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Your Toddler's Sleep Problems: Solved!

Your Toddler’s Sleep Problems, Solved

By Elizabeth Heubeck

Does your toddler stubbornly refuse to naps despite exhaustion, insist on providing you with multiple wake-up calls throughout the night or think that 4:00 a.m. is a perfectly reasonable time to start the day? If you answered yes to any of these questions, chances are your household contains one extremely sleep-deprived child, and at least one, probably two, equally exhausted parents. But it’s not too late to reverse poor sleep habits. Here’s how.

Resisting naps

Most toddlers, true to their nature, will resist their parents’ will every chance they get. Naps rank high on the toddlers’ resistance scale. “Toddlers will do anything to stay up,” says Barbara Howard, MD, Assistant Professor of Pediatrics at Johns Hopkins and Co-director of The Center for Promotion of Child Development through Primary Care. When a toddler resists loud and long enough, parents are likely to give in—especially if the child doesn’t seem tired. That’s when children often fool mom and dad. “Sometimes they just go faster and faster when they get tired,” Howard says. The bottom line is this: “You can’t count on a child to tell you he’s sleepy. You have to set the structure,” Howard explains.

Like all good things, naps eventually come to an end. Howard believes that most children need a nap until they’re close to four years old, but that many toddlers today drop the nap earlier because they have mom and dad believing that they don’t need it. How can you tell for sure when your child is truly ready to let go of napping?
“When the child, no matter how well you structure his nap time, takes more than 20 minutes to fall asleep during nap time or takes less that a 20-minute nap,” Howard suggests.
For the majority of toddlers who do need naps, not getting one can lead to other sleep problems.

Night waking

Sleep deprivation during the day may actually lead to further sleep troubles at night—seemingly illogical, but true. Researchers have linked sleep deprivation to a rise in the body’s level of cortisol, a stress hormone. High levels of cortisol may cause disturbances in sleep patterns, making it difficult to stay asleep. In toddlers, this may mean a greater risk of those dreaded night wakings.

“If they [toddlers] are getting to bed too late, or they’re nap-deprived, their bodies secrete more cortisol. So it takes them longer to get to sleep, and they’re getting a poorer quality of sleep,” says social worker Kate West, LCSW-C, also known as the Sleep Lady, and author of the book Good Night Sleep Tight (CD Books, 2005). Therefore, it’s important to maintain a regular sleep schedule that includes regular nap and nighttime sleeping.
Separation anxiety and nightmares also wake toddlers at night. Because toddlers can’t always express themselves, parents may not know which of these is the culprit. Howard explains how parents can tell the difference.
“A big clue is how children respond to their parents,” says Howard. “If parents are able to console their child instantly, it probably wasn’t a nightmare. If the child appears frightened and requires more time [to be consoled], it was more likely a nightmare.”

So, how do you solve these problems?
Getting rid of fears may require some “exorcism” before bedtime, Howard explains. “Monsters crop up because of a child’s rich imagination. If so, you have to express some good feelings before bedtime,” Howard says. She suggests “spraying” the room to get rid of monsters, checking the closets with your child—whatever works to convince him that the monsters are gone. Guided visualization—thinking about positive images—may work for some older toddlers too, suggests West. Before bedtime, parents may tell their toddler to think of a trip to the playground, a walk in the park—anything pleasant—to induce sleep.

What about separation anxiety, and why does it occur at night?
“By night, some children haven’t filled their tank yet with their ‘parent connection’,” Howard says. “They can’t go back to sleep if they’re thinking about missing mom or dad,” she adds. Although there’s no real substitute for mom or dad, both Howard and West support the use of “lovies”—objects that can be cuddled throughout the night. “They allow the child to make that transition away from mom,” Howard says.

Early risers

Waking up before your body is truly ready to can ruin your whole day. Just ask any parent of an early-riser toddler. But what can you do if your toddler insists on getting up at 4:00 am? A couple of things.
First, determine if your child’s total number of daily sleep hours adds up to an acceptable amount. (See sidebar as a reference.) If your 2-year-old takes a three-hour nap during the day, and you put him to sleep at 7:00 pm, he may indeed be ready to wake up at 4:00 am. Unless you want to rise that early, you may want to curtail the nap or put him to bed for the night a little later.

Sometimes, toddlers wake up early against their body’s wishes—and yours. Why? Oftentimes, it’s because they know there’s something to gain by it. The reward may be as simple as getting into mom and dad’s bed, eating breakfast or watching cartoons. Howard suggests that parents try placing a musical alarm clock in their child’s room and instructing the child not to get out of bed before the music begins.

However frustrating they are, most sleep problems can be resolved in a few weeks if parents commit themselves to using common-sense strategies. If problems persist, parents may want to consult their pediatrician. “Common medical problems such as asthma or sleep apnea are sometimes a cause for sleep disturbances. You want to rule these out if these simple techniques haven’t worked,” West says. BC

How Much Sleep Do Toddlers Need? *

At 18 months:
•Nighttime sleep: 11 ¼ hours
•Nap: 2 ¼ hours
•Total: 13 ½ hours

At 2 years:
•Nighttime sleep: 11 hours
•Nap: 2 hours
•Total: 13 hours

At 3 years:
•Nighttime sleep: 10 ½ hours
•Nap: 1 ½ hours
•Total: 12 hours
* adapted from Richard Ferber’s book, Solve Your Child’s Sleep Problems (Fireside, 1986)

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