What to do when your toddler keeps waking up at night

Linda and Steve Botelho thought they were “golden” when daughter Isabella finally started sleeping through the night, just before her first birthday. A month earlier, with Linda facing the return to work, Isabella was still waking every two or three hours most nights. “I knew I wouldn’t be able to cope with that when I was back to work, so we decided to give sleep training a try,” recalls the Stouffville, Ont., mother of one.

The Botelhos continued their practice of staying with Isabella at bedtime until she fell asleep, but stopped going to her in the middle of the night. The first two nights were tough, but on the third, Isabella went back to sleep after only five minutes. She started sleeping through and continued to do so after Linda went back to work.

According to some lore about infant and toddler sleep, the story ends there. All babies wake in the night, experts say, but the ones who learn to fall asleep on their own won’t need parents’ help to get back to sleep later on. Once babies acquire this “skill,” parents should be able to look forward to peaceful nights from that point onward.

Fast-forward four months. Isabella had been sleeping well. Then she got a stomach bug and, whoosh, sleep went out the window. The comforting Isabella needed during her illness led to a month of rocking, singing and back rubs several times each night to resettle her. Eventually, the wakings dwindled to once a night — better, but not golden.

Two years later, Isabella’s sleep patterns remain fragile. “Even now (at age four), any little cold and she’s up in the night,” says Linda. “It can take weeks to get her back on track.”

Illness isn’t the only thing that mucks up a family’s nighttimes. The end of naps, moving to a big-kid bed, starting school, a move to a new home — any transition can temporarily disturb a child’s sleep, at any age. In a new study conducted by University of Regina psychologist Lynn Loutzenhiser, 41 percent of parents whose babies and toddlers were waking in the night said their child had previously slept through the night at some point. (Read more about that research in Sleep Training: What Works for Parents?)

Even an enjoyable change like getting away for a family vacation can bring unwanted repercussions, as Laura Hagen of Whitby, Ont., can attest. A summer holiday that included a spell of hot weather with no air conditioning, and two different sleeping places for her daughter, Sarah, left the toddler waking twice a night, even weeks after the holiday was over.

According to Wendy Hall, a sleep researcher and professor of nursing at the University of British Columbia, it’s a pervasive myth that little ones who learn to sleep through the night will never go back to waking up. “I sometimes say to parents, the nature of parenting is that your child constantly changes and you can’t count on any strategy you have used in the past to be a magic bullet that works forever.”

So what should you do when your child’s sleep is thrown for a loop? It’s tricky to prescribe solutions because the strategies you might be willing to consider depend very much on your beliefs about parenting, your child’s age, your perception of the problem, and your family circumstances. Single parents may consider different solutions than parents with partners. Moms about to go back to work may have priorities that differ from those of families with a stay-at-home parent. Read on for some things to think about when deciding how to handle sleep upsets at your house.

Might the problem go away on its own? Don’t assume that all sleep disturbances call for radical changes, says Ariana Birnbaum, founder of Toronto’s Becoming Maternity and Parenting Centres, as well as a private sleep consultant. “Some resolve on their own over several weeks without big changes in the parents’ approach,” she says.

In fact, that’s exactly what happened in Hagen’s case. When Sarah called out at night, Hagen’s husband, Paul, would lie on the floor beside her crib and hold her hand through the bars. After about a month, Sarah stopped calling out at night and things went back to normal.

Is something else bothering my child? Are there big changes in your child’s life, such as a change in daycare staff, a fight with a friend at school or a move to a new home? If you suspect an emotional problem is at the core of your child’s wakefulness, then this is not the time to start sleep training. Instead, focus on helping your child feel more secure emotionally. With young kids, especially babies and toddlers, it’s not always easy to figure out what’s bothering them, but you don’t always need to know. Just give your child a little extra TLC, says Birnbaum. Deal with her emotional needs, not just at night but during her waking hours too, and the sleep situation may improve without any change in your nighttime parenting.

You’ve probably heard that setting consistent nap and bedtime routines can go a long way toward helping your child sleep better. Starting the routine at roughly the same time every night and following the same steps (washing, brushing teeth, changing into PJ’s, reading a book) help your child wind down, anticipate what’s coming next and understand that sleep is the end result. During times of stress or change, routines become even more important. Both Hall and Birnbaum say that when kids are out of sorts, it may help to read the exact same story or sing the same bedtime song every night. All that repetition may sound tedious — and that’s exactly why it helps prime some children for sleep.

I can’t live with the way things are going now. What can I do? Regardless of the cause, what starts as a temporary sleep disturbance can turn into a persistent pattern of night waking, says Hall, and “sometimes it is not possible for parents to go back to what they were doing before the disruption because the patterns have become established.” For babies over six months and toddlers who are still in a crib, Hall is a proponent of “controlled comforting.” Rather than ignoring a child’s nighttime cries, parents can go in and offer physical comfort, such as patting his back for a minute or so. The idea is still to leave before the child falls asleep, so he does eventually learn to fall asleep and get back to sleep on his own.

For parents who can’t or don’t want to do sleep training, Hall suggests “camping out” as a gradual way to encourage kids to sleep through the night. This is less stringent than controlled comforting in that initially you can stay in the room while your child falls asleep. Over time, however, the idea is to reduce contact with and proximity to your child: holding her; then, as nights go by, stroking her head or holding her hand; then standing or sitting by the bed until you move closer to the door and, eventually, out the door.

Hall warns that this approach can take quite a long time and doesn’t work with some children. “I have found that having their parents present without picking them up makes some babies even more upset,” she says. But older toddlers and preschoolers are more often comforted by a parent’s presence, even if holding or cuddling isn’t part of the package. “You can talk to them about what you’re doing and why,” Hall says. “They understand that you’re not far away in the next room and you want them to stay in their own bed so you can get enough rest yourself.”

Another strategy Birnbaum often suggests to parents who don’t want an older child in their bed is to put a sleeping bag on the floor beside the parental bed. Then explain the deal to the child: “Say, ‘You can come in [the] and sleep in the sleeping bag as long as you don’t wake me up when you come in,’” Birnbaum suggests. “I found this to be gentle and effective in getting kids back in bed when they are emotionally ready.”

Some parents are quite content to handle these situations by simply lying down with their kids whenever they seem to need it. When our children were young, my wife and I lay down with them in their big-kid beds most nights, both to help them fall asleep and if they woke in the middle of the night. Even after they were sleeping through the night on a more regular basis, we’d return to this practice whenever one of our boys hit a rough patch. Hall would say that doing so may have delayed the development of their ability to go back to sleep on their own; but having failed quite miserably at sleep training, we found lying down with the boys to be a stress-free way to settle them. The occasional middle-of-the-night lie down didn’t seem to have any negative impact on their sleeping patterns or their overall independence.

Whatever you decide to do in search of better sleep for you and your child, you should be prepared to do it more than once. As mentioned, there’s no guarantee any one strategy will provide a permanent fix. In fact, for some families, sleep disruptions are simply a recurring part of life. Toronto parents Keira and Kevin Brown have come to accept that dealing with three-year-old daughter Dayna’s uneasy sleep patterns is simply a part of their parenting experience. “Dayna has always been an intense, spirited child, and transitions are difficult for her,” says her mom. “It seems when anything new comes along in her life (starting daycare, an exciting outing), she gets mentally worked up and the first thing that gets disrupted is her sleep.” When that happens, Dad camps out in Dayna’s room for as long as it takes for things to settle down and she stops calling out — usually within a few weeks.

Taking the long view also helps them stay positive. “I just remind myself what life was like when she slept really poorly, and I accept that whenever there’s a transition, we’re probably going to have to spend some time working on Dayna’s sleep,” Keira says.

This article was originally published in February 2012.

Read more: Toddler sleep: Your top questions answered> Poor toddler sleep may cause anxiety, depression: Study> Confessions of an accidental co-sleeper>