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Everything You Need to Know About Sleep Regressions

Sleep regressions can be stressful. They disrupt a child’s sleep patterns, and can cause many a night of no sleep and frustration. However, with proper understanding and coping strategies, parents can navigate through these challenging times with as minimal disruption as possible to their baby’s sleep or toddler’s sleep. In this blog, we’ll do a deep dive into sleep regressions (do they even exist?), discuss their triggers, symptoms, impacts on feeding schedules, causes, and duration.

What is a sleep regression? 

If you are a seasoned parent, you probably know all about sleep regressions. For those who don’t yet know what it is (especially if you are a new parent), let’s give you an overview. Picture this: your child, who has been sleeping soundly through the night, suddenly starts fighting their bedtime routine, waking up multiple times, starts taking shorter naps, starts fussing, refusing the pacifier, and is generally more irritable. It’s like a mysterious switch has been flipped, altering your child’s previously predictable sleep routine. Welcome to what could be a dreaded sleep regression…

The term ‘regression’ itself might seem alarming, suggesting a step backward in your child’s progress. But contrary to what the term implies, sleep regression are not a regression in the developmental sense at all. In fact, it’s often a step forward in a child’s development that causes them to ‘regress’ in sleeping (1). All that sleep regression is, is a period marked by a disruption in a baby’s sleep habits at certain key stages in your baby’s life.

Now what may come as a surprise is that the subject of sleep regressions is not clear-cut. The most accepted view is largely supported by pediatricians who view sleep regressions as a legitimate phase in a child’s development, often coinciding with significant cognitive and physical milestones (2), (3), (4). They argue that the noticeable changes in sleep patterns are attributable to the child’s developing brain and body. They put these extended periods of sleepless nights down to one thing: biology. 

On the other hand, some experts argue that sleep regressions are more perception than reality, and that the study conducted by Dr. Plooij and Dr Van de Rijt in 1992 proving sleep regressions existed, was not in fact scientifically watertight (5). If fact, Dr Mindell, a sleep psychologist at Children’s Hospital in Philadelphia argued that the sample size was so small that conclusions could not be drawn, and went on to publish her own research disproving “timed regressions” are real (6). They suggest that the term has become an umbrella diagnosis for any disruption in a child’s sleep, which can be attributed to various factors like illness, change in routine, or teething. According to this school of thought, sleep regressions are not an inherent developmental stage, but rather a reflection of external changes impacting a child’s sleep.

In part, both camps are probably correct, although the data remains inconclusive. There is no doubt that, given the relative predictability of these regressions, there is an argument to be made that they coincide with a child’s key developmental milestones. It makes sense that sleep regressions are either based on a cognitive shift (such as the maturation of the circadian rhythm around ~46 months), or a physical shift like learning to stand (7). However, there is also truth to the claim that a lot of parents blame every poor night of sleep on a regression when in reality it’s just a bad night’s sleep. The truth it seems, is a blurry line: sometimes what seems like a regression – can just be poor sleep habits and vice versa. 

Regardless of whether a child’s sleep is caused by developmental leaps or not, there is certainly benefit to assuming they are ‘real’ as it adds some level of predictability to when you may see changes to your baby’s sleep (regardless of whether they are developmentally prompted or not). So we will proceed on the basis that sleep regressions are developmentally prompted, as it gives a parent some benchmarks that hold true with a lot of children. If you are one of the lucky families whose child doesn’t go through a period of disrupted sleep – great! But for all the others out there – let’s break down some of the key ages to be aware of and what to look for.  

Sleep Regressions by Age

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The clearest indicator that your child is likely going through a ‘sleep regression’ is their age and the developmental leaps they may be experiencing day to day. While sleep regressions don’t come with a predetermined schedule, there are certain well-established sleep regression ages that parents should be aware of. Now, not every child will experience each or any of these stages, but most parents report disruptions at approximately 4-6 months, 8 months, 12 months, 18 months, and 24 months of age (8).

The 4-month sleep regression or 6-month sleep regression is especially noteworthy. Around this time, your baby begins transitioning from a newborn’s sleep pattern, marked by multiple naps throughout the day, to a more structured, adult-like sleep cycle with consolidated nighttime sleep (9). During this stage, babies become more alert and aware of their surroundings, which might result in increased periods being awake and difficulty falling asleep. Their circadian rhythm also matures. This change is considered a significant milestone in a baby’s life and can be a challenging period of adaptation for both the baby and the parents.

As your child continues to grow, each stage of sleep regression carries its unique set of challenges. At around 8 months, babies often experience another sleep regression coinciding with advancements in physical abilities like crawling and pulling up to sitting (10). They may also develop separation anxiety – as they become more attached to their parental figures, leading to increased night wakings (11).

The 12-month sleep regression happens as wake windows are increasing and many parents mistakenly assume their child is ready for one nap, but transitioning too soon leads to overtired, which causes frequent waking and early rising (12).

The 18-month sleep regression is often considered one of the more challenging periods, as it frequently coincides with an increasing sense of self and increased independence. This newfound autonomy, coupled with the ability to express themselves through words, can lead to bedtime battles and disrupted sleep (13).

Around the 2-year mark, your child might experience another sleep regression. This period is characterized by an active imagination that could lead to nightmares and night-time fears, which can also disrupt sleep patterns (14).

Remember, this overview is broad, and the intensity and duration of sleep regressions will vary greatly from child to child. Some might breeze through these stages with minimal sleep disruptions, while others might have a more pronounced reaction, sometimes even prompting their parents to seek out medical advice in the hopes of getting better sleep.

It’s important to also note that while we can’t decouple the sleep issues that arise with developmental progressions, a strong sleep foundation, and a sustainable response framework can mitigate the duration and intensity of the sleep disruptions that developmental progressions bring.

This means that when parents are looking for some form of sleep training, they should optimize for methods that address the underlying issues, not just the superficial habits (as happens in cry-it-out or Ferber methods). Understanding sleep regression’s nuances is critical for parents striving to navigate through these sleep-deprived periods.

Symptoms and Characteristics of Sleep Regressions

Aside from using age as your basic guide, you should be aware of common symptoms associated with sleep regression can help parents spot it early and manage it more effectively. Let’s dive into some of these symptoms:

  • Frequent night awakenings: One of the telltale signs of sleep regression is a surge in night wakings. If your baby or toddler, who used to sleep soundly, suddenly starts waking up multiple times during the night, it could be a symptom of sleep regression. This can be particularly challenging to handle, given that both you and your child need your rest. The American Academy of Pediatrics (AAP), recommends certain amounts of sleep required per age, and sleep regressions often cause frequent night wakings that eat into this time (15).
  • Disturbed and shortened naps: Alongside night-time disruptions, changes in nap patterns are another signal. The calming, long naps that offered you a brief respite during the day might become fitful or markedly shorter. In some cases, your baby may resist napping altogether, appearing to be powered by an inexhaustible energy source. Be aware though that a child fighting their nap may also be a sign it’s time to drop the nap – so make sure you are following an age-appropriate sleep schedule.
  • Changes in appetite: You might observe fluctuations in your child’s appetite, with some children eating less due to increased tiredness, or refusing food out of irritability. Others might show increased food intake, especially if they’re going through a growth spurt or seeking additional comfort. Several studies show that even mild sleep deprivation increases that chance of a child being overweight  (16). Again, there are lots of potential reasons for changes in eating habits, so remember to look at all the signs in context.
  • Increased clinginess or irritability: Sleep deprivation doesn’t just make adults cranky; it has the same effect on children. During a sleep regression, your little one might become unusually clingy, seeking comfort and security in your presence. You might also notice heightened irritability, fussiness, or general changes in their behavior (17).

While these symptoms provide a general framework, they manifest differently in every child, reflecting their individual temperaments and the specific developmental stage they’re navigating. For example, a 2-year-old going through a sleep regression might exhibit more tantrums or emotional volatility as they grapple with increased autonomy and the frustrations that might come with it. In contrast, a 4-month-old might display more sleep disturbances due to the sudden heightened awareness of their environment and the significant shift in their sleep cycle.

How Sleep Regressions Affect Feeding Schedules

Sleep regressions can often feel like a chain reaction setting off a series of disruptions in a child’s routine, with feeding schedules being one of the significant areas affected. As your night gets punctuated by frequent wake-ups, the rhythm of feeding schedules can shift in response.

One of the primary changes parents might notice is an increase in night feeds. A baby or toddler undergoing sleep regression may wake more often and seek the comfort and familiarity of feeding to soothe themselves back to sleep. This increase can be due to various factors: the need for extra comfort during these unsettling times, an increased calorie requirement because of reduced daytime feeding, or even hunger if they’re going through a growth spurt (18).

Daytime feeding schedules can also face a shake-up. Changes in appetite are common during a sleep regression. Tiredness from disrupted sleep might make some children less interested in food, leading to a decreased intake during the day. On the other hand, some children might increase their food consumption, using it as a source of comfort to navigate through the choppy waters of sleep disruption.

For breastfeeding mothers, the impact of sleep regression can extend further. Mothers need adequate rest for optimal milk production and frequent night awakenings can create problems to this. Sleep and hormonal regulation are closely tied, and disruptions in sleep can, in turn, impact the hormone production essential for maintaining a healthy milk supply. It’s crucial during this period for breastfeeding mothers to ensure they’re eating well, staying hydrated, and grabbing opportunities to rest whenever possible. Remember, taking care of a baby undergoing sleep regression also means taking care of yourself (19).

Do I Just Wait It Out? For How Long?

The million-dollar question. And unfortunately, the answer is “it depends”. On average, episodes of sleep regressions typically last between two to six weeks, although this can vary from child to child. However, what you do during that sleep regression is absolutely crucial and will determine the trajectory of your child’s sleep (unless you intentionally intervene) going forwards.

Statistically, around 50% of children will have a chronic sleep issue by the age of 12 months (17). And a lot of these issues emerge as a result of what associations and behaviors children developed during times of regressing. The reason is that parents tend to be quite reactionary when a child starts regressing, and try everything possible to calm the child, including feeding to sleep, rocking to sleep or holding their hands. And while the regression itself may pass, these behaviors and sleep habits remain. So make sure that you don’t make a short-term decision in the middle of the night that compromises the longer-term sleep habits of your little one.

The TL;DR on Sleep Regressions

In conclusion, while sleep regressions can be a challenging period (especially in the first year), it’s vital to remember that this too shall pass. The key is to make sure you don’t inadvertently create entrenched sleep associations that cause ongoing sleep disruptions.

Remember that sleep disruptions are a typical part of your child’s development and not indicative of your skills or success as a parent. During this time, don’t hesitate to seek advice or support from healthcare or wellness professionals if you’re struggling or notice anything concerning your child’s behavior or health (18). Also, consider speaking with a sleep consultant or Sleep School who can give pointers on how to come out the other side with even better sleep than you started with.

Remember, you’re not alone in this journey with Batelle, and there are resources and support systems available to help you navigate these choppy waters.

This article was written by Batelle – a team of sleep experts, lactation consultants, therapists, doulas, and early education specialists.

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