based on the data you keep and his mood and behavior.
So the first step for 3-5 days is temporarily to not let him sleep past 7am, try your best to get a midday nap starting as close to 12 noon as possible, cap this nap after 90-120 minutes, and bathe, feed, soothe, and leave the room at 5:30pm with extinction overnight. Keep data and let me know how it goes. This 3-5 day trial might or might not be sufficient to see a trend or improvement before moving on to the second step.
How does this sound?
The transition to single nap started about 15 months old on March 11 and we had one and two nap days until about May 1. Then its been 1 nap since. I agree that he has developed cumulative sleepiness and it has just now really shown over the past few weeks. We have been tracking his sleep since birth basically.
Based on a lot of your responses and book, we have begun your step 1 above. The early bedtime of 530pm and even put him down closer to 5pm some days for the past week or two. Tried to fix this on our own essentially. He never sleeps past 7am so that wont be a problem. Nap usually starts at 1130am but I can shift towards 12pm. The only concern here is when he wakes at 5-6am, making it to 12 seems counterproductive because he will just be overtired for the nap and then have a short nap under 1.5 hours. I considered a 10am nap the day he woke at 5am but pushed it to 1120am.
But I will continue the 530 bedtime and try the 12pm nap as best I can and record the data. So far the 530pm bedtime is still leading to falling asleep around 630pm or later
“So far the 530pm bedtime is still leading to falling asleep around 630pm or later”
What exactly occurs between 5:30-6:30pm?
Please describe the duration and behaviors that occur during a typical bedtime routine.
If he is short of sleep, during the bedtime routine, you might not see pre-sleep arousal. Do you think a 5:15pm expected falling asleep time should be tried to decrease the latency to sleep onset?
Once he is in his crib at 530pm and until he falls asleep he just lays in his crib and rolls around, sits up some, tugs at his sleep sack, holds his stuffed animal. He is quiet and content and wants to go to sleep. But being overtired it takes a while for him to fall asleep. I wouldn’t say he’s playing. Just calm and laying with some moving around like he’s waiting to fall asleep.
I do think I see the pre sleep arousal you mention. He also is always rubbing his eyes throughout the day being so overtired. During bedtime routine after he eats dinner he gets in the bath about 10-15 minutes, enjoys his bath but rubs his eyes a lot. Then change pad to get dressed 3-4 minutes. He rubs his eyes a lot on the change pad and does a little fussing. Then we sit in his nursery chair and he drinks his milk about 5 minutes. Next is brush teeth, which he lets us do in the mirror and he tries to do it himself some 3-4minutes. No fussing during it. Then back to his chair for a book for 5 minutes which he enjoys again no fussing. Then in the crib until he falls asleep. There’s never any crying.
Two days ago I put him in his crib for bed at 503pm and he actually went to sleep at 530pm and woke at 5am.
Yesterday’s nap was 1120am-151pm (2.5 hours) and during the nap he woke after 1.5 hours and went back to sleep 10 minutes after waking. I shouldn’t have let him go back to sleep probably I just know how tired he is and let him. Last night he went into crib at 530pm and fell asleep at 653pm. He woke this morning about 520-530am.
I think putting him in his crib at 5pm would help him fall asleep faster. I just don’t think his wake up time will move much past 6am. So then a 12pm nap is hard.
“Two days ago I put him in his crib for bed at 503pm and he actually went to sleep at 530pm and woke at 5am…I think putting him in his crib at 5pm would help him fall asleep faster. ” This short latency to sleep onset suggests that a temporary 5 or 5:15pm bedtime is a good idea. Please read about the “5:30am Rut” in my book to see a potential problem (that is solvable) with this strategy.
“Yesterday’s nap was 1120am-151pm (2.5 hours) and during the nap he woke after 1.5 hours and went back to sleep 10 minutes after waking…So then a 12pm nap is hard.” Starting the nap earlier might prevent pre-sleep arousal and if the nap is long (don’t cap it) it will help repay his sleep debt and eventually maybe allow a slightly later bedtime.
Please collect data over 3-5 days and let me know how it goes.
How does this sound?
Here are the days we have had since doing the following routine. In crib for bed at 5-510pm every night. We also never go in the room once he is in the crib for sleep. Have not done that since he was a small infant. I get him out of his crib every morning 715am-730am no matter when he wakes. I never let him sleep past 7am.
Day 1 Crib 1201pm Nap 1207pm- 204pm (1h58m)
Night 645pm-650am (12h5m)
Woke at 931pm for 3m then back to sleep. Woke 339am for 1m then back to sleep. Sat up at 421am for 1m then back to sleep. Sat up 601am for 1m then back to sleep.
Day 2 Crib 1130am Nap 1142am-127pm (1h46m)
Night 630pm-200am then 410am-639am (9h59m)
Cried in his crib for about 5-10 minutes on and off when put down at 510pm. He never cries when we put him to sleep so this was weird. Woke at 938pm for 1m then back to sleep. Night waking from 2-410am. No crying. Stood up once then just laid and rolled around. Oddly enough, his mood after this night sleep was pretty good. Eye rubs early though at 945am.
Day 3 Crib 1130am Nap 1131am-1247pm then 1251pm-138pm (2h5m)
Night 646pm-312am then 329am-529am (10h27m)
Short night waking of 17m. Tried to sleep after 530am with eyes closed but was always fidgeting or rolling. Decent mood at wakeup. Eye rubbing at 745am. Behaved well at church 8-9am. Played outside happy. Slightly fussy about 1110am.
Day 4 Crib 1130am Nap 1135am-134pm (1h59m)
Night 615pm-617pm (12h)
During this nap he woke twice at 46m and 1h6m and sat up then went back to sleep within a minute. During night sleep he woke at 1006pm, 158am, 312am and sat up and looked stared at the door. Went back to sleep though within 2m.
My thoughts are no matter when I lay him down he really wont sleep before 6pm unless i stop naps around 1pm maybe. Is it his internal clock or being overtired? Hard to fix this. It would be great if I could just get him on some rigid schedule like 7pm-7am with a 12-2pm nap. He’s tough to figure out.
Please tell me how you have such precise data.
It appears that you have him in his crib about 5pm and he falls asleep around 6-6:45pm and awakens around 6am +/- 30 minutes. Is this correct?
It appears that he begins a nap around 11:30am and he naps for about 2 hours. Is this correct?
In any way, is this pattern different from before we started? If so, please specify.
Have you noticed any change in his mood or behavior? if so, please specify.
We watch back the recording of it from the monitor I have. 24/7 recording to SD card. My husband scrolls through it everyday to see what he did throughout the night. We also use an app to track sleep start and stop times.
Yes crib at 5pm and asleep between 6-645pm. Occasionally it has been outside of this time frame even close to 8pm when we let bedtime get too late and caused this problem.
Wakes 6am +/- 30m. Have had wakeup prior to 530am occasionally.
Yes nap starts about 1120-1145am. Its usually 1.5-2h long but we started having the short nap problems (less than an hour some and less than 1.5 hours some). The last few days he did return back to sleep after waking as you can see how I notated that.
This pattern is mostly the same except for 5pm bedtime is new. He has never really slept past 645-7am in his life. We have always done early bedtime 6-715pm at least throughout his life. Never done late bedtime.
His mood has improved some. The fussing is less but we still get eye rubs and yawns in the middle of and early in wake periods. We also get eye rubs during bedtime routine on change pad around 445pm. The “misbehaving” includes shrieking for attention I think and some hitting me. I dont think those are sleep related though.
“Yes crib at 5pm and asleep between 6-645pm. Occasionally it has been outside of this time frame even close to 8pm when we let bedtime get too late and caused this problem.”
Has the too late bedtime occurred recently? If so, when and/or how often does this occur?
It appears the he has a long latency to sleep onset so the actual falling asleep time is too late.
Forgive me if I asked and you already answered this: How long is the bedtime routine that ends around 5pm, who does what and where does it occur? Do you think making the room darker or a noise machine might help?
Tonight he fell asleep at 540pm. Nap was 1134am-128pm. Maybe some progress.
We have been putting him in the crib at 530pm or earlier for about 3 weeks now. And the past week about 5pm. We don’t really have anything hindering this so we can continue. Too late of bedtime happened because we just thought he was handling it fine until he crashed a few weeks ago with his built up cumulative overtiredness.
Dinner is about an hour before he goes in crib for about 15-20 minutes with dad usually and at the dinner table. Then bath time with dad for about 15 minutes. Dad gets him dressed for bed and gives him milk about 15 minutes before crib time in his room. I usually come in and read him a book after that and lay him down. We have a sound machine that plays a quiet calming melody during the bedtime routine in his room and then change it to white noise when he goes in the crib. The room is completely black when it’s sleep time. Also, his room is not a play area. He has a separate play room if that’s helpful info.
To add to the last message and how he went to sleep last night at 540pm; he woke up shortly after at 714pm for 16m and went to sleep again at 730pm. Woke up this morning at 5am exactly. I’m really confused.
Previously, you wrote “Based on a lot of your responses and book, we have begun your step 1 above. The early bedtime of 530pm and even put him down closer to 5pm some days for the past week or two.”
It appears that for about 3 weeks you had a 5:30pm bedtime and then for 1 week even earlier (closer to 5pm.). But he continues to have a long latency to sleep onset and actually falls asleep around 6:30-7pm, a nap that begins around 11:30am, some eye rubbing, and some night waking. Moving the bedtime from 5:30ish even earlier did not help. Is this correct? Please confirm.
If the earlier bedtime did not help, then I suggest that you attempt to shift his sleep schedule to a later bedtime and a later nap time. In the beginning, he might still wake up early in the morning and he might become more overtired and sleep will become worse. Eventually, over a few days or several days, the expectation is that increased homeostatic pressure to sleep will cause him to wake up later and then it will be easier for him to have a later onset nap and a later bedtime. The sleep durations (nap, night, total) might not change but by shifting his schedule (hopefully more in alignment with his circadian sleep rhythm), he will have better quality sleep with a shorter latency to sleep onset, more consolidated sleep, and less eye rubbing.
Let me know your thoughts on this strategy before attempting it and you want to proceed, I will give you more specific suggestions.
You first question…you are correct. I think there have been minimal improvements (slightly less fussy) but not enough to say this is working right now.
I agree, the sleep duration seems good but the timing has been off and I have not figured it out. I would like to try the nap at 12-2pm (maybe 12-130pm) and possibly in the crib for bed at 6pm? The only concern I have is that prior to the 530 and 5pm bedtimes the schedule was close to this….1145-12am nap start. Crib at 615-630pm, asleep usually 7-730pm (still long latency) and wakeup was closer to 7am. I think that is how he got to being overtired and spiraling into trying the early bedtimes. That was the cumulative overtiredness that added up I think.
What do you suggest?
How long ago and for what duration of days had you tried the “Crib at 615-630pm”?
When you were doing the late bedtime, did you notice signs of pre-sleep arousal (fatigue signs)?
It is hard to remember crib times exactly. I only have asleep times recorded.
So I would say this timeline. around 8 weeks ago we were doing crib time around 630pm. Asleep time would range and go as late at 750-8pm. Sometimes though he would fall asleep closer to 7. Wakeup time would be closer to 630am and 7am. But somewhere in here cumulative overtiredness developed and we noticed his behavior and mood crash about 4 weeks ago. So for the past 3-4 weeks we have been trying the 5-530pm bedtime.
During later bedtimes for a few weeks I felt everything was going well so I do not remember fatigue signs but he likely was doing some eye rubbing. Once mood and behavior degradation became apparent we tried to correct with 6pm crib time for about a week. Then shifted to 530pm for a week or so, and are now at 5pm for the past week.
It appears that a bedtime in the range of 5:00-5:30 has not helped and was associated with a long latency to sleep onset.
Perhaps a bedtime around 6:30 (around 8 weeks ago) was a little too late and pre-sleep arousal caused a late falling asleep time plus cumulative sleepiness evolved.
The conflicting goals are:
1. Keep him up later to get a later nap and maybe a later wake up time so he is sleeping more in phase with his circadian rhythm and has a shorter latency to sleep onset and is better rested.
2. Keep him up later might produce pre-sleep arousal and cause an increased latency to sleep onset, cumulative sleepiness, and daytime drowsiness.
So it’s prudent to go slowly and to make gradual incremental steps to try to find a sweet spot for his bedtime.
I suggest a 4 day trial of a 6:00pm bedtime and continue to keep a written record. If there is no worsening and no improvement is his sleep, then I would suggest a subsequent 4 day trial of a 6:15 bedtime. During these trials, try to start the nap later, closer to 12 noon or even later if no fatigue signs (rubbing the eyes) are seen before the nap. The conflicting goals regarding the bedtime also apply to the nap time. Do not cap the nap.
I do not expect a straight forward linear improvement but hopefully a trend might be observed during these trials.
How does this sound?
As you attempt to get a slightly later nap and bedtime, extra soothing and distraction might be needed to help dampen pre-sleep arousal.
I will start trying 6pm bedtime and 12pm nap the best I can and balance the overtiredness and later crib times. The only concern I have is do not cap the nap. If he sleeps 12-2pm, I’m fairly confident he wont fall asleep until close to 7pm. So sleeping past 2 might push night sleep onset to later than desired. But wont know until I try.
Please be patient and look for trends over 4 days and not focus on an individual day.
Hi Dr. Weissbluth. Back with some data on 12pm crib for nap and 6pm crib for night. My thoughts are he’s doing okay with this schedule. Not doing worse but not doing much better. It’s not perfect. Still long time before night sleep occurs after in crib. Still eye rubbing throughout day. We tried bedtime earlier at 5 and 530pm in the past and that did not work. Not sure what to do now. I’m thinking continue with this. Does the falling asleep trend drifting later towards after 7 mean its getting worse? Is his latency to sleep for nap too quick suggesting exhaustion by nap time?
7/23 Day 1 Crib 1157am Nap 1203pm-129pm (1h26m) Crib 553pm Night 627pm-213am then 219am-545am (11h12m)
Previous night had about 45m-1h night waking at 330am. Woke for day at 640am. Morning mood before nap was good. Got agitated towards nap time. Some eye rubs throughout morning. Mood after nap was good. A few eye rubs around 230-3pm. More eye rubs during bedtime routine 515pm. Night waking sat up for 1m then laid down asleep again after 6m.
7/24 Day 2 Crib 1201pm Nap 1205pm-145pm (1h40m) Crib 554pm Night 637pm-558am (11h22m)
Okay mood in morning. Eye rubbing 10am. Bad mood and behavior 1015am. Took him out in car. 1130am playing at home alone happy. 2nd wind? Happy during bath. Started fussing/cry 2m after in crib for night for 5-10m. Usually never cries. Then babbled. Early wake up. Tried to keep sleeping never fell asleep again.
7/25 Day 3 Crib 1152am Nap 1157pm-113pm (1h16m) Crib 555pm Night 649pm-510am (10h21m) then 726am-803am (37m)
Average mood. Some agitation. 1045am yawn. Cried during naptime milk and diaper change. Eye rub and fussy at wake up diaper change. Ok mood after. Lots of eye rubs at 445 on. Cried when put down for night for 20m. Likely cause no binky in crib (forgot but need to get him off of one). Early wake. Babbling/fussing randomly until 7am. Back asleep 726am. Let him sleep because early wakeup. Maybe shouldn’t have? Woke him at 8am.
7/26 Day 4 Crib 1155am Nap 1208pm-134pm (1h26m) Crib 550pm Night 715pm-652am (11h38m)
Eye rubs at 11am. Fussy 1140am. Woke from nap tried to go back to sleep. Woke from nap tried to go back to sleep but didn’t. Decent mood afternoon. Eye rubs and yawning around 5pm. Fussy and ready for bed after bath 540pm.
7/27 Day 5 Crib 1158am Nap 1204pm-111pm then 124pm-224pm (2h8m) Crib 559pm Night 718pm-556am (10h38m)
Decent mood this morning. Eye rubbing 10am during church. Had to leave church from shrieking. More eye and ear rubs 1045am. Woke from nap after 1h8m and cried for a minute. Went back to sleep. 330pm crying and won’t leave my side. Think he’s sick. Slight fever on and off. Maybe a faux teething fever from canines.
7/28 Day 6
Cried a little when woke up early (556am) as noted above in the morning. Then just laid there until got him from crib this morning. Slight agitation. Happy at breakfast. Playing independently 9am. Eye rubbing still present.
Over the past 5 days, with the bedtime around 6pm, it appears that the falling asleep time has drifted later (6:30 to 7:18) and his wake up time has drifted later (5:45 to 5:56) without any dramatic improvement or worsening in his sleepiness during the day.
One idea is to not make any changes for a few more days to see if a more clear trend is observed of either improvement or worsening. I know that getting rid of his eye rubbing sleepiness is a goal but it does not appear that the previous idea of trying an earlier bedtime or the current later bedtime is doing much. So maybe ‘watchful waiting’ is the best strategy.
Watching for drowsy and fatigue signs before the bedtime is important because they represent clues to suggest that maybe it’s OK to try, for a few days, a bedtime of 6:15pm to see how he does.
In general, his naps are fairly consistently about 1.5 hours, so I would expect the falling asleep time to also be fairly consistent. So for now, I would not suggest abandoning the effort to find a fairly consistent bedtime.
Am I correct that although there is some yawning and eye rubbing, in general his general mood and behavior in general is excellent with the possible exception before nap times? If so, please consider making this one change now: Move the nap time earlier based on drowsy signs. This nap onset time will vary a bit because the wake-up time will vary. Depending on the nap duration and his mood and behavior during the hour before bedtime, the bedtime might later be shifted earlier or later or stay the same. If you like this idea, then, for now, keep the bedtime around 6:00pm
Your thoughts?
.
I like the idea of continuing on this schedule to see what happens. I wouldn’t call his behavior excellent. His behavior is hit or miss throughout the day. Plays on his own some, listens decently. He is learning not to hit, throw toys, or shriek/scream. He almost always seems some level of agitated. Always fusses or shrieks on his change pad, for example.
I am a bit confused on plan forward. We used to have nap time slightly earlier at 1130am crib time based on drowsy times and it didn’t seem to work but I could be wrong. Previously we were essentially doing what you describe….naptime and bedtime based on drowsy times. Doesn’t that interfere with the regularity concept? I could be misunderstanding.
In summary and the overall picture, he usually has a good nap at a decent midday time, but sometime shorter than ideal. He falls asleep at an age appropriate time usually before 8pm at least except for sleep latency is long. The issue is we cannot get him to wakeup later towards 7am consistently and we get random night waking. So we have what appears to be constant fatigue (eye rubbing, agitation).
Understood. Let’s stay the course for a while and observe.
One theme is to allow days to go by after a sleep change is made to see if a trend of improvement or worsening develops.
Another theme, sometimes, is to make just one sleep change to see if that variable helped or not.
I understand that an earlier nap time did not help in the past. Do you think his bedtimes then, his falling asleep times then, and his wake-up times then were the same as now?
I think with an earlier nap his bedtimes were about the same range 6-630pm. Those 1130am naps were closer to 2 hours or a little more. His falling asleep times were about the same 7-730pm but started to drift later. His wakeup times were a little better (630am and sometimes close to 7). Honestly thought it was going well until cumulative overtiredness led to some night wakings, irritability, and naps shortening. For now, Im going to stick with 12pm nap and 6pm bed to see if early wakings go away.
Dr. Weissbluth,
It has been 7-8 days of the following routine since my last message above. In crib for nap at 12pm. Asleep between 1157am and 1210pm for naps.
In crib for bed at 6pm. Still not falling asleep until 650pm earliest and 736pm latest.
Wakeup has started to drift towards 630am and sometimes a little later (I think this good). One wakeup was 605am.
Nap average over past 7 days is 1h47m. Night average 11h14m.
Yesterday 8/4 seemed like a great day. Very happy, didn’t notice any eye rubbing until close to nap time, behavior was good.
Then this happened:
Last night 8/4, he went to sleep 651pm and woke at 320am. He babbled for a moment which woke me. Then he was quiet and laid/rolled around for 2 hours. Back to sleep at 530am until 733am. I let him sleep past 7am because of the night waking. Then the nap today was 1215pm-102pm (48m). No crying during the night waking or when waking from the nap. Today’s behavior has been bad as a result (shrieking, hitting, agitated).
I feel like we are returning to what happened previously and caused me to contact you in the previous posts (thought sleep was going well until an issue came). I’m not sure what to do. I thought maybe put him in crib for bedtime later since he’s taking longer to fall asleep. Moving bedtime up is what we previously tried. The overall sleep quantity seems ok but I still cannot figure out the timing issue.
8/4 Day was great
In the past, you often mentioned eye rubbing and/or yawning even when his mood and behavior was fine. Have you had many days as good as 8/4 in the past? How was his nap on 8/4?
8/4 Night was not
I trend data over several days should be the focus and I know that it is frustrating to have a bad night but I would encourage you to stay the course for at least a few more days.
8/4 woke at 707am, fell asleep night before at 736pm. Nap was 1207pm-148pm.
He has had good days and bad ones in the past. Usually there’s always some slight agitation at least. Like if he wants something on a counter and we won’t give it to him. I put him down early tonight at 540pm. I will continue the 12pm nap and 6pm bed. Is variance okay? +/- 15 minutes it okay? For example if I put him down for nap at 1145 some days.
I think a variation of +/- 20-30 minutes for the timing of sleep might be fine for some children, but for others, it might be only 10-20 minutes. My guess is that the harmful effects of pre-sleep arousal are an individual trait so that some children can tolerate later bedtimes better than others. Additionally, for every individual child, the harmful effect of a pre-sleep arousal from a late bedtime might be related to preceding sleep and wakeful intervals and the child’s chronic state of being well-rested or not. So again, watching your child is better than watching the clock.
Do you agree?
I agree but he isn’t getting a late bedtime so I don’t know what else can be done. I think there’s a balance between regularity and watching my child. I think he is extremely sensitive to timing not being perfect. It’s confusing because even if I watch him for drowsy signs and put him to sleep early vs the more rigid 12pm and 6pm crib times, he still has issues. And I doubt a later nap or bed time would help.
Last night he had a second night waking in a row. Asleep at 615pm after crib at 545pm. Woke at 320am until 508am. Then slept until 637am. Im really not sure there is anything else I can do but accept he will never be a consistent sleeper at this age.
Understood.
When he has a night waking, do you respond or not?
No. Once he is in his crib for sleep we do not enter the room until at earliest 7am. He doesn’t cry.
“…trying to get my 4m old to sleep without a pacifier.” Why are you doing this?
Hello Dr Weissbluth,
Firstly, I have to apologise for taking so long to respond to your message. About 9 months ago you helped me a lot. My son was 6 months and wanting 4 naps per day. Following your advice, my husband and I consistently followed the same routine for naps and bed time, and my son’s quality of sleep improved. Between 6 to 9 months, he napped 3 times. He then naturally dropped to 2 naps at 9 months and now at 15 months he is taking 1 nap a day. When we first started his bed time was 5pm but this gradually moved back as we followed his sleep signs, and he now sleeps from 6pm to 6/6:30am every night with no wake ups. Our consistency I think has been the most beneficial part. I heard other parents describe their baby having sleep regressions at 9 months, 11 months and even 13 months, but we never experienced that. I feel that our approach was gentle and let my son graduate adjust as needed. We did need to feed him at night for a long while, but as he got older, he dropped to one feed a night, and now none. Perhaps because he’s older now and understands what’s is happening, when we put him in the crib and tell him it’s bed time and it’s time to sleep. He doesn’t cry but calmly lies down and drifts off. He did cry for a really long time though, like as if going to bed was a trauma. We stayed consistent throughout and practiced extinction. I think that all our work and patience has paid off. We now have a happy sleeper who is well rested, so he can be very energetic and playful during the day. Thank you!!