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Articles and Updates from Phoenix Children's

May 24, 2022, Kirkilas, Gary, DO ,
Managing sleep regression in infants and toddlers
Managing sleep regression in infants and toddlers

New parents have a lot on their plates. Changes in a child’s sleep pattern can be stressful, so we spoke to Dr. Gary Kirkilas, a Phoenix Children’s pediatrician, to answer the most common questions families have around sleep regression.

What is sleep regression? What are the symptoms?

Sleep regression is when children who have already consolidated their sleep in the night suddenly have difficulty falling asleep or have increased nighttime awakenings.

Although sleep patterns are highly varied among children, there are some points along a child’s development where we see sleep regression more frequently. One of those points is between 18-24 months, or early toddlerhood.

This is the point where toddlers become more self-aware – developing fears of separation or the dark. They also tend to start having occasional nightmares at this age.

Parents may notice that their child starts resisting going to bed, especially when the lights go out or a parent leaves the room. It’s important to know that although sleep pattern changes can be challenging, there are ebbs and flows, and regressions are just phases that pass.

What causes sleep regression?

There are several causes of sleep regression and they aren’t always immediately apparent. Children experience sleep regressions differently and at different times. Some causes include:

  • Teething is a common culprit in infants and toddlers. The pain causes fussiness and difficulty falling asleep.
  • Any illness during a child’s development can also cause new sleep disturbances. This is seen with viral illnesses — such as the common cold — that cause congestion, making falling asleep tough.
  • The pain that accompanies ear infections can cause fussiness. Fortunately, most of these infections clear after 7-10 days, but may take up to 2 weeks before normal sleep routines resume.
  • Life or routine changes can impact a child’s sleep including a new daycare, moving to a new home, changes in nap times or changes to a parent’s work schedule.

How long does sleep regression last and what can you do about it?

Most sleep regressions only last 2-4 weeks if normal and consistent sleep routines are continued. Problems occur when well-intended parents change sleep routines to accommodate their child’s new sleep behaviors.

Don’t allow your child to sleep in your bed or stay in their bedroom before they fall asleep. While these accommodations are done with compassion in mind, they prolong the sleep regression.

Do provide compassionate reassurance and stick with a consistent bedtime routine.

Don’t add screen or TV time to a bedtime routine.

Do predictable and relaxing activities like bath time and reading stories before bed. Put the child down when they are sleepy so they can develop independence falling asleep. Use an appropriate transitional object for toddlers like a blanket or stuffed animal.

Don’t enter the room right away when an infant wakes up crying in the middle of the night.

Do allow the child an opportunity to self-soothe. Self-soothing is far better for both the child and the parent in the long run.

Don’t pick up or hold the child if you do enter the room.

Do give brief reassurance.

As frustrating and tiresome as this can be on parents, try to keep bedtime a positive and encouraging experience.

When do you need to see a doctor?

If the sleep regression is lasting longer than a month, it is a good idea to schedule a visit with your pediatrician or family doctor. They can help root out any potential causes to sleep regression and provide some advice on how to get them back to their sleeping routine.

Additionally, if a child is sick with a fever, or an illness is not improving, it’s always a good idea to schedule a sick visit with their pediatrician to rule out any conditions like an ear infection.

We hope these tips bring peace of mind to new parents, as well as a peaceful night’s sleep!

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