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.
(Continued.)
As a child grows in length, the bones get longer in either a fairly gradual or continuous fashion or instead, there are periods of no growth alternating with periods of rapid growth, or growth spurts. Different researchers have published papers supporting both points of view. One researcher, promoting growth spurts, claims on her website (Growing Up Human): “How can parents know when their child is experiencing a “growth spurt”? Babies share their discomfort loudly, and need emotional support, comforting and temporary increased food intake. [The growth spurt] can turn even a calm and good-humored child into a whiney, hungry and irritable person with sleep perturbations [emphasis added].” Nowhere in her research (nor any other’s research) is data presented documenting sleep disturbances associated with growth. After multiple email exchanges, the author reneged on her promise to me to share data to support her claim that growth spurts disrupt sleep schedules.
This myth results from the promotion of a book and an app.
An older version of this myth is that when a child was mastering a new motor skill, such as standing without support or walking freely, sleep became disrupted. I routinely asked mothers in my practice who were pediatric physical therapists or pediatric psychologists if they were aware of this notion. They all agreed that they knew about it from their training. When I asked at the age-appropriate visit whether their own child had shown this behavior, they all agreed on the answer: No. The modern version of this myth is called ‘sleep regressions’:
From Wikipedia:
The Wonder Weeks is the English translation of the Dutch book Oei, ik groei! (literal translation: Ai, I’m growing!) by former professor Frans Plooij, originally published in 1992. It has been republished several times, with an updated version published in 2017. It describes the theory that the cognitive development of babies occurs in predictable jumps. However, a follow-up study by Plooij’s PhD student, Carolina de Weerth, failed to find any evidence of predictable leaps. A New York times article concludes: “experts (and parents) agree that sleep patterns can vary wildly throughout a baby’s first two years, no rigorous data support the notion that nap and nighttime changes happen at predetermined times or are linked to specific developmental milestones.” Despite this, the book continues to be popular, and the publisher has produced a mobile app based on the book.
According to the book, a baby should go through 10 predictable jumps or “leaps” in its cognitive development during the first two years, with 8 in just the first year, counted from the due date if the child was premature. These jumps consist of two phases; A phase where the baby is generally unhappy, followed by a period where the baby is generally happy, due to discovering new things with the newly gained cognitive skills. The “leaps” are predicted to occur at 5, 8, 12, 19, 26, 37, 46, 55, 64 and 75 weeks old.
A follow-up study by Plooij’s PhD student, Carolina de Weerth, examined the claims of the book. She tested both behaviour and cortisol levels and failed to find any evidence of greater fussiness or higher cortisol levels corresponding to the leaps. Frans X Plooij tried to prevent the British Journal of Developmental Psychology from publishing her study. Van Geert, a coworker, described his behaviour as “very indecent.” He also described the claims made by the book as contradicting the greater body of research on child development. The controversy over these results that ensued led to Plooij’s firing and departure from academia. [emphasis added]
Some adults have an eveningness preference (owls) while others have a morningness preference (larks). But research in children shows that between birth and 8 years of age, evening types (owls) occurred in less than 2 percent of children at every age. In fact, using objective measures of sleep and salivary melatonin, in the age range of 30-36 months, the number of definite evening types was zero. A parent-response survey, in the same age range, found evening types to be 0.9 percent of children. So the vast majority of babies and young children are larks and benefit from early bedtimes (Blog Post 7) although this statement might not apply to all populations (Blog Post 14). Additionally, among mothers, but not fathers, who are owls, it is more likely that their children will have late bedtimes, require more time to fall asleep after being put down, and have more sleep difficulties. Please respect your child’s natural sleep rhythms (Blog Post 8) and watch for drowsy signs (Blog Post 9), even if you are an ‘owl’.
Hello Dr. Weissbluth, you have already helped me a lot in the past with my daughter (she had severe colic). She has just turned one year old (she was born 2 weeks before the due date). I read the article because you hear about a big regression in the first year of life and I am very skeptical about it, which the article confirmed.
Nevertheless, we are having problems with sleep again. But I think it’s the routine and not the baby. Our baby always falls asleep on her own and is not fed at night. She always goes to bed very early (around 6) because she is very tired. She is sometimes awake at night or very early in the morning, but doesn’t cry loudly and stays in bed if everything is okay with her.
Sometimes she falls asleep again, sometimes she is awake at 5 and doesn’t go back to sleep. She takes 2 naps, but I have the feeling that this is hardly doable for her..in general all her nap „transitions“ have been very late and hard..I am very strict and always put her down at 9am and 1pm on 2 naps regardless of all factors (so no wake times or awake windows).
Now I’m wondering if this is wrong…some days it’s fine but for the last few days the second nap hasn’t worked at all and I have the feeling it’s due to overtiredness. She cries a lot, shows tired cues. She has her typical overtired cry.
My fear to put her down earlier is that if I put her down 12:30 and she then only sleeps for 40 minutes we are at 1pm and it’s far far too long until 5:30pm. That’s why I’ve stuck with 1pm. Is that nonsense? How can I help my daughter? She seems very tired and full of cortisol. She doesn’t seem to cope well with being awake longer than 3 hours (more like 2,5).
Maybe you could give me some advice? Sorry it was a long explanation. Thank you so much for everything. You helped me so much and I recommend your book to friends that expect their first babies.
Hi Dr Weissbluth,
Can you explain why you believe that age-related sleep regressions are a myth? It seems that across parenting circles many mothers have found their infants/toddlers to exhibit nap refusals/deviate from regular sleep patterns right around the 9 month and 18 month mark. In my case, even when my 18-month old toddler has been sleep trained since 5 months old, and I have done everything in my power to put her to nap (putting her down at a reasonable midday time of 1pm, with a full stomach, 45 minute long nap routine, she has suddenly refused naps when she used to be a great napper. It just seems like by saying developmental leaps, or other factors like teething do not affect sleep, you are telling mothers that every factor affecting her child’s sleep is within her control and ultimately to make her feel like a failure for not having been able to yield good naps for her child even when she has exhausted every effort in sleep training and scheduling.
Sleep Regressions
Sleep regressions and other myths and fads are described in Bog Posts 36,37, 143, 146, and 147. I read all the cited literature in the original paper(s) on sleep regressions and concluded that there is no data to support the concept of a ‘sleep regression’. For a more thorough discussion of sleep regressions, please look at:
https://www.babysleep.com/sleep-advice/what-is-a-sleep-regression/
https://www.babysleep.com/experts/dr-jodi-mindell/
Nevertheless, the notion of a ‘sleep regression’ remains popular. But please remember that other popular myths were also produced for commercial purposes such as the idea that solid food made your baby sleep better (promoted by the Gerber baby food company).
My experience is that no neurotypical child is destined to develop sleep problems for innate reasons any more than a biologically normal child is destined to develop breathing problems. Sleeping, like breathing, is such an evolutionarily old and vital process that it is highly regulated. Of course, environmental adverse effects such as too much artificial light or air pollution might create problems.
Please give me more data on your child’s sleep schedule and your child’s mood and behavior when alone (no screens or parental involvement) during the hour before naps and the bedtime and I will try to help your child sleep better.
How does this sound to you?
Thank you for the insightful article. While it does indeed say that there is no data supporting specific junctures in a child’s life when sleep regresses, it seems to me that it still acknowledges the possibility of sleep “bumps” along the way. Also, it seems to define sleep problems strictly in the form of night wakings, not nap refusals, which is what I am struggling with my child. She is definitely tired, and is put to bed at the first appearance of being tired (rubbing eyes, slowing of movement), yet after a brief period of sleep, she is up again and refuses to sleep.
That being said her schedule is as follows (roughly): 6am wake up (will only get her out of bed at 7am), 1245pm-1pm nap (most often at 1pm, but sometimes will push forward to 1235pm if her wake up time was earlier, say 545am, which has occured on mornings following an exceptionally bedtime of 530pm, per your book’s advice in the event of a missed nap). It takes her frustratingly long for her to show tired signs. She just won’t get tired.
I follow a rule that I won’t get her up until 2 hours after her being put down, whether she is awake or sleep.
Would it be acceptable to first help your child sleep better and then later engage in the more general questions that you posed?
If so, if I am correct, she usually wakes up around 6am and begins a nap around 1pm. How long does this nap usually last? On most nights, when does the bedtime soothing usually begin and when does she actually fall asleep?
When did she transition from 2 naps to 1 nap?
Please carefully review the Blog Posts on Drowsy signs.
I also want to mention that my child is 18 months old. Based on talking with most other mothers, so many have experienced bumps with naps as they approach 2 years old. I disagree that the absence of scientific basis for the link between nap refusals and teething, growth spurts, or specific developmental milestones necessarily disproves the possibility of nap difficulties as a child gets older and that this has everything to do with the mother’s fault and what she has done wrong. The article also mentions that these studies were done on infants, have there been studies that incontrovertibly shows that toddlers in the 15-24 month age range do not exhibit difficulties in napping due to factors outside of the control of the caregiver?
She transitioned from 2 to 1 nap at 15 months. Naps have been rough since then (no more consistent naps as was the case prior to the transition). The trigger for the transition was that she had been skipping naps for two successive weeks on a 2 nap schedule, and stopped sleeping well at night. The soothing process generally starts at 5? On a crap nap day, which is just about everyday, she goes down at 530 but never truly falls asleep until 630-640 her usual bedtime. I try to time the start of the soothing process as late as I can so as to allow her to have a substantial dinner to last the next 13 hours or so
Around 15 months of age, before the 2 week period of not napping well, when she was taking 2 naps, what was her usual falling asleep time?
Back then, what came first, napping problems, night sleep problems, or both around the same time?
Currently, please describe her mood and behavior when alone with toys (no screens or parental interaction) between 10am and 12-1pm.
Currently, please describe the bedtime routine you use and when it begins and when it ends.
Please review ‘Nap Drill’ (pages 289-292).
When she was on a two-nap schedule, she would go down around 945am and 2pm. The details are hazy at this point as it was a long time ago. Between 10am and 11am, she returns from playing outside and sits down for a snack. At 12pm, she is alone with her books (no toys) in her room with the sound machine on. She is generally bright and active, but always contemplative (pulling books from shelves, flipping through pages, and asking for her to be read anything that catches her interest). I do this until I catch signs of tiredness, around 1245-1250, switch lights off, rock and sing to her for 5 minutes before putting her down.
She has never had issues with night sleep in her lifetime thus far. Bedtime is always 6-645pm, 530pm for crap
Nap days
“signs of tiredness, around 1245-1250”: please describe in detail the signs of tiredness that you observe.
Please describe her mood and behavior when alone with toys (no screens or parental involvement) between 5-6pm on days that she naps.
Please describe the bedtime routine you use and when it begins and when it ends for both nap days and no nap days.
Please be a little more specific: about how many days a week does she actually take a nap.
“signs of tiredness, around 1245-1250”: please describe in detail the signs of tiredness that you observe. – she rubs her eyes, some slowing of movement. it is very subtle and to this day i don’t even have it pat down.
Please describe her mood and behavior when alone with toys (no screens or parental involvement) between 5-6pm on days that she naps. – they are no different from days she does not nap. at 5pm she sits down for her dinner. after a few minutes of eating she will get distracted and active. if her nap is successful, she her routine starts at 545pm and she is put down at 630pm. days when she has a successful nap are always followed by 2-3 days of unsuccessful naps.
Please describe the bedtime routine you use and when it begins and when it ends for both nap days and no nap days.: bedtime routine – brush teeth, change into sleepwear, potty, diaper, books, lullaby, then sleep. for nap days – they start at 515pm and end at 530-535pm. for no-nap days, start at 545pm and end at 630pm.
Please be a little more specific: about how many days a week does she actually take a nap. – she only has a successful nap 1-2 days out of the week. it’s not having a perceptible impact on her mood, but i’m sure her development is taking a tremendous hit from the accumulation of overtiredness.
another thing i would mention is that on days where she has had successful naps i have experimented with pushing her bedtimes later, say 645am or even closer to 7am. she usually ends up waking up earlier thereby getting far less sleep.
What are your thoughts so far?
Here are my observations based on your reports:
Please carefully read Blog Post 83 to fully understand why you are sometimes confusing drowsy signs with fatigue signs (such as “rubbing the eyes”): ““signs of tiredness, around 1245-1250”: please describe in detail the signs of tiredness that you observe. – she rubs her eyes…”. This suggest that sometimes the nap time is too late.
Even though she is not showing dramatic signs of pre sleep arousal (Blog Posts 171, 172, and 204), it is possible that sometimes her body is fatigued and she is fighting sleep at the end of the day (such as “at 5pm she sits down for her dinner. after a few minutes of eating she will get distracted and active.”)
Because of “..on days where she has had successful naps I have experimented with pushing her bedtimes later, say 645am or even closer to 7am. she usually ends up waking up earlier thereby getting far less sleep.” This suggests that this bedtime is too late causing her to wake up earlier in the morning.
My suggestion is to have a 5-10 day trial as follows: Do everything sleep-related that you normally do, but with a temporary change of sleep timing.
Independent of when she awakens in the morning, do your nap-time routine earlier and leave the room at 12 noon. If agreeable, do the ‘Nap Drill’ as described on page 289 in my book. If able and willing, have the father do nap duty on the week-end and you leave the house.
Independent of whether or not she naps (or the duration of a nap), do your bedtime routine and leave the room at 5:30 pm. If agreeable, do extinction overnight.
No parent is 100% consistent (we are not robots) but during this trial, rigidly follow this schedule.
Keep a daily written record of mood and behavior, wake-up times, naps, latency to sleep onset, and falling asleep times.
Do not attempt this trial unless you see ahead that there are no scheduled conflicts and you can commit for the duration.
Check in on Day 3 and based on your report, we might make some changes.
The expectation is that naps will become more regular. When this occurs, the timing of the bedtime, based on drowsy signs will be later, maybe 6 or 6:30 but probably not 7:00pm. Then, the wake up time might change (earlier or later) and based on drowsy signs, the nap might occur earlier or later.
that sounds great, thank you for the advice!
Hi Dr Weissbluth, first day was a complete disaster. The 530pm bedtime the previous day completely backfired. My little one woke up at 520am in the morning. She has never woken up before 6am. I put her down at 12pm following a 20 minute routine as advised. She did not appear to be tired and actively resisted being put down when the time came for her to be put down. After she was put down at 12pm for her nap, she woke up after 10 minutes and cried, went back to sleep, woke up 15 minutes later, cried, did not attempt to sleep and cried throughout. There has never been a worse no-nap scenario since she was first sleep trained at 5 months. Usually, even when she doesn’t nap, she will stay up in her crib and play quietly. Is it likely that she needs a later nap time to be tired enough for an afternoon nap? She is 18 months old today
Sorry.
Please stay the course and let me know how the next 24 hours go.
You might be right about the timing of the nap but I think that keeping a plan in place for 2-3 days to see what might help and what needs to be changed is better than making changes after 1-2 days because often after 3 days there is more certainty regarding what is working and what is not. I know this is frustrating, but changing plans too quickly often leads to more confusion.
Hi Dr Weissbluth, given the disastrous nap schedule yesterday she was put down at 530pm as prescribed. This morning, she woke up at around 511am and returned to sleep until about 640am. Unfortunately, after putting her down for a 12pm nap it was the same nap disaster. A brief sleep of 15 minutes before getting up to cry. I think she may need more time to get tired before her nap. She does not show sleepy cues, never has, so it is next to impossible to know if 12pm was the appropriate time to put her down. The failed nap probably shows this just isn’t the optimal schedule for her. In general, do you think nap times should be set based on the morning wake up time as a daily rule? I think an additional 40 minutes of sleep in the morning makes a difference in my 18 month old’s ’sleep tank,’ which may entail a later nap time for that fuel to sufficiently burn off. What do you think?
I think I agree with you but may I ask a few questions first?
Correct me or clarify:
For the past two nights she had a bedtime of 5:30pm and she fell asleep quickly around this time.
Yesterday, she awoke at 5:20AM and today around 6:40am for about 12 and 13 hours of sleep respectively.
Before we started all this, what were common durations of night sleep?
Having read about subtle drowsy signs that precede eye rubbing, you saw none before 12 noon?
Yesterday and today: are you actually doing the nap drill as described in my book?
Have usually sleeps for 11.5-12 hours at night (bedtime at 6pm (then fall asleep 630pm-645pm, based on observations in sleep monitor), wake up at 630pm. Over the past two nights, I would say she genuinely fell asleep at 615pm (yesterday) and 640pm (previous night). You are correct about the wake up times.
On the subtle tired signs – nothing of her pre-nap time comportment suggests a slowing down of movement, no yawning, no sucking or fussing. She just enjoys sitting down to read or follows me around the house while I finish my chores. I am following the nap drill. Typically, I leave her for at least 2 hours if she does not nap. For the past two days, even though they have been nap disasters, her longest sustained sleep has been at 1pm. She sleeps for around 30-35 minutes during this time period before she wakes up. I give it another 20-30 minutes before getting her up at 2pm.
My initial thought was that she might be a little overtired (rubbing eyes) and that a temporary earlier bedtime and earlier nap time might allow her to repay a sleep debt and lead to regular naps.
But her long latency to sleep onset at night (30-45 minutes) and the failure to nap and her long night sleep duration suggests that maybe she would do better on a later schedule (as you have suggested).
How do you feel about abandoning my initial plan and instead try for 3-5 days:
Based on subtle drowsy signs soothe her to sleep anytime between 12-2pm without trying for a regular clock time, but always give a nap opportunity.
Do not wake her in the morning.
Based on what happens around nap time, there will be variability but soothe her to sleep at night anytime between 5:30-7:30pm based on subtle drowsy signs.
Subtle drowsy signs are best observed when she is alone with toys (no screens or parental involvement).
Please do not attempt to keep her up past the time of subtle drowsy signs.
Monitor and record sleep times and latency to sleep onset.
The attempt here is to synchronize sleep with her own natural body’s need to sleep and for now, ignore clock time.
How does this sound.
That makes sense. I can run with that. Would you suggest continuing the 530pm bedtimes on poor nap days and begin the nap time routines towards a say 1230pm nap time as a starting point? In your opinion, should nap times vary day to day based on morning wake up time or stick to a by the clock nap time?
For the next 3-5 days, please abandon any notion of a clock-time schedule and watch her mood and behavior carefully to get a handle on when she might best need sleep. That’s why I wrote
“Based on subtle drowsy signs soothe her to sleep anytime between 12-2pm without trying for a regular clock time..”
“Based on what happens around nap time, there will be variability but soothe her to sleep at night anytime between 5:30-7:30pm based on subtle drowsy signs.”
So for the next few days, expect variability in the timing of naps and bedtimes.
Our hope is that by synchronizing soothing to sleep with drowsiness, the latency to sleep onset will be shorter and naps will occur more often.
Questions?
How dark and quiet is her bedroom for naps?
Her bedroom is cave dark and quiet (we live in the woods). We have a white noise machine on and the temperature set to a warm 65 degrees. Nothing has changed as far as sleep environment goes since she was an excellent sleeper all the way to 15 months of age. So far, i haven’t had a day of naps since abandoning the 12pm naptime. she doesn’t show sleepy signs and all the way to 1pm she is still active and asking to read books. she woke up at 5:55am today and i put her down at 1215pm, she did not nap a wink, even though 6 hours and 20 minutes seems well past when she is supposed to nap. do you have any guidance on a time range i could go by after her morning wake up to determine when to put her down for her nap? This is exhausting, especially between juggling a full time job at home and raising her by myself.
Understood.
Previously, I wrote:
“Based on subtle drowsy signs soothe her to sleep anytime between 12-2pm without trying for a regular clock time..”
“Based on what happens around nap time, there will be variability but soothe her to sleep at night anytime between 5:30-7:30pm based on subtle drowsy signs.”
Because she is not showing subtle drowsy signs around up to around 1pm, please experiment with a nap onset time around 1:30-2;00Pm.
Thank you. Perhaps i am being too conservative here, so you are saying it is possible her nap time may be over 7 hours after her morning wake up time?
I agree that that is a long stretch, but correct me if I’m wrong, she shows no sleepy signs around 1:00PM so I think it’s worth a try for a few days.
Please describe the usual duration and activities you do to soothe her for a nap. Do you think that spending a longer time to soothe her at naptime might help her nap better?
Please clarify or correct my impression which is that for a long time she has not napped at all or had brief naps frequently but surprisingly, shows no sleepy signs on those days around 4-5 pm or earlier.
My suggestion is to offer a nap opportunity (but try this at 2pm at the latest even if you see no drowsy signs) and bedtimes based on drowsy signs ever day for a few days
Looking ahead, if this strategy fails:
A. Another strategy might be to always keep her up a little late at night and always wake her in the morning to deliberately shorten night sleep a little in an attempt to have regular and long naps. The problem with this strategy is that there are conflicting goals;
1. Keeping her up later means less night sleep.
2. Keeping her up later might cause presleep arousal which makes it harder to fall asleep and/or stay asleep.
Trial and error is usually needed to find a sweet spot for this to work.
B.My nap study was based on 172 infants in my practice and they were all napping at 24 months of age, but it is possible that some children out grow naps before then. One possibility is that she is beginning to outgrow naps.
If so then you might consider offering a nap opportunity only on those days when she shows drowsy signs midday. This means that their might be a lot of variability from day to day regarding napping and the bedtime. Another consideration might be that you forego naps entirely and always have a super early bedtime. This means that their is more consistency from day to day. Your life style and her behavior and mood might clearly indicate which consideration might make more sense.
I mention A. and B. now for you to think about but for now, please continue with trying a flexible schedule based on drowsy signs.
That makes sense and thank you for providing the two options to put her current sleep situation into perspective. I put her down for her nap at 130pm today (7 hours and 10 minutes after her morning wake up time) and she slept for about 45 minutes, which i still consider progress relative to the past few weeks. I will try putting her down at this time tomorrow again.
Just curious, were any of the toddlers in your study routinely put to bed at 6pm? Could a long period of early bedtimes potentially contribute to curtailed/premature phasing out of naps? Sleep needs decline with age, and naturally an early bedtime may mean “too much” sleep on the front end?
Please clarify or correct my impression which is that for a long time she has not napped at all or had brief naps frequently but surprisingly, shows no sleepy signs on those days around 4-5 pm or earlier:
That is correct, she does not show sleepy signs around 4-5pm but i have been routinely putting her down early (between 530pm-6pm) anyway. Putting her down later at night almost always backfires (she ends up getting less night sleep as she wakes up at the same time regardless of what I do – and tendency towards a nap does not change even with less night sleep).
Were any of the toddlers in your study routinely put to bed at 6pm? I do not know; my nap study did not include night sleep.
Could a long period of early bedtimes potentially contribute to curtailed/premature phasing out of naps? Excellent question. In well rested children, there is no correlation between day sleep duration and night sleep duration at age 4 months and three years but your specific question has not actually been studied.
Is her primary medical caretaker a pediatrician, pediatric nurse practitioner, family doctor, or other?
Does this person or do you have any observations that suggest that your daughter might have advanced or delayed development?
Correct me if I am wrong, but over the past many weeks whether she has had no nap or a brief nap, you have mostly used early bedtimes and in general, she does not awaken early at 4-5am to start the day. If so, at what times does she commonly start the day?
Tried putting her down at 130pm today and she was back to refusing her nap after a brief 20 minutes of sleep. I may try pushing it to 145pm tomorrow to see if would improve things. Again, no tired sign, although at one point she rested her head on the floor against a bag for a few seconds before resuming play (at which time I promptly moved her to her quiet bedroom to begin her routine. She was happily playing in a quiet room with the white noise on and being read to before lights off at 130pm. No mood changes or tantrums to suggest overtiredness.
I am awfully puzzled. I wish there was something I could do to get her to sleep during the day so she will be a better rested child.
Hi Dr Weissbluth, hope you are well. Read your book, did extinction, we exchange messages as my son’s extinction process took a couple of weeks when he was 3 months old… now he is 7month old. He sleeps in his room and crib. He sleeps well (still requires 1-2 feedings in the night). Started to think of moving him from crib to a floor bed. My husband thinks it might disrupt his sleep and we should wait fot when he stops night feeding. Would appreciate to hear your thoughts and experience on this crib to bed transition. Look forward to hearing from
You. Best, Gabi
I suggest that you let him ask for a bed when he is much older (see the brief comments in my book). Moving now may disrupt his sleep because he might feel lost in the oceanic new big space.
Will do. Thank you Dr. Weissbluth