Inappropriate sleep associations are the primary cause of
frequent nightwakings. Sleep associations are those conditions that are
habitually present at the time of sleep onset and in the presence of
which the infant or child has learned to fall asleep.
conditions are then required in order for the infant or child to fall
back to sleep following periodic normal nighttime arousals. Overall, studies indicate that 15 to 20% of one to three year
olds continue to have nightwakings.
‘Problematic sleep associations require parental intervention and thus cannot be reestablished independently by the child upon awakening during the night. These tips may help your child sleep through the night.’
According to Stephanie Zandieh, Director, Pediatric Sleep Disorders and Apnea Center, The Valley
associations can be appropriate (e.g., thumb sucking) or problematic
(e.g., rocking, nursing, parental presence). Problematic sleep
associations are those that require parental intervention and thus
cannot be reestablished independently by the child upon awakening during
Here are some helpful tips to help your child sleep through the night:
Develop an appropriate sleep schedule with an early bedtime.
Ironically, the more tired your child is, the more times she will awaken
during the night. As such, be sure your child continues to take naps
during the day and set an early bedtime.
2. Introduce a security
or love object to your child. A transitional object, like a stuffed toy,
doll or blanket, helps a child feel safe and secure when you are not
present. Help your child become attached to a security object by
including it as a part of the bedtime routine. In addition, try to
include this object whenever you are cuddling or comforting your child.
Bedtime routine: Establish a consistent bedtime routine that includes
calm and enjoyable activities, such as a bath and a bedtime story.
Consistent bedroom environment: Make sure your child's bedroom
environment is the same at bedtime as it is throughout the night. (e.g.
5. Put your child to bed awake: After the bedtime
routine, put your child into her crib awake and leave the room.
Remember, the key to having your child sleep through the night is to
have her learn to fall asleep on her own, so she can put herself back to
sleep when she naturally awakens during the night.
method: If your child cries or yells, check on her. Wait for as long or
as short a time as you wish. For some children, frequent checking is
effective; for others, infrequent checking works best. Continue
returning to check on your child as long as she is crying or upset. The
visits should be brief (one minute) and non-stimulating. Calmly tell you
child it's time to go to sleep. The purpose of returning to the room is
to reassure your child that you are still present and to reassure
yourself that you child is okay.
7. Respond to your child during
the night: In the beginning, respond to your child as you normally do
throughout the night. Research indicates that the majority of children
will naturally being sleeping through the night within 12 weeks of
falling asleep quickly and easily at bedtime. If your child continues to
awaken during the night after several weeks, then use the same checking
method during the night as you did at bedtime.
8. A more gradual
approach: Some parents feel that not being present when their child
falls asleep feels like too big of a first step for them and their
child. A more gradual approach is to teach your child to fall asleep on
her own, but with you in the room. This approach may take longer, but it
can feel more comfortable for some families. The first step is to put
your child into her crib awake and sit on a chair next to it. Once she
is able to consistently fall asleep this way, sit farther and farther
away every three to four nights until you are in the hallway and no
longer in sight.
9. Be consistent and don't give up. The first
few nights are likely to be very challenging and often the second or
third night is worse than the first night. However, within a few nights
to a week, you will begin to see improvement.