kids, kids Health

Signs of Sleep Regression in Toddlers

The toddler years are filled with growth and excitement, for both you and your little one. That’s why sleep is so important at this age—it helps both of you reset and recharge. So, when your toddler starts resisting their naps, stalling at bedtime, waking in the middle of the night, or even getting up for the day around 5 a.m., it can feel a bit unnerving, especially if your child has been a great sleeper until now.

If your toddler is suddenly struggling with all things sleep-related, you may be at a loss for what is happening. Unless your toddler is ill or has another medical condition, what you’re likely experiencing is a sleep regression, especially if they are between 18 months and 2 years old.

Here, we’ll walk you through what a sleep regression is and what it isn’t. You also will find information on the signs of sleep regression and when to reach out to your pediatrician. Here’s what you need to know to help your child regain a more peaceful, predictable sleep schedule.

What Is Sleep Regression?

As your baby changes and grows, their sleep patterns change, so it should come as no surprise that your toddler will experience a sleep regression from time to time. Sleep regression occurs when a toddler who is typically sleeping well suddenly refuses to take a nap, starts waking up at night, or wakes at night and refuses to go back to sleep. In older kids, it can mean waking at night or being unable to fall asleep at a decent time.

“I like to encourage caregivers to think of this [time] as a ‘sleep progression’ versus a ‘sleep regression,'” explains Tyanna Snider, PsyD, a pediatric psychologist with Nationwide Children’s who works in an integrated primary care setting and specializes in early childhood behavioral health. “Your child is developing, growing, and changing in many ways, and this includes sleep.”

Although sleep regression can happen at any point in a baby or child’s life, it often occurs during times of growth and development. Other factors that can influence sleep and lead to sleep regression in toddlers are teething, family conflict, moving, travel, stress, illness, and even a change in routine. With the exception of teething, these factors can affect older children as well.

“Usually, the most common reasons for sleep regressions have to do with developmental progression,” says Renee Turchi, MD, MPH, FAAP, a pediatrician and the medical director of the Pennsylvania American Academy of Pediatrics (AAP) Medical Home Program. “There are other factors, too, that can have an impact like moving rooms, getting a new sibling, or even visiting grandma’s house. Babies and kids are very aware of the cues of change.”

If you suspect that your baby has an illness or other medical issue, be sure to see their pediatrician. They can help you determine if your toddler’s resistance or inability to sleep is a sleep regression or something else.

Sleep Regression Signs

Just when you think you have mastered your toddler’s sleep patterns, they start experiencing sleep struggles again. Whether they are stalling at bedtime or refusing to nap, these disruptions in sleep can leave you both feeling tired and frustrated.

For this reason, it is important to be able to distinguish between the signs of sleep regression while also looking for other explanations for their sleep disruptions. Here are some of the most prominent signs of sleep regression.

Resisting Naps

Often, resisting naps is related to sleep regression. Perhaps your toddler is mastering a new skill or is really enjoying some new freedoms, like moving to a big kid bed. These new experiences and discoveries can make it hard for them to settle down and nap. The key here is to be consistent with your nap routine and even require quiet time if your toddler insists they are not tired.

Of course, it is also important to recognize that sometimes there could be other reasons your toddler is resisting their nap. For instance, Nikki Smith, MEd, NCC, NCSC, CSWC a certified pediatric sleep consultant with Sleep Wise Consulting, recommends watching and observing how much sleep your toddler is getting in a 24-hour period.

“Sleep regression can occur at a pivotal time in your toddler’s development,” Smith says. “Their sleep needs could be changing. Or, they could be making nap transitions—any big developmental milestones can cause disruptions or those regressions.”

If your toddler is getting the recommended 11 to 14 hours of sleep and you are still trying to get them to take two naps, it could be that they are ready to transition to one nap a day, she says.1 And, if they are an older toddler, it could be that they are getting ready to give up their nap altogether. As hard as it may be to say goodbye to naps, it is important to have realistic expectations of your child, Smith says.

Another reason toddlers resist naps is their growing sense of independence and autonomy, Smith says. If you believe this is the case with your toddler, she suggests trying to find ways for your toddler to have some control like allowing them to choose which book to read before a nap.

Waking Early

Sometimes waking early, like 5 or 5:30 a.m., can be a sign of sleep regression. Perhaps your toddler is learning a new skill and they are excited to start the day. Or maybe their budding independence has them jumping out of their toddler bed as soon as their eyes are open simply because they can.

Waking early also can be an indicator that their sleep needs are changing—either they are not getting enough sleep and are overtired or they are going to bed too early and need a slightly later bedtime. Again, Smith suggests watching for patterns in your toddler’s sleeping habits.

You should observe how long they are awake before and after their naps, how long their naps are, and what time they are going to bed at night. All of these things help you determine if your toddler is going through a sleep regression because their sleep schedule needs to be adjusted in some way.

Stalling at Bedtime

You have probably heard all of the excuses: “I need a drink,” “I have to go potty,” and “Just one more book.” Toddlers are notorious for their stall tactics at bedtime. But these stall tactics also can be a sign of sleep regression.

Perhaps your toddler is simply testing the boundaries. Or, maybe they are struggling with separation anxiety and need a little more reassurance. Whatever the reason, there is something at the root of their sleep regression and once you figure out what that is, you can help your toddler get back to sleeping well.

“It is important to remember that sleep regression never really happens in isolation,” explains Dr. Turchi. “It always occurs in conjunction with something else.”

If your toddler is stalling at bedtime, it is important to stick to your routine and reinforce bedtime boundaries like staying in bed. Even though they naturally push to see where the boundary lies, toddlers feel safe with limits, says Smith. Also, sticking to your guns helps to establish a foundation of good sleep hygiene which can benefit your child throughout their life.

Struggling to Stay Asleep

All people wake up throughout the night, but those with strong self-soothing skills can roll over and go right back to sleep. If you find that your little one is waking in the middle of the night and calling out to you, it could be related to something as simple as discomfort from teething causing the sleep regression. If this is the case, talk to your pediatrician about the best way to handle those emerging 2-year molars.

As mentioned earlier, hitting developmental milestones as well as separation anxiety can cause toddlers to wake at night and ultimately lead to sleep regression. During these times, it is important to be patient and loving as well as reassure your child. But be sure you are still promoting good sleep hygiene by encouraging them to learn how to self-soothe and not bringing them into your bed.

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