Preventing Sleep Issues in Toddlers

It’s 3 a.m. and I can’t believe it’s happening…again! I nudge my husband awake to the sound of our toddler, Emily, crying. We wonder: Will she fall back asleep, or will it be another night of crying?

This family could sure use some help, but what? The solution is really pretty basic.

Toddlers: 101
Your 1- to 3-year-old needs about 10–13 hours of sleep a day. For many toddlers, this will include one or two naps per day. Some will be intermittent nappers, others will re-energize with a little quiet time in a room or bed, and some tots will loudly protest any hint of slowing down, choosing instead to storm on through their day. All are normal.

Separation anxiety may still be in full swing at this age, so keep in mind that if your 2-year-old resists going to bed, it’s normal. She just wants to be with you and does not want to miss any mom and dad fun. How gently (but firmly) and, above all, consistently you deal with it will determine if it will be an ongoing issue or not.

Don’t make the mistake of letting a toddler stay up late into the night so she will be good and ready for bed. Overtired children have a much harder time falling asleep, and they’re crabbier due to lack of sleep.

Give Me a Routine 
Supporting your toddler in forming her own consistent bedtime routine is an excellent start in building a solid foundation for healthy sleep habits. She should be doing the same bedtime activities every evening at the same time and falling asleep by herself in her own bed. She should know what is expected of her. The routine should be pleasant and predictable and make her feel safe.

Bedtime routines need not be complicated and typically last about 15 to 30 minutes.

Let’s look at some ideas.

1. Bring the house lights down.

This will be your transition from day to nighttime activities.

• Create a quiet period.
• Turn TV and video games off. Read books, do puzzles, play board games or listen to quiet music.
• Throw in a few subliminal suggestions, such as “Your eyes are looking kind of sleepy.”
• Depending on the age, give notice 10 to 30 minutes before it’s bedtime.

2. Set a consistent schedule for bedtime.

Set a specific bedtime. Period. No discussion. No debate.

• Only special occasions change bedtime.
• There is never a need to engage or argue about bedtime.

3. Set the mood.

• Soothing music or a nightlight creates a warm environment.
• A back or shoulder rub can ease muscle aches or tensions.

4. You’ve got a friend.

A stuffed animal or blanket can be a great comforter, especially in the middle of the night. Be sure to check for any potential choking hazards such as loose buttons, ribbons, stuffing or pellets. Family pictures or those of friends/favorite people on a nearby nightstand can make children feel safe.

5. I’m listening.

• Tuck your child into bed for a feeling of security.
• Read the book she chose.
• Sing some songs together.
• You can discuss your favorite and not-so-favorite parts of the day. It’s a good time for your toddler to unburden any fears or worries.
• For younger toddlers, review the day with them.

6. Now scoot.

• It’s up to her to fall asleep. Always try to leave while your child is awake so she can then fall asleep on her own without needing you to help her. You are teaching her and giving her a wonderful gift—independence.
• Tell her you love her and she is safe.
• If she is resistant and anxious, you are calm and quiet. You explain that you are willing to come back in 10 minutes to check on her if she is quiet. When you go back in 10 minutes, offer praise, but quietly and quickly exit the room. Repeat until she has fallen asleep.

Sometimes things like illness, vacation and power outages will make your routine anything but predictable. That’s okay! Just get back to your bedtime routine as soon as you can.

Barb Warner, RN, is a nurse on the Answer Line at St. Louis Children’s Hospital. If you have further questions regarding your toddler’s sleep, call the nurses at 314.454.KIDS (5437) or 800.678.KIDS.