If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial. I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. This is a reference book. Read only the topic of interest to you.
When a child is not sleeping well, the effects spread. Over time, the entire family becomes stressed, and the changes in the child’s mood and behavior begin to attract labels: a difficult temperament, an anxious attachment, a psychological problem between parent and child. Sometimes those labels are correct. But sometimes the correct description is simpler — a bedtime that is too late, or night sleep that is fragmented — and the mood and behavior problems dissolve when the sleep is fixed.
The younger the child, the shorter the duration of the sleep problem, and the milder the disturbance, the faster improvement tends to appear. The three accounts below span a wide range — from a 10-month-old whose clinginess resolved overnight, to a toddler who needed six weeks to recover her sunny disposition, to a 6-year-old who had been misdiagnosed with autism before anyone looked at her sleep.
“I began reading Healthy Sleep Habits, Happy Child when my son was about two weeks old after a friend recommended it. I did my best to follow Dr. Weissbluth’s advice, such as putting my son down drowsy but awake and watching for his sleepy cues. Around six weeks, I implemented what I thought was an early bedtime of 7:00pm. However, I soon realized that I was rarely getting him down by that time — it was often 7:30 or 8:00pm by the time I left the room.
When my son was 14 weeks old, everything suddenly fell apart — almost overnight. He would cry for over an hour when put down at night and began waking every 2–3 hours, needing to be fed to fall back asleep. This was a dramatic change from the 8–9 hour stretches he had previously been able to do.
Dr. Weissbluth helped my husband and me realize that our son was severely overtired due to his too-late bedtime. He recommended that my husband take over the bedtime routine. We started a 5:30pm bedtime for over a week to help our son pay back his sleep debt, and agreed to implement the extinction method unless our son was hungry during the night.
The first night we implemented the 5:30pm bedtime, our son slept 9 hours uninterrupted, only waking for a feeding. The next day, his naps improved significantly — from sporadic, short naps to three solid naps. Over the next 3–4 weeks, we gradually moved his bedtime later, until it settled between 6:30 and 7:00pm. Since he turned 6 months old, he has been sleeping through the night uninterrupted.
About two weeks ago, I noticed a shift in his nap routine. He started having trouble going down for his morning nap. Having recently learned to pull himself to standing, he would stand in his crib and cry out, shouting ‘MAMA!’ when it was time for his nap. He also became very clingy throughout the day, which wasn’t typical for him. Dr. Weissbluth suggested a temporary early bedtime between 6:00 and 6:15pm, believing his previous bedtime had been slightly too late and that his recent illness had pushed him over the edge.
The day after implementing the earlier bedtime and nap schedule, I noticed a significant improvement. Our son no longer fought his naps. Instead of crying and standing in his crib, he rolled over and fell asleep within 5 minutes. His clinginess around naptime disappeared. In both instances of implementing an earlier bedtime, we saw our son’s sleep improve within 24 hours.
Over the past 10 months, I’ve learned that overtiredness can manifest in many different ways. A slightly earlier bedtime is almost always the solution to sudden, unwanted behaviors, particularly those related to sleep.”
“While early bedtime took away our night problems quickly, it did not quickly fix her demeanor. I also want to add that she was such a smiley baby — even strangers commented on her happy disposition. During her awful sleep period she became extremely cranky and fussy. After a solid 6 weeks of good sleep we finally got our happy baby back. I’m not sure I have much advice because we lost our happy girl during our sleep issues.”
The contrast between these two accounts is instructive. In the first, a 10-month-old who had been sleeping well, then experienced a relatively brief setback, recovered within 24 hours. In the second, a baby whose sleep problems had gone on longer required six weeks of good sleep before her temperament fully returned. The depth and duration of the sleep debt shapes how long the recovery takes.
Zaylin’s story is the most striking of the three — and the most sobering.
“My daughter Zaylin was born with complex birth defects requiring multiple surgeries and prolonged hospitalizations during her first few years. She had many behavioral problems not only at school but also in our home. We regularly got reports from her teachers for ‘acting out’ and she had an IEP as she struggled academically. She was very mean and nasty to her brother and very defiant at bedtime. I sought out many therapists and advice, but nothing seemed to work. At first, she was diagnosed with autism. She was later diagnosed with developmental delay and PTSD from her repeated and prolonged hospitalizations. After many tests and many therapists, none of these diagnoses seemed to fit my daughter.
We used Sleep Rules and she protested. I started by taking away her stuffed animals one by one. Then I offered her a cookie for breakfast. I would let her dad put her to sleep because I would baby her and he didn’t. Her normal bedtime was 9:00pm and we moved it to 6:00pm.
It was not until I got Zaylin on a better sleep schedule, at age 6, that I realized her sleep deprivation was causing all of these behavioral issues. I was skeptical because of my past failed attempts. After one week of applying Dr. Weissbluth’s advice, I saw some changes. It has been four months and my daughter is a new person. Her improved behavior in school was noticed by her teachers, and at home she turned into an entirely different child, saving my daughter and our family.”
Two years later, Zaylin’s bedtime was 7:00pm. She was thriving academically, socially, and artistically.
Zaylin was cared for at a nationally ranked academic pediatric center. She had been evaluated by psychologists and psychiatrists. She had received diagnoses of autism, developmental delay, and PTSD. None of those diagnoses led to improvement. What led to improvement was a bedtime moved from 9:00pm to 6:00pm and Sleep Rules consistently applied.
This is not a criticism of the clinicians who evaluated her. Her medical history was genuinely complex, and the behavioral consequences of repeated hospitalizations are real. But the sleep deprivation was present, unaddressed, and driving the behavioral presentation in ways that no amount of therapeutic intervention could reach — because the root cause was still active every night.
The Pattern Across All Three
A 10-month-old’s clinginess. A baby’s lost sunny disposition. A 6-year-old’s misdiagnosed behavioral disorder. Three different children, three different ages, three different clinical pictures. The common element was a bedtime that was too late, producing sleep deprivation that expressed itself as mood and behavior problems that looked like something else.
Move the bedtime earlier. Watch what happens next.
— Marc Weissbluth, M.D.
