Sleep Rules are designed for older children who understand consequences. These are described in detail on page 309 in Healthy Sleep Habits, Happy Child.
One family instituted this five-step program when their daughter, Nicole, was 26 months old—after 26 months of poor sleeping. She had always had difficulty falling asleep and difficulty staying asleep. Nicole always wanted to, and did, get out of her bed and go into her parents’ bed. After the birth of Daniel, her brother, her parents decided this had to stop.
Their record showed the following results:
Night 1: Between 8:13 and 9:45 p.m.—69 return trips to bed. Slept until 8:30 a.m. with one brief awakening at 2:15 a.m.
Night 2: Between 8:20 and 10:30 p.m.—145 return trips to bed. Slept until 7:20 a.m. with one brief awakening at 2:15 a.m.
Night 3: After 9:14 p.m. (bedtime)—0 return trips to bed! Slept until 7:40 a.m., awakening once at 3:20 a.m.
That’s it!
An important point to note is that almost all of Nicole’s getting out of bed occurred within the first hour or two of the night. Many children follow this pattern, so don’t expect that you will necessarily lose a complete night of sleep during this training period.
Here is a mother’s story about her daughter, Zaylin. She was cared for at a nationally ranked academic pediatric center and was so severely impaired that her psychologists and psychiatrists thought she was autistic. Sleep Rules were used with positive and negative contingencies, Mom got Dad to put her to bed at night, and the bedtime hour was moved much earlier.
My daughter Zaylin was born with complex birth defects requiring multiple surgeries and prolonged hospitalizations during her first few years. The consequence of this medical history, that resolved approximately one year ago, at age five years, is that 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 [Individualized Education Plan] as she struggled with academics in school. In addition, she was very mean and nasty to her brother and very defiant at bedtime. I sought out many therapists and advice in an effort to help her, but nothing seemed to work. Part of the stress for me was Zaylin’s struggles and also, the difficulty for doctors to properly diagnose her problem. 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. She loves them and has plenty of them on her bed. 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 9:00 p.m. and we moved it to 6:00 p.m.It was not until I got Zaylin on a better sleep schedule, at age 6 years, that I realized that 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! The sleep strategy allowed Zaylin to sleep longer through the night without any more bedtime battles and her improved behavior in school was noticed by her teachers, and, at home, she turned into an entirely new child, saving my daughter and our family.
Two years after her mother wrote her story, her bedtime is 7:00 p.m. and she continues to thrive academically, socially, and artistically!
Could you use the sleep rules for a 2 year old that is refusing to nap but it seems that he still needs the nap?
Please read the section on ‘Sleep Rules’ in my book to fully understand why they are probably not useful for a 24-month-old.
What bedtime do you suggest for a child who is 4 years 4 month old who does not nap? I have used a 5 PM bedtime for him many times in the past when he was younger. And he would still wake up at his normal time in the morning, giving him a very long night stretch, which was great. I’ve noticed since he was four years old, if he has a day that he does not nap and I put him to bed at 5 PM he only sleeps for 12 hours overnight and then Is awake extremely early in the morning. I then get into a vicious cycle where he does not nap the following day because he is overtired by the time we get to his normal 12:30 PM nap nap time. Do you have any suggestions? Thank you!
Does he have any respiratory allergies?
Please sit at his bedside for 10-15 minutes at night when he is asleep to see there is snoring, mouth breathing, or respiratory pauses.
Is he unusually intelligent, creative, or gifted?
When he falls asleep around 5pm, when does he awaken in the morning?
On the 4th birthday, about 50% of children are napping, 5 days/week.
On the 5th birthday, about 25% of children are napping, 4 days/week.
Would like to continue to attempt naps? If so, because of the pre-sleep arousal (“refused 12:30p nap attempt today, was clearly on a second wind by 11am”) consider starting the nap earlier (perhaps 11:30-12:00) on days he shows drowsiness late in the morning from an early wake-up time.
One idea is to try for a nap only on days when he awakens very early and another idea is to attempt a nap every day.
It might take a several days trial to determine whether either is, or is not, a good strategy.o
How does this sound?
No to all of the questions on allergies/mouth breathing/gifted.
Last night he fell asleep by 5:15pm and then woke up 5:20am. Tonight I put him to bed at 5pm after not napping again and he was asleep 5:30pm so I expect he will sleep 12 hours then be awake by 5:30am tomorrow morning (refused 12:30p nap attempt today, was clearly on a second wind by 11am after being awake SO early today)
That sounds good. I do plan to continue to offer naps. Will try for the earlier adjusted nap time based on drowsy signs on a day with a very early wake up. Thank you!
Dear Dr. Weissbluth,
I’d appreciate your guidance on nap refusal in my 22 month old.
She is on a one-nap schedule and since about 1 year old has had a consistent early bedtime between 5:00–5:40 pm (occasionally 6:00 pm after a long nap). Bedtime is almost always very smooth, and during the day she is generally happy and energetic, with only typical toddler mood variability.
Previously, her nap occurred around 10:30-11:00 am. Then she began refusing that timing and would only go down easily if the nap was later, around 11:30–12:00. However, over the past few days, she has not seemed tired enough even at noon.
For example:
• We put her down twice (around 12:00 pm and again around 1:15 pm).
• Both times, she seemed completely alert, not tired at all, just calmly talking/babbling in bed, alternating between sitting, standing, and lying down.
• She did not appear hyper or “second wind”-like.
• Even after ~7 hours awake, she still could not fall asleep, including with assistance.
On another recent day with a similar late timing, she was clearly very tired (“melting”) and took a 1.5-hour nap in our arms.
I read your section on nap refusal at this age, but this doesn’t seem like chronic overtiredness given her long nights and early, consistent bedtime.
My questions are:
1. How should we interpret nap refusal when the child appears calm and not tired, even after a long wake window?
2. In this situation, should we keep trying to assist the nap or stop and move to early bedtime?
3. Does this suggest a shift in nap timing, or just day-to-day variability?
Thank you very much for your guidance.
Because of her age, please continue to offer nap opportunities. How about a 4-5 day trial of soothing her to sleep for a nap around 1:30-2:00pm. If she naps well at this later time, be prepared to shift the bedtime to a later time, based on drowsy signs.
How does this sound?
Sounds good. I will try that. Thank you!