Sleep regression in infants and toddlers

Just when you think you've got a handle on getting your little one to sleep through the night, he or she starts waking up frequently or refusing to sleep at all. Sleep regressions are common, especially during a baby’s first year, and can leave both you and your child sleepy and frustrated.

Elisa Basora-Rovira, M.D., a pediatric sleep medicine physician at Children's Health℠ and Assistant Professor at UT Southwestern, shares tips for handling sleep regressions in infants and toddlers to help you and child get back to a sleep routine.

What ages do children have sleep regression?

While every child is different, common sleep regression ages include:

• 4 months
• 6 months
• 9 months
• 12 months
• 18 months
• 2 years old

These sleep regressions often last for two to six weeks, depending on the child.

Why do sleep regressions happen?

"During the first year of life, your child’s brain is developing quickly," explains Dr. Basora-Rovira. "Those changes can lead to changes in their sleep."

Different milestones, such as rolling over or crawling, can be associated with sleep regressions. These changes mean your child moves more at night, which may wake him or her up more frequently. Children’s bodies also release a lot of growth hormones in the first year of life, helping them get bigger and grow teeth. This hormone releases can be linked to disturbed sleep.

Dr. Basora-Rovira says infants are also developing a circadian rhythm. This rhythm helps children’s brains recognize light and dark so they know when to sleep and when to wake. Without this rhythm, it may be harder for their brains to stay asleep.

How to handle a sleep regression

While Dr. Basora-Rovira says that sleep regressions can’t be avoided, parents can take steps to help their children quickly return to a healthy pattern of sleep. You can help your child develop his or her circadian rhythm starting at 4 months old.

"They need to have a good and consistent sleep routine and hygiene," says Dr. Basora-Rovira.

She says a good sleep routine includes the same steps every night. For example, you may start with a bath, then care for your child’s dental hygiene, read a story or pray, then sing a song. All of these steps help train your child’s brain to know when sleep is coming.

Good sleep hygiene also means have a great environment for sleep. Your child’s room should be:

• A cool temperature
• Dark or with only a dim nightlight
• Quiet or only a low-volume white noise machine
• Completely screen-free

"Good sleep hygiene helps sleep regression and other sleep disturbances," says Dr. Basora-Rovira. "It helps for life. Even as adults, we should all have these routines."

Habits that can make sleep regressions worse

Dr. Basora-Rovira says that some things, such as changing where your baby sleeps, can make sleep disturbances worse.

Once your baby is feeding well, you should also stop feeding him or her right before sleep. If children fall asleep while feeding, they may wake up confused that they aren't still feeding.

Similarly, Dr. Basora-Rovira says you should always put babies down in the crib when they are drowsy. If you hold babies until they fall asleep, they may be upset when they wake up alone.

How much should your baby sleep?

Dr. Basora-Rovira says its normal for children to have some arousals or awakenings through the night if they return back to sleep. Parents should make sure their child is sleeping enough time. This sleep is vital for their development, helping their brains and bodies grow. In general:

• Newborns should sleep 16 hours per day
• 1-3 month olds should sleep 15 hours per day
• 6-12 month olds should sleep 14 hours per day
• 2-year-olds should sleep 13 hours per day

"Not every baby in the same family will sleep the same," says Dr. Basora-Rovira. "Some will need to sleep more. Some will need to sleep a little less, so parents shouldn't compare their new baby to other kids."

With time, your child will be able to sleep longer and longer without waking up thanks to his or her circadian rhythm. If you follow a good sleep routine and good sleep hygiene, they'll get all the sleep they need throughout childhood.

Learn more

Concerned about your child's sleep? See more reasons your baby might be having trouble falling asleep and tips to make sure they are sleeping safely. For more questions, talk to your pediatrician or contact the Children's Health Sleep Disorders Center.

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