Blog Posts 1–5, based on the United States of America Department of the Army Field Manual: Holistic Healing and Fitness, describe what really matters for your child’s sleep. If sleep is an important enough topic for national defense than surely sleep should be considered a serious topic for parenting!
A 2022 review of 45 published peer-revied randomized clinical trials involving 13,539 children asked the question: What interventions work to help your child sleep longer at night. Every intervention regarding soothing strategies, bedtime routines, parent behaviors, physical exercise during the day for the child, and so forth was examined.
The answer: “Based on the best available evidence to date, earlier bedtimes offer a simple pragmatic strategy to meaningfully increase sleep duration.” The best interventions included earlier bedtimes and were associated with a 47-minute sleep extension compared with the remaining studies of only a 7-minute sleep extension.
Blog Post 74 explains how to move the bedtime earlier.
Blog Posts 6 and 154 document how just a few extra minutes of sleep may help your child.
Blog Posts 68, 123, 130, and 140 explain how late bedtimes harm your child.
Dr. Marc, I hope you can help! My son is 5.5 months (6 months on 1/21). He has always been a good sleeper and for several weeks was sleeping 12-13 hour stretches with one, sometimes two wake-ups for feeds (he is breastfed). After the holidays, everything changed. He wakes up frequently – sometimes as often as on the hour – and he is quickly soothed with his pacifier, but keeps waking up. Since the holidays we decreased him from 4 naps to 3 and extended his day sleeps so that his first nap is ~2 hours after he wakes, and we try to add 10 mins to each wake window. His naps are slowly extending but are still as short as 30 mins and very occasionally over one hour long. Is this a sleep regression? How can we help him get back on track? Thank you for your help!!
Please read the sections in my book on teething, wake windows, and sleep regression to fully appreciate why these are all bogus concepts. Please describe a typical schedule of naps and bedtimes. Have you read the age-appropriate section of my book?
I did read the age-appropriate section of your book, yes, but am still not sure what is best because if I watch my child and not the clock then I’m putting him to bed more frequently than appears to be recommended because he always looks so tired at the 90-135 min. mark.
Here is a typical schedule though it varies depending on nap times:
Wake around 7am
Nap 1 at 9am typically to 945 am
Nap 2 around noon typically to 1245pm
Nap 3 at 3pm typically to 345 pm
Bedtime around 7pm
I wonder if he is in need of the “Reset” that you describe in box #4 of blog post 140.
Please describe his mood and behavior when alone with toys (no screens or parental involvement) between 6-7pm.
He slows down. He is sometimes fussy and cries, but mostly just gets quiet and low energy around that time. If we do interact with him he might “wake up” a bit and engage, but if we were to leave him alone he’d just sit quietly or start to fuss.
Your description tells you that his sleep tank is near empty (“slows down”, “gets quiet and low energy”, “sits quietly”) or empty (“sometimes fussy”, “starts to fuss”) because the falling asleep time is too late. Read the section on cumulative sleepiness to understand why this causes disturbed night sleep and review drowsy signs to determine when an earlier falling asleep time is best for your son. Does this help?
Oh – a few other things – he is teething (has 1.5 erupted through so far). On 12/31 he had a terrible night of sleep, as his grandparents were watching him and bedtime was off and he couldn’t settle the rest of the night. On 1/1 he had a full 13 hours with one wakeup, but since then it’s been terrible. And the last thing to note is that he shows drowsy signs very early which is why he was still on 4 naps until recently. He seems to have a high sleep need for his age.
Hi Dr. Weissbluth,
We’ve been following your books and recommendations to help our son sleep since he’s a newborn. He is 27 months old and sleeps 11 hours solid at night, and takes a 2.5-3 hour nap during the middle of the day. One of the potty training method recommended to us is based on the book by a potty training expert named Jamie Glowacki. With regards to night potty training she recommends fluid restriction few hours prior to sleep, and waking up the toddler 2 times a night to prompt them to pee (until you figure out their night time pee schedule, then go down to 1 time, etc.). Our concern obviously is would this lead to habitual night time waking and sleep debt due to sleep interruptions? If this is indeed not a great approach from your experience, do you have some other recommendation for potty training at night (when day time potty training is completed)? Thank you kindly for your expertise.
Sleep is essential for brain development.
Toilet training was part of my 40 years pediatric practice: Nobody ever suggested fluid restriction. Opinions and claims, even by ‘experts’ without evidence should be ignored.
Hi Dr Marc,
I would appreciate some input regarding my almost 4 month old son.
He was sleeping quite well for quite a few weeks, we had 4-5 hour stretches and sometimes even up to 7 hours.
We previously did extinction with him at 2 months, so he is able to self soothe and he puts himself to sleep for all of his daytime naps.
His bedtime is around 5pm, sometimes earlier if his last nap ended very early.
His naps are usually fine
I usually do a bedtime routine with him where I then feed him a bottle and he falls asleep on his own in his cot. For all day naps he also falls asleep in his cot.
During the night, after his first waking, I pick him up from the cot and place him on a floor mattress in his room to breastfeed him. He usually falls asleep from nursing, I then leave him on the mattress to continue sleeping and leave the room I do this as I am concerned I will wake him when placing him back into the cot or it will be too stimulating.
The past two weeks, he has been waking a lot more frequently in the night, about every 3 hours, sometimes 2 hours. His first stretch in the cot is always the longest, usually about 4 hours.
I am wondering whether removing him from the cot after his first waking and allowing him to sleep on the floor mattress is causing him to not return to sleep after he wakes up in the night, since it is a different location from where he usually goes to sleep?
In the night, he wakes with making lots of little sounds and after about 30 minutes of being awake, he will start to cry, but before that he sounds happy.
He does seem hungry when I go to him, but he often does not nurse very long before falling asleep, so I am not always perfectly sure if he is really hungry or not and it is confusing since he was previously able to go much longer stretches without being fed.
Another concern is, around 5am he is usually awake for about an hour before he goes back to sleep after I nurse him. I try to get him to start the day at 7am, so that his first nap is not too early.
As mentioned, his day naps are mostly fine, on days where has napped particularly well, I do not see any improvement in his sleep at night, even after a few days of good naps in a row, there is still no improvement in his night sleep.
Any suggestions on the way forward would really be appreciated. I am feeling rather tired!
Thanks in advance
He is able to fall asleep in his cot (“I usually do a bedtime routine with him where I then feed him a bottle and he falls asleep on his own in his cot. For all day naps he also falls asleep in his cot.”)
Therefore, stop doing this (“During the night, after his first waking, I pick him up from the cot and place him on a floor mattress in his room to breastfeed him. He usually falls asleep from nursing, I then leave him on the mattress…)
Because you are correct: “I am wondering whether removing him from the cot after his first waking and allowing him to sleep on the floor mattress is causing him to not return to sleep after he wakes up in the night, since it is a different location from where he usually goes to sleep?”
Also shorten the duration of soothing + nursing so you are putting him down drowsy but awake.
How does this sound?
That is a great suggestion, thank you very much, I will attempt that approach this evening!