A Healthy Child Needs a Healthy Brain, A Healthy Brain Needs Healthy Sleep

“When my son was about 4 weeks old and still waking every 1–2 hours throughout the night, out of desperation, we purchased a second-hand Snoo with the hopes that this smart bassinet would help him sleep better. Unfortunately, the Snoo did not provide us with much relief. By 6–8 weeks of age, his sleeping habits had not improved and he even started to reject his Snoo bassinet, waking up as soon as we would try to transfer him into it while asleep.

At about 9 weeks, we moved our son to the crib since he was no longer sleeping at all in his bassinet. Amazingly, he slept for 3 hours that first time. We soon got rid of the Snoo and continued to work on night crib sleep. Meanwhile, we continued with contact naps during the day. Around this time, I had also started to follow the most popular social media sleep accounts recommended by friends and spent hours reading about others’ experiences through Reddit, Google, and Facebook support groups.

By 10 weeks, we noticed he was able to get himself back to sleep in the middle of the night by sucking on his hands. Encouraged by his ability to self-soothe, we felt comfortable starting sleep training. We started extinction with a cap to get him to fall asleep independently at night. This seemed to work incredibly well and he soon was sleeping for 10.5-hour stretches from 8:30pm to 7am.

During the day, we were following age-appropriate wake windows recommended by Google and the sleep resources we were using. These popular sleep resources were advising capping naps to prevent too much day sleep and maximizing wake time in order to build up enough sleep pressure to sleep longer through the night. I also read that drowsy signs can become unpredictable after the newborn phase and that sometimes these signs can indicate boredom instead. We read that you should push through the fussiness and drowsy signs to maximize the wake windows.

We soon started nap training and used extinction with a cap for his first two naps of the day. While he was able to fall asleep on his own after the first day, it continued to take 10–15 minutes of heavy crying to fall asleep and his naps were only lasting about 30 minutes each. We also noticed him getting fussier and more irritable during the day. He wasn’t playing independently with his toys as long and wanted to be held more frequently. He was waking up from naps upset and also falling asleep while nursing.

Around this time, I had started reading Dr. Weissbluth’s book Healthy Sleep Habits, Happy Child. Before this, I was not aware of the significant benefits of an early bedtime and I felt that my son’s behavior met the criteria for chronic sleep deprivation. I believe that following the clock — wake windows — instead of following his drowsy cues, having a late bedtime, and getting poor day sleep through short naps led him to be chronically sleep deprived.”

What Went Wrong — and Why

This family did several things right. They moved their son to the crib at 9 weeks when the bassinet stopped working, and immediately saw improvement. They recognized self-soothing when it appeared and responded appropriately. Extinction at night worked well — 10.5-hour stretches by the end of the process.

The problem was what happened during the day. Following wake window guidelines from social media and sleep apps, they were instructed to cap naps, maximize wakefulness, and push through fussiness and drowsy signs in order to build “sleep pressure” for the night. They were also told that drowsy signs after the newborn phase are unreliable — that they might reflect boredom rather than genuine sleepiness — and that the clock, not the child, should determine when sleep begins.

Every element of that advice runs counter to what the biology of infant sleep actually requires.

Wake windows are a commercial sleep industry concept, not a scientific one. They assign fixed intervals of wakefulness based on age, directing parents to watch the clock rather than the child. When a baby’s actual drowsy period arrives earlier than the prescribed window — which it often does, especially in a baby already carrying sleep debt — following the window means missing the signal. The result is a baby who arrives at the crib in pre-sleep arousal rather than in the drowsy state that produces long, restorative sleep.

Capping naps to build nighttime sleep pressure compounds the problem. Day sleep and night sleep are not competitors. They support each other. A baby who is well-rested during the day falls asleep more easily at night and sleeps longer. Sleep begets sleep. Restricting naps does not produce better night sleep — it produces a more overtired baby who is harder to settle and more likely to fragment at night.

The signs this mother observed — heavy crying before naps, 30-minute nap durations, increasing fussiness, reduced independent play, waking from naps upset, falling asleep while nursing — are the textbook presentation of a baby in chronic cumulative sleepiness. The wake window approach had produced the problem it claimed to prevent.

Drowsy Signs Are Not Boredom

The claim that drowsy signs after the newborn phase may indicate boredom rather than sleepiness — and that parents should push through them — deserves direct rebuttal. Drowsy signs are neurological signals. Decreased engagement with the environment, a shift toward quietness: these reflect what is happening in the brain, not a momentary loss of interest in the toy in front of the baby. A baby who appears drowsy after 90 minutes of wakefulness is not bored. She is sleepy. The drowsy period is real, it is brief, and it passes. Missing it consistently is what produces the chronic overtiredness this family experienced.

Watch your child, not the clock. The child’s biology knows when sleep is needed. The clock does not.

— Marc Weissbluth, M.D.