Have you heard the joke about sleeping? Some people are so good at it, they can do it with their eyes closed. If sleep comes harder to you or your child, understanding changes in sleep as children age can help everyone get a restful night’s sleep.
Infants
From birth to four months of age, most infant sleep occurs in two- to four-hour sleep-feed-wake cycles, with relatively short periods of wakefulness. After an hour awake, most newborn infants are ready to be put back to sleep (which means literally on their backs) on a firm, flat sleep surface for their next cycle. The longest stretch of sleep may be four to six hours. Waking infants regularly, which encourages two- to four-hour sleep-feed-wake cycles during the day, can help encourage the long stretch to occur during the night. A common lesson in sleep training is to never wake a sleeping baby or child, unless you’re helping them align to a better schedule. You can use this tip from the start.
By four months of age, many infants will be ready for three structured naps a day, one about an hour after they wake up, one in the early afternoon, and another nap in the late afternoon. Parents often rely on these nap times and are better able to schedule feedings, chores, and work around this schedule. Most babies this age will nap two to four hours per day. Aim for about twelve to sixteen hours of total sleep.
Toddlers and Preschoolers
By twelve to fifteen months, many babies have dropped the late afternoon nap and are ready for either two naps, early morning and early afternoon, or one nap around noon. The majority of childcare providers follow the one-nap schedule for this age group. Either way, most toddlers require eleven to fourteen hours of sleep in any one day (including naps), so as children begin to skip their naps, it is important for caregivers to move bedtimes earlier.
As preschoolers, total sleep needs decrease to about ten to thirteen hours. Some children resist all naps at this age, while others continue to nap through their kindergarten year.
When a parent asks me if it’s reasonable for a child this age not to nap, I remind them that most schools have a rest time in the middle of the day when kindergartners are asked to either sleep or rest quietly. Practicing this at home can help children learn to manage this skill at school.
School-Age Children
By six years of age, most children no longer nap, but sleep requirements continue to be high, at around nine to twelve hours a day. This means later bedtimes are not helpful when wakeup times remain consistent. Most grade schoolers will need to be asleep by seven to nine o’clock, depending on their wake-up time.
In the teenage years, changes in physiology mean children’s bodies often don’t feel ready for sleep until later in the evening and aren’t ready to wake up as early as they did just a few years earlier. Though this may be worsened by societal pressures – like screen-time and overbooked schedules – the shift is rooted in normal development, just like the changes earlier in life. When parents ask about this, I also liken these changes to what older adults experience, though in the opposite direction: Think of older grandparents having dinner at five o’clock, then nodding off in their recliner by eight at night. Just like older adults are programmed to go to bed earlier, teenage bodies are programmed to go to bed later, so schedules need adjustment.
Some school districts have begun to recognize the physiologic truth that teenagers are less ready for early mornings and have swapped high school and grade school start times. Teenagers who start school later are more likely to get the recommended nine hours of sleep and are more likely to experience better attendance, stronger academics, safer driving, and even higher-quality family interactions. This is a wonderful example of well-researched policy resulting in better child health.
Age-Specific Sleep Challenges
Helping infants sleep through the night can feel impossible, especially for an overtired new parent. By four months, if an infant is growing well and meeting milestones, parents can often help them sleep ten to twelve hours at night by slowly decreasing night feedings and offering a bit more during the day. This can be achieved by adding an extra nursing session or an extra half-ounce or so in the bottle with each daytime feeding. At this age, a baby’s rate of growth slows, from about a pound every two weeks to about a half-pound every month, so cutting back slowly takes advantage of decreasing calorie needs. If this slower transition isn’t successful, sleep training – essentially teaching your baby that nighttime is for sleeping – can start around this age as well.
Toddlers are often notorious for drawing out the bedtime routine – from bath, to books, to bed, to water, potty, hugs and kisses, to more water, more books, and yes, more kisses! It can be helpful to write out your routine and keep your expectations very clear – for yourself, your toddler, and other adults who might be helping. It’s easier to maintain that schedule if it is clearly outlined and displayed. This is why preschools have rules posted even before children can read them. Consider offering a morning reward, like a quick book or playing a favorite song, if the schedule was met the night before. We know children respond better to praise than they do to punishment and frustration, so try to stay calm and positive as you are establishing this pattern.
For elementary students, settling into sleep can be difficult. As evening activities increase and independence with screens increases, children battle their normal feelings of fatigue, become overstimulated, and lose routines. Set guidelines and device bedtimes (you can check your wireless and cell phone provider for tools) and turn lights down about an hour before bedtime. Help kids maintain a comfortable, quiet, and calm place to sleep. And don’t forget, morning sunshine and daytime outdoor activity help keep all ages ready for sleep as well.
In addition to the same challenges younger children face, teenagers face increasingly complex school and activity schedules and academic demands. Ideally, solving this challenge with your child works best, as they know their goals and preferences and are more likely to adopt and maintain healthy behaviors if they are included in decision making. Share with your teen that their body is changing to prefer a later bedtime, while educating them about the importance of nine hours of high-quality sleep. Guardrails like keeping screens and devices out of bedrooms during sleep hours are best practices. Parents can draw lines to help teens make good choices, but establishing new routines with teens to maximize their mental health and their academic and extracurricular performance with adequate sleep is something best done together.
When it comes to teens and sleep, I’m often asked if it’s better for kids to stick to a routine or to try to make up for lost sleep by taking naps or sleeping excessively on weekends. These approaches shift internal sleep clocks and can make going to bed on those nights more difficult, causing even more fatigue the next day. It is best to avoid attempting to catch up on sleep on a routine basis.
Finally, parents can help their children recognize the importance of sleep by modeling healthy sleep habits themselves. Prioritizing your own sleep habits will likely be the best way to ensure your children establish good sleep habits as well!
