Troublesome Night awakenings are a common sleep problem in infants and toddlers. Most healthy babies by 3-6 months of age are able to sleep through the night with a consolidated sleep. All normal infants and children have brief night awakenings, but most children will go back into sleep on their own (also called as self-soothers). However, 25-50% of babies continue to have frequently awakening which are prolonged and troublesome. These troublesome night awakenings are likely to persist in future years.
Why do some children have frequent night awakenings?
The persistent and prolonged night awakenings are commonly related to inappropriate sleep-onset associations. Sleep-onset associations are conditions that the baby learns to need in order to fall asleep at bedtime.
For example, some children do thumb sucking at bed-time, others need a favourite soft toy to be beside them in order to sleep. These are not necessarily inappropriate.
Some children require to be rocked or held in lap by the parent to go into sleep. These sleep-onset associations are considered to be inappropriate, as they may not be available throughout the night. When the child does not get these sleep associations, the nocturnal awakening become persistent and prolonged. This cycle can continue throughout the night and go on for months and years if no intervention is done.
What are the other causes of persistent and prolong night awakenings in young children?
There can be many medical causes which can lead to troublesome night awakenings among young children. These causes could be infantile colic, gastroesophageal reflux disease and any other chronic medical illness which can disrupt a child’s sleep.
What is the problem associated with persistent and prolonged night awakenings?
The night awakenings leads to a fragmented sleep predisposing the child today for behavioral problems such as irritability and temper tantrums. In addition this leads to sleep disruption for the parents which can lead to stress, anxiety and health issues amongst parents.
How do we treat persistent and prolonged night awakenings among young children ?
The basic management of a child having troublesome night awakenings is to have a consistent bedtime routine and removing the inappropriate sleep onset associations. A consistent bedtime schedule will allow adequate sleep in the baby and also helps the child to fall sleep easily. A consistent bedtime routine includes soothing activities like by bathing, gentle massage, wearing night clothes and storytelling. All electronic items should be avoided near to the bedtime.
There are many ways to reduce the inappropriate sleep concept associations. The most common technique which is used is called as graduated extension which involves putting the child drowsy but awake into the bed. With these strategies most children have a significant reduction in the night awakenings within 2 to 3 weeks.