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Interpreting and solving different types of Night Waking


Cute baby wide awake in crib

Decoding your baby’s night waking pattern can be very helpful if you are trying to make improvements in sleep. Understanding if your baby is hungry, overtired, not tired enough, waking out of habit, or simply uncomfortable is very important so that you can troubleshoot appropriately. This blog describes six common types of night waking: False Starts, Never-ending Bedtimes, Sleep-cycle Waking (Every 60-90 mins), Periodic Waking (every 2-3 hours), Irregular Waking (every 10-20 minutes) and Split Nights (night waking that lasts for hours). Note that your baby may have more than one type of waking in a single night. This blog applies to babies over five months old. Younger babies may have variable sleep patterns simply due to their age and sleep development.


1. “False Starts” at Bedtime

The Sleep Pattern

Your baby falls asleep well at bedtime but you usually get a short stretch of 20-60 minutes, then a wake-up requiring you to re-feed, re-rock, or re-soothe your baby back to sleep. Your baby may do this once or even 2-3 times before settling into a longer, more predictable stretch of sleep.

The Science

False starts often occur due to a misalignment between the circadian rhythm and the homeostatic drive for sleep (more on how the sleep drives work here). This misalignment can be caused by short daytime napping, or bedtime being too early. A day of short or non-existent napping can translate into more fragmented nighttime sleep. For example, babies who have too much awake time or insufficient daytime sleep are more likely to experience a wake up after a short bout of rapid eye movement (REM) sleep at the beginning of the night. Similarly, when bedtime occurs too early a baby will often have very fragmented sleep at the beginning of the night. This often happens after the spring Daylight Saving Time transition, or after a day with short naps. This is because the circadian rhythm is strongly promoting wakefulness right before your child's biological bedtime. If you try to put your child down too early, then she may keep popping up because her internal clock is preventing sleep from stabilizing.


Finally, sleep associations can cause frequent waking early in the night. If your baby doesn’t know how to fall asleep on her own, she may wake and cry for help again in the first part of the night a few times before she gets into her first long stretch of deep sleep.

The Solution

For overtiredness from daytime naps that are too short, plan to prioritize napping and catch your baby up on daytime sleep even if this means providing some extra soothing, rocking, or holding for several days. Use these better naps to help move bedtime later to better align with your baby's sleep pressure and circadian rhythm drive for sleep. If you aren't sure how much sleep your baby needs, then see our age by stage schedules blog to make sure your expectations are reasonable.


For sleep association pop-ups, using a sleep training method that feels like a good fit for you and your baby will help solve this problem (our sleep class covers four different options for sleep training).

 

Need More Help?

We offer several options for optimizing your child's sleep:

SLEEP TRAINING CLASS (for well babies 6-15 months)


PHONE CONSULTATIONS (with one of our sleep experts)


THE SECRET TO NAPS (downloadable e-book)

 

2. sleep-cycle Waking (Every 60-90 minutes)

The Sleep Pattern

Your baby may do one fairly long stretch of sleep (usually 2.5 – 5 hours) at some point during the first half of the night, but then wakes every 1-1.5 hours during the second half of the night. Not all of these wakings will be associated with hunger/full feedings, though some parents may be nursing briefly or offering a small bottle at each wake-up. Some babies will not eat at all overnight, but will wake at this frequency and require other comforts to get back to sleep.

The Science

Babies wake briefly between each sleep cycle. This is a normal and natural occurrence and happens approximately every 60-90 minutes during the night. Deeper sleep dominates the beginning of the night, which is why babies will often sleep for longer stretches in the first part of the night. Babies who have a parent-led sleep association (a need for something external from their parents like sucking, rocking, soothing) will often wake fully at each of these sleep cycles and call for help going back to sleep. Note: A baby can fall asleep independently at bedtime and still expect certain conditions to be present to go back to sleep at night. Note also that babies with very strong sleep associations will often wake every hour starting at the beginning of the night.

The Solution

Implementing a sleep training method that feels like a good fit for your family is the best option in this situation. You’ll work towards changing a parent-led sleep association into a baby-led sleep association by following a consistent set of responses in the night. These responses could be very interactive and involve you staying in the room with your child, or less interactive with periods of being out of the room. If you need help figuring out how to change your baby's sleep associations, then you may find our sleep training class helpful. It includes both in-room and out-of-room options for different parenting styles and baby temperaments.

3. periodic Waking (Every 2-3 Hours)

The Sleep Pattern

Your baby is usually able to sleep a long stretch of 3-5 hours during the first third of the night, but then wakes approximately every 2-3 hours.


The Science

Babies who are sleeping 2-3 hours at a time are usually capable of putting themselves to sleep independently, so usually wakings of this frequency are truly due to hunger. If you do not think that your baby needs to eat at night (based on your baby's age or your pediatrician's advice), then it is possible that your baby is not getting sufficient daytime calorie intake to make it longer stretches overnight.

The Solution

If your baby is eating more than needed overnight, you’ll want to taper down the extra feedings and rebalance the calories into the day. See our blog on how to reduce night feedings here. Our sleep class also provides guidance on how to create a plan to taper night feeding.

4. irregular Waking (Every 10-15 Minutes or at atypical times)

The Sleep Pattern

Your baby can’t seem to get comfortable for more than 10-15 minutes at a time at bedtime and it’s very difficult to get into the first long stretch of sleep. Or, your baby wakes at a time when he or she is NEVER awake (e.g., 9:30 pm). Or, your baby has a good first stretch of sleep but then is fitful (often after a feeding) and can’t seem to settle for more than 15-20 minutes at a time.

The Science

Randomly timed unexpected and frequent waking is often due to pain/discomfort/illness or, more rarely a sleep disorder.

The Solution

Your child may be uncomfortable. Take steps to adjust your child’s environment or clothing for more comfort and be sure your baby is not too hot or too cold. Feed your child if he is hungry. Go up a size if your baby's diaper seems uncomfortably wet. Discuss treatment options with your pediatrician for pain or illness and try to return your child to a state of comfort so that he may fall asleep again. Talk with your pediatrician about other potential causes of pain or discomfort, such as acid reflux, allergies, or itching.


5. split nights (very long night wakings)

The Sleep Pattern

Your baby is wide awake for hours in the middle of the night. No amount of comforting or feeding will cause your baby to fall back to sleep. Your baby may seem happy and playful. If you leave your baby in the crib, she may try to sleep or roll around appearing restless. Older babies may stand in the crib for extended periods of time.


The Science

Babies who are wide awake for extended periods of time overnight are typically on the wrong schedule. Specifically, this is often a too-long-in-bed problem. There are a few ways that this problem evolves. Sometimes it occurs when parental expectations are misaligned from their child's sleep needs. Most babies are not able to sleep for 12 hours straight, despite popular social media posts that suggests that is typical (check out this post for norms for your child's age). Sometimes parents will allow their babies to sleep late in order to make up for lost sleep, which can perpetuate the cycle. In some cases, parents will try to compensate for poor napping by offering an early bedtime too often. In other cases, this pattern will begin when a baby drops a nap.


The Solution

Split nights typically require a schedule adjustment. This might mean helping your baby get better naps during the day, shifting bedtime later, waking your baby in the morning, or a combination of these actions. This blog reviews this sleep pattern in detail and offers suggestions on how to fix it.


References


Jenni, O.G. and LeBourgeois, M.K., 2006. Understanding sleep–wake behavior and sleep disorders in children: the value of a model. Current opinion in psychiatry, 19(3), p.282.


Martin, J., Hiscock, H., Hardy, P., Davey, B. and Wake, M., 2007. Adverse associations of infant and child sleep problems and parent health: an Australian population study. Pediatrics, 119(5), pp.947-955.


LeBourgeois, M.K., Carskadon, M.A., Akacem, L.D., Simpkin, C.T., Wright Jr, K.P., Achermann, P. and Jenni, O.G., 2013. Circadian phase and its relationship to nighttime sleep in toddlers. Journal of Biological Rhythms, 28(5), pp.322-331.


Akacem, L.D., Simpkin, C.T., Carskadon, M.A., Wright Jr, K.P., Jenni, O.G., Achermann, P. and LeBourgeois, M.K., 2015. The timing of the circadian clock and sleep differ between napping and non-napping toddlers. PLoS One, 10(4), p.e0125181.


Sadeh, A. and Anders, T.F., 1993. Infant sleep problems: Origins, assessment, interventions. Infant mental health Journal, 14(1), pp.17-34.


Machado, R., Woodley, F.W., Skaggs, B., Di Lorenzo, C., Splaingard, M. and Mousa, H., 2013. Gastroesophageal reflux causing sleep interruptions in infants. Journal of pediatric gastroenterology and nutrition, 56(4), pp.431-435.

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