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. 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.
When to Call Your Child’s Pediatrician
When it comes to sleep regression in toddlerhood, it is important to remember that every child is different. Some kids will experience multiple sleep regressions throughout their development and some may only experience a few days of disruption. That said, sleep regression should only last a few days. If your toddler’s sleep disturbances seem to be lasting longer than what is expected, you may want to talk to your child’s pediatrician about your struggles. There could be any number of reasons why your child’s sleep is being impacted, many of which are nothing to worry about and can be fixed by changing their sleep environment or how you respond to the disruptions, says Smith. But, there are times when something else is at play. For instance, sleep issues are more common in kids with medical, developmental, or mental health concerns. Likewise, one study found that sleep disturbances among 18-month-olds can be caused by genetics, environmental factors, and even by parental behavior. “One of the things that we often think about is really looking at the whole child,” explains Dr. Turchi. “We need to consider if the child is still developing and growing appropriately and if there are other signs that things are not going well. Sometimes sleep regression can be part of a bigger picture.” Keep in mind, too, that ongoing sleep issues can have a number of health ramifications. Studies have shown that poor sleep quality or reduced sleep quantity is associated with academic, social, developmental, and behavioral difficulties, as well as weight abnormalities and other health problems.
A Word From Verywell
Sleep regressions can be challenging and even draining—especially if they interfere with your sleep as well. But you can rest assured that it is likely to be short-lived. As long as you respond with patience and consistency, most sleep regressions will resolve within a few days to weeks. If your little one’s sleep issues persist—or you believe there might be a medical reason for your child’s sleep disruption (like an ear infection)—do not hesitate to reach out to your child’s pediatrician. They can evaluate your child as well as offer a referral for a pediatric sleep consultant if needed.
