1. The single most important fact to remember is that the time when sleep occurs is more important than the duration of the sleep period. You can’t fight circadian rhythms! We all have internal clocks that are genetically controlled. These clocks create an internal timing mechanism for sleep. These clocks evolved from dark (night)/light (day) cues. This signal is very primitive because it is based on the rotation of the earth on its axis. Sleeping in synch with circadian rhythms is more restorative, of better quality, than sleeping out of synch with circadian rhythms. Jet-lag syndrome is an example of sleep not in synch with circadian rhythms.
Additionally, a bout of sleep that is continuous (consolidated) is much more restorative than a bout of sleep that in interrupted (fragmented).
2. The Myth of Total Sleep Duration
Some parents observe that their child is getting 12 hours of sleep (e.g. 9pm to 7am plus a 2 hour nap) and therefore they think that there is no problem. Sleep duration is probably less important than sleep quality (intensity, consolidated, and in phase with circadian rhythms).
February 16, 2012 at 2:50 am |
We have had success with early bedtime of about 5:30
with our now 4 1/2 year old daughter.
She had been a poor sleeper most of her life, but we had several consultations with Dr. Marc Weissbluth 2 years ago, and she now falls asleep within 15 minutes of going to bed and sleeps about 12 hours most nights. We are so greatful.
Our question is do children her age need such an early bedtime, or can we safely move it a bit later without disrupting her good sleep? Any thoughts?
Thanks
February 4, 2012 at 11:05 am |
Is is better for a 9 month old to go to bed early and have consolidated sleep only to wake up early and still need 3 naps? Is a cat nap at 6 am better than a cat nap at 5 pm? For example: bed 5:30. Wake 4:30. Roll around in crib until 6. Nap 6 to 6:45. Nap at 9. Nap at 1. Bed at 5 or 5:30. Not sure what to do here.
February 3, 2012 at 4:16 am |
My 11 month old daughter has been a great sleeper since day one and we have used Healthy Sleep Habits, Happy Child as our guide to support our family’s sleep all along the way. For the past several months she predictably wakes up around 5:30-6:00 a.m.and goes down for a 1.5-2 hour nap at around 7:30-8:00 a.m. and then another 1.5-2 hour nap at around 1:30-2:00 p.m. with a bedtime between 6:30-7:00 pm. I still nurse her once in the middle of the night for about 10-15 minutes and she goes right back to bed. I work 4 days per week so she is used to being cared for by Dad on Mondays, one grandma on Tuesdays-Wednesdays and her other grandma on Thursdays. She has a lot of stamina and on the occasions when she misses one of her naps or has stayed up late she appears to turn into a little comedian rather than to become cranky. Still we make sleep a priority. However because of some changes in her grandma’s availability we just started our daughter in a 1/2 day (morning) Montessori program two days per week which means she regularly misses her morning nap and then takes a mid-day nap at around 12:00 for 2-3 hours. The transition has been seamless and seems natural for her. She still goes to bed between 6:30-7:00 p.m. but is now sleeping in until 7:30 a.m. so it seems as if she is making up the 1.5-2 hours of her missed morning nap by sleeping in later.
On the outside everything appears to be fine. But since I need a lot of sleep myself and I’m a wreck (rather than a comedian) when I miss sleep I’m worried that it is too young for my daughter to transition to one nap because of an outside force, as opposed to her biological rhythm, and that perhaps she is being deprived of a necessary and healthy sleep pattern. Am I just being a worry wort?
Or should I try to encourage this new sleep schedule on the other 5 non-school days or continue with her morning and afternoon naps on those days?
Thank you in advance for any insights you have to offer.
Blair
February 1, 2012 at 7:32 pm |
My pediatrician recently recommended HSHHC to help me get my 4.5 month old on a schedule. He was never a colicky baby, I just realized I was letting him get overtired and I wasn’t consistent with his sleep. Now I am pretty confident in recognizing his sleep cues. He is on a good sleep schedule and goes down with only a few minutes of fussing or none at all. I don’t even have to nurse him to sleep anymore. His bedtime changed from 11pm to around 7pm! I was a little concerned that his naps were sometimes too short, but feel a lot better after reading this post.
There is one thing that is still troubling me, however. He is still waking up about 3-4 times a night to nurse. As soon as he eats he falls right back to sleep. But he was sleeping 5-7 hour stretches before I moved his bedtime up. I am concerned that at this age it is too often. Should he not be waking up to eat so often and is there anything I can do to decrease the number of night feedings?
Thanks!
February 2, 2012 at 3:35 pm |
Are you sure he is actually hungry when he wakes up? I just assumed my DD was hungry and fed her each time she woke. Then she started waking every 1-2 hrs, which was ridiculous, I knew she could not be hungry that often! So I started to pay attention to how much she nursed (instead of dozing off ;o)) and she only ate for a min or two and then flutter sucked herself back to sleep. So then I stopped feeding her until at least 5 hrs had elapsed- and I was right. She can now go 9 hrs at night (although we still have bad nights where she wakes too frequently). HTH.
February 2, 2012 at 10:25 pm
Thanks for the reply. You may be right. We call him a grazer b/c he eats often throughout the day (about every 2 hours or so), but only eats for about 5 minutes. His night time feeding lasts about that long as well so I just assumed he was still hungry. I may just try to let him be for a while and see if he goes back to sleep on his own.
January 31, 2012 at 4:14 pm |
If an infant of 3 months is waking up at 6:30 or 7, how long should she stay up? Wakefulness should be short, but then the nap won’t occur between 9-10. Which takes precedent? Also if an infant of the same age has full awakenings when transitioning between sleep cycles and can’t self soothe yet– what to do to promote consolidated sleep? Bed time is early and naps are in place. Parent soothe until an appropriate age to CIO?
January 31, 2012 at 5:48 pm |
Self-soothing is the foundation for healthy sleep habits. Work on “drowsy but awake” for the first “nap” within one hour of wakefulness and at bedtime. After self-sothing skills are developed, expect the first real nap to occur closer to 9 AM. Then, there will never be CIO.
Marc
February 1, 2012 at 12:33 am
Thank you. She is a motion junkie, but in one day I think we’ve transitioned from being swayed to sleep to being patted to sleep. I will work on setting her down drowsy.
I know you may have had this question before, but can self soothing occur with the swaddle? She has a very strong startle reflex so it helps calm her, but she goes after her hands like crazy when awake and tired–they just don’t soothe her yet, they more seem to frustrate her right now.
January 31, 2012 at 4:12 pm |
Oh also, how many hrs should a 4-5 month old be sleeping? I think she might have had colic, or else been quite fussy in the evenings (till midnight)
January 31, 2012 at 4:10 pm |
My DD is 4.5 months old and I am really struggling with her naps (and sleep in general). She will fall asleep just fine but then wakes after 30-45 minutes. She was waking 6+ times a night but finally started sleeping better last week (when she began going to bed at 7 pm).
My question is, how do I get her on a decent schedule if she won’t nap!? I’m scared to wake her up too early in the morning (7 am) and if she doesn’t nap she will be miserable! I put her down around 9am but she won’t sleep, or dozes on and off, so after an hour or two I get her up. Then she is really tired so I try to get her to sleep again, she doesn’t etc etc and by evening she is so tired she is screaming. Then she wakes at night crying (not hungry) I want my happy baby back but don’t know how/what to do! Thanks.
February 1, 2012 at 2:09 pm |
We’re struggling with the same problem with our 4.5 mo old. He gets up at 630 am and will nap for 30-45 minutes around 830 am and 1 pm. Its been about 6 weeks of this. Because his naps are so short, I’ve been starting the bedtime routine around 5 pm in order to avoid getting a sleep debt. Every three or four days he is super cranky and wants to take a nap at 1030 am. I usually let him – the nap lasts about 30-40 minutes and doesn’t seem to interfere with the 1 pm nap. The afternoon nap (around 3) is so variable, he takes it about 50% of the time, but when he does it really smoothes out our evenings.
For a while, I went back to “brief periods of wakefulness” to see if maybe he would do better with that because his naps rhythms weren’t developed yet…no dice. If he woke up from a nap during “biologically appropriate drowsy times” (eg napped from 8-840) he had horrible sleep inertia and would be cranky for about an hour…but completely unable to sleep more.
I think that I might try to get him a bit more sleep by popping him in the baby carrier and taking him for a walk as soon as he wakes up from a 30 min nap. I know its not motionless sleep, but maybe its better than no sleep?
I’m really exhausted from these (long) days of short naps and cranky baby…I’m waiting for those naps to lengthen and hoping this will be just a distant memory when we hit 6 mo.
February 2, 2012 at 3:27 pm
Sorry to hear you have the same problem, it is exhausting isn’t it? Not so much physically (I find) but more mentally/emotionally as I hate so see my sweet DD cranky from no sleep
(
So from what I understand if she doesn’t sleep at the appropiate times (9, 1 etc) I should keep her up and not let her sleep until the next time? Won’t she get crazy overtired though and then sleep even worse? I do find that a short WT in the morning helps, I let her sleep until 8 am (late I know, but she can’t handle more than 1 hr WT) story at 8:50 bed by 9 am. She is asleep ATM so crossing my fingers it lasts more than 45 min!
February 5, 2012 at 12:17 am |
It magically that my son managed to stay up later and later and his nap, that used to occur within 1 hour of waking in the morning just gradually moved to 9 over the course of a week or two. Until it did, we often ended up with a nap at 11 and another at 2…but it all sorted itself out over time as long as I either put him down when he was tired or at 9 am, whichever came first. From HSHHC, I understand daytime nap rhythms don’t establish themselves in some kids until 5 or even 6 mo. During the period of transitioning from “brief periods of wakefulness” to naps at 9 and 1, sometimes we needed two naps, sometimes 4 depending. I think if you watch your child and slowly work to 9 am for the first nap it will all work out over time.
January 30, 2012 at 7:52 pm |
Question on sleep consolidation:
If a baby sleeps from 6:30-7 pm till 6:30-7 am with 2 wakings to nurse (11 pm and 3 am), but also wakes briefly and calls out 3 to 5 additional times (and settles by herself) – would you consider this consolidated sleep?
January 31, 2012 at 10:34 am |
Excellent question! I think that there is no standard defintion of consolidated (or fragmented) sleep but it is normal for babies to vocalize at night and to be fed at night. Often they are not fully alert/awake during these times so I think it reasonable to describe this as consolidated sleep. In contrast, a mother of twins might be up at night often feeding her babies so that her night sleep is comprised of short segments alternating with feedings and this can be thought of fragmented sleep. Adults with sleep apnea often fully awake to breath better and they suffer from fragmented sleep. The notion of fragmented sleep is that even if the sum of all the short segments equals the duraton of consolidated sleep, fragmented sleep is less restorative. Fragmented sleep means sleep punctuated by full arousals that normally would not be expected to occur.
Marc
January 30, 2012 at 7:02 pm |
I was getting ready to post a question when I read this! I get it now!I am trying to get my 9 month old on a 9 and 1 nap schedule. At 8 months old, he was waking at 6. Nap 8 to 8:45. Nap 11 to 12. And nap 3:30 to 5. Bed at 7. When he started doing that routine is when he finally started sleeping through the night. So I thought, great! Well, after about 1 1/2 weeks of this he started getting very cranky, fighting naps or taking 20 to 30 min naps and even not eating well for the babysitter. So I decided to get him on a 2 nap/day schedule. We have been doing it 3 days now. My question is he takes an hour nap 9 to 10. But then at 1–only 30 min. He will not go back to sleep even if I let him CIO. That works at night for him but not for naps. I put him to bed at 5 pm last night. He woke at 2:30 and he didn’t go back to sleep until 3:30. Still woke up at 5:30. I thought maybe I had gone to 2 naps too soon but I get it now! Timing of naps is more important than duration of naps. I’ll stick with it and hopefully the naps will lengthen and STTN will return. It’s hard to change when he had been sleeping through the night, but his days were very irregular and cranky at times. Any advice? Earlier bedtime? Give it more time?
January 31, 2012 at 1:47 pm |
Your situation is so similar to ours! I have been following HSHHC since day one, but always feel like I am doing something wrong when issues like these pop up.
I am confused though. I thought that naps less than an hour were not restorative.
Can you please clarify this seeming contradiction, Dr. Weissbluth? Is a 30-40 minute nap at one pm ok? And will it eventually lengthen?
January 31, 2012 at 6:48 pm
I have been following it since day 1 too but my LO has been a short napper from 6 weeks old on. Then he’ll have an amazing by the book day and I try to repeat it the next day and he short naps again. I have decided to stick w it and see what happens and slowly it is getting better. Yesterday he slept 8:45 to 10. And 1 to 1:50. Bed at 5:30. Slept until 6:45 and has done well today though I don’t have exact nap times yet reported by the babysitter. I’ll keep you posted as to our progress. Good luck to you too!
January 31, 2012 at 7:15 pm
Thanks, Darcy. I hope things get better for both our little ones. For now I am sticking with an early bedtime to hopefully repay sleep debt from the shorter naps. Good luck to you too!
January 31, 2012 at 11:33 pm
You are welcome. Sticking with the early bedtime seems to be working for us. Today he slept 9:30 to 11 and 1:20 to 2:40. In bed at 5:30. I hope I have a better night tonight than the last 2. Both naps and bedtime were drowsy but awake and no crying at all so this is an improvement as well. What time is your little one going to bed? My mom thinks I’m crazy for putting him to bed even as late as 6 and she is visiting tomorrow so I’ll have to defend myself but it’s worth it for a good nights sleep and a peaceful day with a good routine. On the day he slept 1 to 1:30 I had him in bed at 5, and I think even that was too late on that particular day but I certainly couldn’t have put him to bed at 4 or 4:30? Keep me posted with your progress.
February 2, 2012 at 12:53 pm
How is the early bedtime working? Still good? We had a good day yesterday. Naps from 9-10 and 1-3pm. I couldn’t believe it!! However, our other ongoing issue is morning wakeups. We put our son to bed at 530, usually. Yesterday, I put him down at 545 since he had such good naps. He was awake this morning around 4 kicking his crib. He went back to sleep until 6, but I am at a loss for why he can’t sleep through. Any thoughts?
February 2, 2012 at 1:29 pm
Early bedtime is still good but we are having same early wake up issue too. Naps yesterday from 9 to 10:30 but then only 12:50 to 1:10. Bed at 5:30 then he woke at 4:15 and it took him until 5:30 to go back to sleep and slept until 6:30. The night before he woke at 3:00 and took until 4:30 to go back to sleep and up at 6:15. Dr Weissbluth says to not over analyze day to day or we will go crazy. If in general early bedtime is helping stick with it. It may take several weeks for the early bedtime to help the naps and night sleep. Any advice or words of encouragement Dr Weissbluth or other bloggers?
February 2, 2012 at 1:23 pm
I wanted to add that we have been doing a 530 bedtime for the last couple of months, since he dropped his third nap.
February 2, 2012 at 1:54 pm |
Thanks, darcy, for the update. It is just good to know I am not alone. We are both just doing our best!! Dr W is right. I need to learn how to not overanalyze. After all, our babies ate just human!
January 30, 2012 at 6:56 pm |
So….I’m not sure if I feel better or worse? My son is 22 mos. he sleeps 7/7:30-6:30ish. Naps 1’15″ -1’45″ at home. But 2.5 – 3 hours at his sitters!!!!!! (talk about making me crazy). As an infant he averaged 13-14 hrs of sleep. I only ever hit 15 if he was catching up. Even tempered, well behaved, good natured boy. Tantrums age appropriate.
Transition from 2 to 1 nap took 3-4 months. Was painful! Naptime varies from 11:30-1:00 for start time.
How do we decide firm start time? What about the shorter naps at home? Do I CIO for naps? Or just roll with it? I think he knows I’m home and that I’ll come get him. But since mood & behavior seem fine – I stopped (finally) worrying about it.
Thanks!!!!!