Stress Busters: Sleep

Sleep phases in newborns

Babies have different sleep cycles than adults. Babies spend much less time in rapid eye movement (REM) sleep (dream-time sleep) and tend to wake up more. Babies are also different in how alert they are during the time they are awake.

Quiet alert phase

When a newborn wakes up at the end of the sleep cycle, there is typically a quiet alert phase. This is when the baby is very still, but awake and taking in the environment. During the quiet alert time, babies may look or stare at objects, and respond to sounds and motion. This phase usually progresses to the active alert phase. This is when the baby is attentive to sounds and sights, and moves actively.

Crying phase

After the quiet alert phase, there is a crying phase. The baby’s body moves erratically, and they may cry loudly. Babies can easily be overstimulated during the crying phase. It’s usually best to find a way of calming the baby and the environment. Holding the baby close or wrapping them snugly in a blanket may help calm a crying baby.

It’s usually best to feed babies before they reach the crying phase. During the crying phase, they can be so upset that they may refuse the breast or bottle. In newborns, crying is a late sign of hunger.

Parents should watch for changes in a baby’s sleep pattern. If the baby has been sleeping consistently but suddenly is waking more often, there may be a problem. The baby may also be going through a growth spurt and need to eat more often. Some sleep changes are simply due to changes in development or because of overstimulation.

See CHOC’s article, “Babies and sleep: The utlimate guide” for sleep schedules and more tips.

Newborn sleep: Frequently asked questions

What are the symptoms of sleep problems in a baby? 

Uh oh! Your baby used to sleep all night, but now they’re waking up again! Don’t worry, this is super common around 6 months old. It might seem frustrating, but there is a reason for it. This is often a normal part of development called separation anxiety. This is when a baby does not understand that separations from their parents are temporary. Another reason your child might wake up more is because they are too tired, which makes it harder for them to fall asleep. 

Common responses of babies having these night awakenings or trouble going to sleep may include the following: 

• Waking and crying one or more times in the night after previously being able to sleep through the night. 
• Crying when you leave the room. 
• Refusing to go to sleep without a parent nearby. 
• Clinging to the parent at separation. 
• Illness. 

What are signs that my baby is tired? 

You can help your baby sleep by recognizing signs of sleep readiness, teaching them to fall asleep independently, and comforting them with awakenings. Your baby may show signs of being ready for sleep by: 

• Rubbing eyes 
• Yawning 
• Looking away 
• Fussing 

How can I help my baby fall asleep? 

Babies may not be able to create their own sleeping and waking patterns. Not all babies know how to put themselves to sleep, and not all babies can get themselves back to sleep once awakened at night. 

Here are things parents can do to help babies learn how to fall and stay asleep: 

• Allowing time for naps each day as needed for the baby’s age. 
• Not having any stimulation or activity close to bedtime. 
• Creating a bedtime routine, such as bath, reading books and rocking. 
• Playing soft music while the baby is getting sleepy. 
• Tucking the baby into bed when they are drowsy, but before going to sleep. 
• Comforting and reassuring the baby when they are afraid. 
• For night awakenings, comfort and reassure the baby by patting and soothing. Don’t take them out of bed. 
• If the baby cries, wait a few minutes, then return and reassure with patting and soothing. Then say goodnight and leave. Repeat as needed. 
• Being consistent with the routine and responses. 

How can I help my baby sleep safely? 

Safe sleep is critically important. Here are recommendations from the American Academy of Pediatrics (AAP) on how to reduce the risk of sudden infant death syndrome (SIDS) and other sleep-related infant deaths from birth to 1 year old.

The ABCs of safe baby sleep: 

• A is for alone. Put baby to sleep alone in their crib. Keep soft items like toys, crib bumpers and blankets out of the crib. 
• B is for back. Make sure to lay a baby down to sleep on their back. “Back to sleep” is safest to reduce risk of SIDS. 
• C is for crib. Babies should sleep on a firm surface such as a crib, bassinet or portable crib that meets safety standards. 

Get more advice about safe sleep from CHOC.

Between the ages of 1 and 3, toddlers start sleeping differently. They notice how fun the world is around them and want to play. Their busy minds also develop an imagination, and this can also make it hard to fall asleep. It’s okay, though. We can help them learn to love bedtime. Below are some facts about toddler sleep and some ideas to make bedtime easier: 

• Toddlers need 11 to 14 hours of sleep every 24 hours. Around 10 to 12 hours can be during the night, and 1 to 2 hours during the day, however each child is different.  
• Many toddlers drop from two naps to one between 12 and 18 months, but some not until they are 2. 
• Establishing a routine is important because it helps with healthy sleep patterns. The toddler will know when wind-down time is happening and it won’t feel like bedtime is suddenly coming out of nowhere for them. A common bedtime routine for a toddler could look like this: 
  • 7 p.m.: Brush teeth and change diaper 
  • 7:15 p.m.: Read a book together and sing a lullaby 
  • 7:30 p.m.: Get into bed and say goodnight  
• It is important to stay active during the day to help tire them out. Look through the other Stress Buster Guides for examples of play in nature or even mindfulness activities! 
• Decreasing or avoiding screen time at least two hours before bedtime is recommended by the American Academy of Pediatrics. 
• This is the age that toddler’s imaginations begin to run wild and they imagine things like monsters under their bed. Get advice from CHOC about how to help your child cope with night terrors and nightmares.
• Sleep can be interrupted by jet lag from vacation, new environments, sleep regressions, milestones, teething pain or illnesses, and in order to help your child with these things, they may need extra cuddles, hugs and kisses and that’s OK! Eventually though try to stick to your routine in order to keep these sleep challenges temporary. 
• Separation anxiety is real during this age. You can remind your child you’re just outside the door, that you love them, and you will see them in the morning. Short and sweet sentences, and oftentimes distractions help.  

Why Preschool-Aged Children Need Sleep

Sleep is important for preschoolers as it helps them grow, learn, and feel happy. During this stage there are some changes to sleep to look out for, such as giving up their afternoon naps. Regardless of these changes, the importance of a sleep routine continues to play an important role in this age’s sleep process. Below are some facts about preschoolers’ sleep: 

• Preschoolers need about 10 to 13 hours of sleep each day, including naps if they still take one.  
• Losing a naptime can transition into an hour of quiet time instead for your child where they read books, relax, and recharge 
• Sometimes parents run into sleep problems during bedtime because preschoolers can take awhile to settle and go to sleep. 
• It is important to continue a consistent and calming bedtime routine to help them get ready for sleep. A bedtime routine at this age should include: time to brush their teeth, use the bathroom, read a book, sing a song, cuddle, and then go into bed and say goodnight.  

Nightmares and Night Terrors

Night terrors and nightmares are common around this age and can be distressing for children, and for their parents who never want to see their child so upset. To read more about it, please visit here.  

What are night terrors?  

A child experiencing night terror is partially awake and showing other behaviors, such as screaming, kicking, panic, sleepwalking, thrashing or mumbling. Though it is hard to watch your child experience this, night terrors are harmless, and each episode will end in a deep sleep.  

How to talk to your kids about nightmares

A nightmare is a scary dream that awakens a child and makes them afraid to go back to sleep.  

According to the Children’s National Medical Center, you can teach your child during the daytime about what dreams are — the good and the bad ones. Below is an example of what you can say when introducing the topic. Then you can engage your child in imaginary play during the daytime where she pretends to have good or bad dreams, but can stay in her room and feel safe.   

Did you know that our imagination works even when we are sleeping? In good dreams your imagination puts you in happy, fun places. You can even pretend to be swimming or playing or running – but it’s your imagination. But really, you are still asleep in your bedroom. In bad dreams, your imagination puts you in scary, bad places, sometimes with scary, bad things or people. It feels very, very real, but it is just your imagination. You are still asleep and safe in your bedroom. When you open your eyes and look around the room, you will see that you are home and safe, and that Mom/Dad/Caregiver is nearby. Then you can go back to sleep.  

The next step is to help prepare the child for what to do after a bed dream. Here is one way to talk about it. 

When you have a bad dream, first, turn on the light and look around to see you are in your own room. Find your special bear, snuggle down tight, and go back to sleep. You can even leave the light on in case you want to look around some more. 

After explaining the directions to take, please know that your child won’t be able to do it on their own for awhile. After a nightmare, it is hard for to think rationally so it is important for you to go to them and walk them through the steps. This consistency and modeling of what to do will help your child gain the confidence they need to eventually do it on their own.  

As we can see, as children age there are new developments in their sleep habits. While it might seem like your school-age child (5- to 11-year-olds) might have boundless energy, they still need sleep to help them rest and restore for the next day. Let’s dive into the world of sleep and explore how to best support your child’s healthy sleep habits.  

• At this age, your child needs 9 to 11 hours of sleep at night.  
• Your child’s bedtime and wake-up time should be at the same time every day. During breaks and summertime, a sleep schedule may loosen up, however it is best to keep it as close as possible to their regular sleep schedules. This way there is less of an adjustment period when they have to go back to school.  
• Your child’s bedroom should be comfortable, quiet, and dark. A night light is okay, as completely dark rooms can be scary for some children.  
• Your child’s bedroom should be a comfortable temperature during the night (less than 75 degrees). 
• Your child should not go to bed hungry. A light snack before bed is a good idea, however, avoid excessive fluids prior to bedtime.  
• Avoid caffeine like sodas, coffee, tea and chocolate, especially in the late afternoon and evening.  
• Bedtime routines can include things like taking a warm bath/shower, brushing teeth and washing up, cuddling with a parent, reading a book with a parent or individually, journaling, or meditating  
• The hour before bedtime should be quiet time. Your child should not get involved in high-energy activities like rough play, playing outside, or watching exciting TV shows or movies. Baths can also be a stimulating activity for some children.  
• Your child should spend time outside every day and be involved in regular exercise. However, your child should not engage in vigorous activity one to two hours before bedtime.   
• Try to encourage your child to use their bed for sleep only, and to do homework, reading, or other activities in other locations in the home.  
• To read more about this age’s sleep habits, please check out this blog from CHOC.  

How to help your teen get sleep

Teens are well known for not getting enough sleep, but they still need it for their growth and development! However, many teens struggle to get enough shut-eye. Early school start times clash with their natural sleep patterns, making it tough to wake up and feel refreshed. On top of that, homework, sports, and social activities push bedtime later and later. Here are some sleep hygiene guidelines for teens.

• Teens need between 9 to 9.5 hours of sleep. 
• Encourage your teen to wake-up and go to bed at the same time on school nights and non-school nights.  
• Even though the temptation is strong, try to encourage your teen to not sleep in on the weekends to catch up on sleep. This makes it more likely they will have sleep problems 
• Try to encourage spending time outdoors. Exposure to sunlight helps keep the body’s internal clock on track. 
• Avoid eating or drinking products containing caffeine after dinner. These include sodas, coffee, tea, chocolate and sports drinks.  
• Sleep deprivation in teens is common and can be associated with engagement in high-risk behaviors and can put a teen’s life in danger. 

Technology and Teen Sleep 

Another thing that impacts a teen’s sleep is their phone and devices usage at night. It can be a big part of their routine throughout the day, and also part of the evening process where they stay up late scrolling or texting. But blue light from our devices glaring at us at night can confuse our bodies into thinking it’s still light outside, making it harder to fall asleep. Also, just using a device at night can be stimulating, keeping our brains on alert as our bodies are trying to wind down.

Here are some tips to balance tech usage at night:  

• Set tech expectations. Use a Family Tech Planner to talk about the parameters of social media and the internet. This helps teens think critically about their tech usage and what a healthy relationship with technology can look like.  
• Create a screen-free routine for the evening and introduce reading or listening to a podcast or audiobook to help settle down for the night.  
• Block the blue light by using “night mode” on devices after sunset.  
• Consider putting everyone’s phones in a central charging area 1-2 hours before bedtime 
• Pre-program phones to disconnect or shut off at a certain time 
• Instead of your teen using their phone as an alarm clock, they can use a traditional one.  
• Model for your teen putting away devices at night. It can be hard for adults to do, but when we walk to the walk, they are more likely to listen.  
• To read more about kids and technology, check out Common Sense Media and this article.