Q. I have a query in relation to the dreaded sleep problem for our one-year-old son. He keeps waking up around 2am and finds it impossible to go back to sleep. He is not wide awake but seems to be unable to settle himself back to sleep. We have tried to stay in the room and pat his back or even bring him into our bed. Although he might stop crying after a while, he still finds it very difficult to settle and keeps tossing and turning. I would really appreciate if you have any advice as we are both working full-time and are getting increasingly exhausted being up all night. He has never been a brilliant sleeper but it has gotten worse rather than better lately. He would nap for roughly one and a half hours during the day, but is not too fond of going down for his naps.
A. Getting your child to sleep through the night is a long-term journey with many pitfalls and setbacks. While some parents find themselves lucky with a baby who sleeps through the night at a young age, these children are in the minority. Many other children have intermittent sleep problems throughout the baby and toddler years and some do not get into fully regular night sleeping until three years of age (or older).
In addition, sleep problems can start at any time in the first few years of a child’s life. When their baby first sleeps through the night at 12 weeks, parents may proudly think they have the problem solved, only for their child to start having sleepless nights at six months of age or older, when he/she goes through a period of sickness or takes a new developmental step, or simply becomes more attached to his/her parents.
Tackling a sleepless one year old or toddler is, in many ways, much harder than doing the same thing with an infant or an older child. At one year of age, your child is old enough to be attached to you and to seek you out in the night for comfort, yet he is too young to understand the reasons for sleeping in his own room at night. As parents you need to make sure he does not feel rejected or abandoned.
To help your son have more settled sleep it is important to step back and take a holistic view of his sleep pattern, considering his daytime as well as his night-time routine.
During a night’s sleep, children tend to go in and out of deep sleep and normally wake briefly a few times before falling back asleep. Some young children seek their parents to comfort them when they wake, and some become dependent on their parents to support them getting back to sleep.
If a child is overtired, unsettled or sick, their natural sleep pattern is disrupted and they are more likely to wake and more likely to call their parents. The key to sleep training is to help your child have a more relaxed, rhythmic sleep and to learn how to self-soothe and return to sleep by himself if he wakes. Although it is important to have a clear plan on how to respond when your child wakes at night, the best place to start sleep training is during the day, in particular ensuring a relaxed bedtime and nap routine.
Children who have good naps and who are well rested during the day tend to sleep better at night. To improve your son’s night-time sleeping, you can try to improve the quality and length of his naps.
Generally, these naps should occur early in the day and ideally in his own cot (so he associates his cot as a place of rest and sleep). To help him learn to self-soothe, the key is to bring him to his cot when he is sleepy but not fully asleep, so he takes the final step of getting to sleep by himself.
Parents often assume that a child who is unsettled at night is not tired and thus needs to go to bed later, when in fact the reverse is true. Children who are unsettled at night tend to be over-tired and need to get into the habit of going to bed earlier rather than later.
For this reason, starting a relaxing bedtime routine much earlier than usual can make a big difference to a good night’s sleep. This should involve the same steps each night, such as quiet playtime, bath time, putting on pyjamas, reading a story/listening to music, etc, and finishing once again with your son making the final step of going to sleep by himself. If this is a new habit for your son, you may have to be initially present to support him going asleep, but over the course of a few nights you can gradually withdraw.
When dealing with your son’s night-time waking, the key is to help him get back to sleep with as minimal support from you as possible and in a manner that is least disruptive to you as parents. This might mean first waiting to see if he settles himself after the first few cries, or then going in and simply patting him quietly without picking him up, rocking him for a few minutes before putting him down again or taking him into the bed with you, as you do now.
If taking him into your bed is not working for you, some couples consider the alternative of lying beside their baby in his room for a few minutes, which has the advantage of him learning to go back to sleep in his own cot. Once you have a pattern of settling him at night, then you can choose to gradually reduce your support over the course of subsequent nights (for example, just pat him rather than pick him up, or try to support him falling asleep in his cot rather than taking him into your bed, etc) as he learns to sleep himself.
Finally, dealing with sleepless nights is stressful and it is really important that you look after yourselves as parents. Many couples I have worked with take turns for the “night duty”, so they at least get an alternate decent night’s sleep.
Dr. John Sharry, Irish Times, April 2010. John writes in the Irish Times Health+ every Tuesday.