Congratulations! Your baby has turned 1 – well done for surviving the first wonderful year. As your toddler grows, lots of things will change but there’s one thing that will remain constant: the need for good sleep (and your concern over how they should be sleeping).
Sleep disturbances affect nearly 25% of toddlers – so if you have concerns, you’re not alone. After their first year, sleep for toddlers becomes more regulated and they begin to get used to their routines, but there are many things that can result in sleep disturbances, and these disturbances can then go on to negatively affect their health in other ways.
It’s understandable that you may have worries over your child’s sleep. We have previously looked at the importance of sleep in your baby’s first year, and in this post we’ll be looking at the next 12-36 months of their life – what causes sleep problems, the results of these and tips on how to reduce problems.
We have also previously looked at the importance of sleep for parents and the importance of sleep during pregnancy. It’s very easy to forget about your own well-being when you’re so focused on your little one, but it’s important for you to get a good night’s sleep for both yours and your child’s safety and health.
How much should my toddler sleep?
By 12 months, sleep starts to level out; night time sleep is similar for the next 2 years, and day time sleep very gradually decreases. Many toddlers will drop their second daytime nap by around 18 months, but it’s no cause for concern if they don’t. When they start only having a single nap, after lunch is the perfect time for this as it allows plenty of time for them to become tired again for bedtime.
A 12 month old’s sleep cycle is similar to that of an infant’s: 50% NREM sleep (quiet sleep where we restore, grow and develop) and 50% REM sleep (active sleep where dreaming occurs), in 50-minute sleep cycles. This changes slightly as they age to be closer to an adult’s cycle; by 3 years a child will spend around 33% of sleep in REM and the rest in NREM. This means that as they grow they will need slightly less sleep, as a higher percentage of their sleep is spent recovering rather than dreaming.
Toddler sleep problems
Sometimes sleep problems can be reduced by simple changes such as reducing noise or getting more exercise in the day, but if you have any concerns over sleep problems in your toddler, it’s important that you contact your healthcare professional.
Look out for signs of sleep problems in your toddler such as:
- Trouble falling or staying asleep
- Excessive daytime sleepiness
- Excessive snoring or breathing problems
- Behavioural and mood problems
- Difficulty concentrating
- Frequent headaches
- Hyperactive behaviour
It may also help to be aware of how much your child sleeps to determine whether they have any problems. Adair et al advise that “good history-taking, often accompanied by diary keeping, will usually identify the problem – the first step in effective treatment.” So keeping a record of when your child sleeps and for how long may help you to determine if they’re suffering from one of the sleep problems below.
Similar to adults, insomnia in infants can result in them having trouble settling at bedtime or waking up too early. One of the most common causes of insomnia in toddlers is separation anxiety – it can be tough leaving them to sleep in their own room, but it’s important that you work through separation anxiety, as giving in to children by letting them sleep in your room, etc. can make it more difficult for them to be separated from you later in life.
Insomnia can also be caused by stress, medications, medical conditions such as allergies or eczema, or environmental factors such as heat, light or noise.
Nightmares and night terrors
It may be difficult for your little one to explain that they’ve had a nightmare, but if they’re normally a good sleeper, and they’re suddenly waking up scared, nightmares may be the cause. They may be due to watching or reading something scary before bed, stress or illness, but generally they’re a normal occurrence for children, much like they are for adults.
Night terrors are less common, where a child only partially wakes from sleep – their eyes might open and they may scream, panic or thrash about. They normally occur before midnight and they will not be remembered by the child in the morning. If they are in a safe environment, night terrors aren’t harmful, but it’s important to talk to a medical professional if they occur frequently or cause them to hurt themselves.
Although many toddlers will stick to their scheduled daytime naps, it may be more difficult for some. As they grow their bodies will become more attuned to being awake when it’s light.
They may also have difficulty when switching from 1 nap to 2, as 1 might not be enough but 2 might be too much. As they grow towards 3 years old, if they are getting at least 11 hours of sleep at night and are rested during the day, it may be time to drop that daytime nap for good. It’s important to use their cues, and start by replacing nap time with rest time.
Touchette et al looked at the sleep of almost 2,000 children and found that “parental presence until sleep onset was the factor most strongly associated with not sleeping at least 6 consecutive hours per night at 17 months and 29 months of age.” It may feel natural to want to be with your child, especially if they are experiencing separation anxiety, but it may lead to more disrupted sleep in the long term.
Parental presence includes putting your little one to bed when they’re already asleep or staying with them until they’re asleep, rocking them or bringing them to your bed after night wakings, feeding them during night wakings instead of letting them soothe themselves back to sleep, etc.
Although it’s important to let your child know you’re there and that they’re safe, too much parental presence may get them into a habit where they can’t fall asleep without you. More than 50% of babies who have difficulty falling or staying asleep continue to have sleep problems as children – allowing them to self soothe can help to reduce this.
Underlying medical conditions
Sleep for toddlers can be troublesome, it’s easy to miss underlying problems that may be causing them. For example, obstructive sleep apnoea can interfere with sleep resulting in behavioural problems. You may notice excessive snoring or abnormal breathing during sleep, although it is difficult to detect.
Allergies or skin conditions such as eczema may make them uncomfortable when trying to sleep – these are more noticeable issues and symptoms can have a major effect on their sleep. 10-20% of children have eczema, and 83% of those have difficulties falling and staying asleep.
Psychiatric conditions such as Asperger’s syndrome (73% of children with AS experience sleep problems), autism, and mood disturbances can affect a child’s sleep – they may not only have trouble sleeping but they may also sleep too much due to these.
Effects of sleep problems
At 12-36 months, those little bodies are still growing rapidly and your child will be hitting some huge milestones: talking, walking, potty training, socialising, etc. Similar to babies, a lack of sleep can have some negative effects on a toddler’s development in various areas:
Behaviour and language development
It’s understandable that a poor night’s sleep may make your child feel groggy and irritable, leading to short term behavioural problems, but it has been found that if poor sleep persist, it can lead to long term problems. A study by Kobayashi et al looked at over 40,000 children, how they slept at 2 years old, and how this affected them in the future at 8 years old. They found that poor sleep as a toddler lead to increased behavioural problems at primary school age, related to aggressiveness and attention.
There is a range of research that suggests that sleep disorders put both children and adults at a higher risk for language problems than healthy sleepers. A study by Dionne et al found that “poor sleep consolidation during the first 2 years of life may be a risk factor for language learning.” And good sleep consolidation helped with language learning.
Another study by Gómez et al familiarised 15-month-olds with an artificial language and found that “naps appear to promote a qualitative change in memory, one involving greater flexibility in learning.” So, the infants who napped before recalling the language did so using more abstract techniques, enabling them to recall it better.
During sleep, hormones are released that stimulate growth and appetite, so a lack of sleep can disrupt the balance of these hormones. For everyone, a high percentage of growth hormone is secreted during slow wave sleep (deep NREM sleep that occurs early on in the night). The release of human growth hormone is key in making sure children grow properly.
The effects may also go in the other direction and lead to childhood obesity. Some hormones that control appetite (leptin and ghrelin) are released during sleep, and if sleep is disrupted, these can be imbalanced and lead to overeating. A study by Anderson et al found a connection between later bedtimes and obesity, and found that toddlers who went to bed earlier (before 8pm) were half as likely as children with late bedtimes (after 9pm) to be obese as adolescents.
Memory and problem solving
By 3 years old, your toddler’s brain is already 80% of the size of an adult’s – that’s a lot of growth in such a short space of time. They’re learning so many new things every day, and these are processed during sleep. If they’re sleep deprived, they may have trouble filing these away and going on to learn more new things. It has been found that sleep deprivation causes memory deficits due to a loss of neuron connectivity in the hippocampus, so it’s important that toddlers are getting enough good quality sleep to keep learning as they grow.
A study by LeBourgeois et al found that missing a single daily nap led to “more anxiety, less joy and interest and a poorer understanding of how to solve problems.” Daytime sleepiness may affect their social skills, and they believe that if this lack of sleep continues overtime, it may result in lifelong, mood-related problems.
Toddler sleep tips
All children grow and learn at different speeds, so if they’re not sleeping the same as others, you shouldn’t be too concerned. In extreme cases, you should contact your healthcare professional, but there are some things that you can do at home to encourage your little one to sleep better:
Establish consistent routines
Similar to the first year of your child’s life, this is still one of the key methods in getting your child to sleep better. A study by Mindell et al looked at toddlers aged 7-36 months, and how having a specific bedtime routine affected their sleep. They found that the routine reduced problematic sleep behaviours – the routine meant that they fell asleep faster and had less awakenings during the night.
It’s not always easy to get your child to follow a routine, especially if they want to stay awake and play. Here are some tips on how to get them into a healthy bedtime routine:
- Come up with an easy to follow pre-bed routine. For example: bath, clean teeth, cuddle, story time. It may seem simple, but once your child gets used to following that pattern you can (hopefully) rely on them to fall asleep after story time every night.
- Create a bedtime and stick to it. It has been found that 7:40 may be the optimal bedtime for toddlers, but this might not fit into your schedule. Just try to make sure their bedtime is the same every night.
- Get them into bed before they fall asleep, then say goodnight and leave the room. This will teach them to fall asleep without you. It may be difficult if they are experiencing separation anxiety but it is something they will get used to.
- The Royal College of Paediatrics and Child Health advise that screens (smartphones, tablets etc.) sound be switched off at least 1 hour before bed to avoid them interfering with sleep.
Create a positive sleep environment for them
Similar to their bedtime routine, consistency is also important when it comes to their sleep environment. This can help with getting them used to when they should be awake and when they need to sleep. For toddlers, you can create a positive sleep environment:
- Make sure they sleep in the same cot/bed every night (apart from when you’re not home, i.e. don’t let them get into your bed as a soothing technique).
- As they grow, security items such as a blanket or soft toy can be introduced, and this may help to comfort them if they experience separation anxiety (but avoid extra-large toys and any with ties or strings).
- Use black out blinds if the light wakes them up in the mornings or in summer evenings. This will also get them used to relating darkness with sleep time.
- Make sure their room isn’t too noisy from external sounds in the house, and isn’t too hot or too cold (try to keep it around 18-22°C)
- If they’re guilty of trying to climb out of their cot, make sure they don’t have toys in there that they can climb onto, or things outside the crib that they can reach, such as curtains.
- Try soothing lullabies or white noise to help them to fall asleep.
Stimulate them at the right times
Once they can walk, toddlers need at least 3 hours of physical activity a day. This can range from simply standing or playing with toys, to more intense activities such as running, chasing and climbing. This activity can tire them out to help them sleep better at night.
Avoid exercise in the hour before bedtime as this can be stimulating and may stop them from falling asleep. And if your toddler uses tablets or smartphones, it’s been advised that they don’t use them for at least an hour before bed. Allow them to switch off from this and any other stimulating activity (TV, high intensity games) which can affect their sleep.
If they suffer from nightmares, the content that they view leading up to bedtime may contribute to these. Avoid anything scary in their games, movies and books which you think may affect what they dream about.
If they wake during the night, they will often fall back to sleep on their own. As discussed previously, parental presence is one of the top contributors to sleep problems so, although it may be difficult not to comfort them every time they wake, it is needed to create healthy sleep habits. If they’re upset due to nightmares, reassure them that they’re safe, and guide them to lay down and go to sleep. Avoid turning on lights, moving around the house or letting them get into your bed as this may lead to more disrupted sleep.
Look at their diet
As your child grows, they will add more and more foods to their diet. Carbohydrates can have a calming effect and calcium rich foods can help them feel satisfied, whereas high sugar and protein foods can make them more alert. A few hours before bed, try to avoid:
- Sweets, chocolate, ice cream, biscuits, etc.
- Fizzy drinks
- Spicy foods
- Foods with high salt/fat content as they’re hard to digest
- High-fibre foods such as broccoli and cauliflower which are also hard to digest
Ideas for pre-bed snacks:
- Low sugar cereal
- Yogurt and fruit
- Wholegrain bread with peanut butter
- Scrambled egg
- A banana
- Warm milk
We hope this has helped you to understand the importance of sleep for toddlers when it comes to their health and development. We understand that this time can be difficult, but if you are having problems with getting your toddler to sleep, just remember that you’re not alone – there are always plenty of people who are happy to help and give advice.