Babies’ sleep is most often a challenge for families and the regression of the baby’s sleep is often a topic addressed in paediatric consultations. A newborn baby needs to sleep for several hours, around 16-20h in a day, but for nutritional reasons and immaturity of the sleep cycles, sleep is divided into periods of 1-4h, after which he is awake for feeding and care.
From 3-5 months of age most babies are able to sleep for longer periods during the night, about 5-6h, being more active and awake during the day. We can say that the majority of babies from 6-9 months of age have the capacity to sleep through the night, or rather, they have the capacity to have a longer period of hours of sleep during the night, with physiological micro-awakenings, not needing parental intervention to wake up.
It is frequent to speak of phases of “sleep regression”, although scientifically this is not the most correct term. But we can say that, for different reasons, there are moments when the children’s sleep suffers an alteration to its normal pattern, which is generally transitory, but which may justify the reinforcement of some sleep hygiene rules.
Before going into the causes and moments of alteration of the sleep pattern, it is important to clarify some concepts regarding the structure and organisation of sleep in children.
Circadian rhythm
Until 4-6 months of age, the baby has a sleep-wake rhythm that repeats every 3-4 hours. In other words, every 3h he sleeps, wakes up, is fed, has a variable period of interaction and goes back to sleep.
From 3-5 months of age the baby acquires what we call a circadian rhythm, that is to say, the same routines are repeated throughout 24 hours, with a daytime period, when there is light and activity, and an evening period, with less light and a longer period of sleep.
This rhythm that repeats every 24h is regulated by external factors, such as light and activities, and by internal factors, such as body temperature and hormones like melatonin.
Sleep cycles
Sleep in children and adults is organised in cycles, about 90-120 minutes long, and each cycle has different phases, from shallow to deep sleep. During the transition from one cycle to another small awakenings may occur, which in older children and adults are unnoticeable, but in younger children, especially those who have some difficulty in sleeping without parental help, they may mean waking up in the middle of the night and demanding attention from their caregivers.
It is for this reason that in reality, we cannot say that the baby sleeps through the night, it is more correct to say that the baby, during his nocturnal sleep, has the capacity to wake up without the help of the parents.
Regression of sleep hours: possible causes
There are then periods throughout the growth of babies and children when there may be disturbances in the usual sleep pattern:
- Alteration in sleep rhythm: when the baby acquires a sleep rhythm more similar to that of an adult, with a longer period of nocturnal sleep, he sometimes has difficulty in conciliating sleep alone without the help of his parents; this alteration happens around 4-6 months and is more common in babies who associate their sleep with external factors dependent on the presence of their carers (lap, rocking, breastfeeding, bottle-feeding, …).
- Stages of development: it is frequent to have some transient sleep disturbances at times of great developmental acquisitions (crawling, walking alone, …).
- Changes in the environment: small changes in the temperature or luminosity of the room can affect baby’s sleep.
- Separation anxiety: from 9 months of age the anxiety of separation from the parents (which is a normal stage of development) can lead to the baby asking for your attention more frequently, even at night.
- Changes in routine: the typical example is holidays, in which the change of house, room and routines, end up bringing some insecurity to the child.
How to deal with the sleep regression phases
First of all, we must understand that these moments of change in children’s sleep patterns are frequent and normal during the course of their growth. Most of them are transitory, but it is important to pay attention to some aspects so that a sleep regression phase does not turn into a sleep disorder due to incorrect habits. If we are facing a phase of sleep disturbance due to behavioural reasons, the reinforcement of routines and the application of simple sleep hygiene measures will facilitate the resolution of these periods.
Sleep hygiene precautions
- Keep regular mealtimes and naps during the day.
- Avoid stimulating activities in the moments before going to bed, preferring moments of affection and family interaction.
- A consistent bedtime routine, repeated in the same way every day.
- Reinforcing autonomy when it is time to go to sleep, the idea being that the baby is placed in their cot while still awake and is able to go to sleep without their parents being present.
- Avoid letting the child fall asleep while eating, in order to avoid the association between eating and sleep.
- During short awakenings at night wait a while so that the baby has the opportunity to wake up on his own. If it is necessary to comfort the baby with a lap, feed him or change his nappy, this process must be carried out quickly, with less light and with minimum stimulation, so that the baby understands that this is the time to sleep.
When applied consistently, transmitting comfort and security, sleep routines will help to bring back peaceful nights.
