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Night Waker? Early Riser? Dr. Super Troubleshoots Your Family’s Sleep Woes

Photo by ziggy_mars / iStock
Photo by ziggy_mars / iStock

For their first few years, children spend half their lives asleep. But parents seem to spend much of those early years trying to get more sleep.

That conundrum (familiar to all parents) prompted us to call Dr. Elizabeth Super, a pediatrician and children’s sleep specialist with the Pediatric Sleep Medicine program at OHSU Doernbecher Children’s Hospital in Portland, Oregon.

One of her main messages? There is no magical one-size-fits-all approach to helping your child sleep. “Temperament and age play a role,” says Dr. Super. She notes that the important thing is to choose an approach that fits your family. Still, at each stage, there are smart strategies you can use to help your whole family get the shut-eye they need. Here is Dr. Super’s super sleep advice:

1. Know When He’s Ready to (Really) Sleep Through the Night

By six  months, healthy infants no longer need to be fed in the middle of the night and are developmentally ready to soothe themselves to sleep. “They should be sleeping through the night and can be doing it, but it’s very common that they’re not,” says Dr. Super, adding that roughly 25 percent of kids at age one are still having difficulties with night waking.

2. Commit to a Baby Bedtime

“A good baby bedtime is 7-8pm,” says Dr. Super.   If your child is up much later most nights, it may be time to shift the family schedule to accommodate an earlier bedtime. Perhaps your child eats dinner before the adults, or maybe his nap can be adjusted so that he’s sleepy earlier in the evening.

While it can be a big shift in lifestyle, prioritizing sleep as a family can turn bedtime from a stressful ritual into family bonding time. ”While most kids are morning larks,” Dr. Super also allows that, “some kids truly are night owls.”

3. Make Sure Your Child Is Getting Enough Total Sleep

If your little morning lark is popping up way too early, or your night owl is still hooting after 9pm, your first goal is to make sure that he or she is getting enough total sleep. The National Sleep Foundation recommends that toddlers who are one to two years old get 11-14 total hours of sleep per day. For preschoolers who are three to five years old, the foundation recommends 10-13 total hours of sleep.

4. Commit to a (Reasonable) Schedule

Most children—like most adults—do better with a consistent sleep schedule.  Plus, it’s a place where parents can make a difference. Unlike developmental stages or temperament, “your child’s sleep schedule may be the one thing that you can control,” says Dr. Super.

But you don’t have to be rigid down to the minute. Target a bedtime, like 7:30 pm, but give yourself a break and allow for the normal fluctuations of life. Try to get your child to bed within a half hour to an hour of that time each night.

5. Set a Simple Bedtime Routine

Bath, brush teeth, book, and bed, is an easy example and really helps a baby understand that it’s time to go to sleep.

6. Put Your Child Down Drowsy but Awake

Teach her to soothe herself to sleep by giving her a chance to practice. Babies wake up 5 to 7 times per night, and this cycle continues into adulthood (though it’s often imperceptible to adults), so this helps young children develop a lifelong skill. When responding to night wake ups, be consistent and structured. Once your child no longer needs to feed at night, Dr. Super recommends providing reassurance, but not reinforcement (nothing fun and no feeding).

7. Keep Your Expectations Flexible

Your child may be a great sleeper one week and then start night waking the next. This is normal. “Know that lots of kids have sleep issues, and that sleep issues will come and go as they grow,” says Dr. Super. With each developmental change or stage—like learning how to pull up, or sit up, or babble—sleep can be affected. Keeping your approach consistent: a bedtime routine, a schedule, and putting your baby down drowsy but awake will help the whole family get more sleep during the big changes of these early years.

When is it time to seek medical advice?

Talk to your pediatrician about sleep as part of your routine visits, especially if sleep has been a challenge for your family. Definitely speak to a doctor if there is  frequent snoring, labored breathing, or pauses in  breathing, or if your child ever appears to be significantly in pain while sleeping.

And remember, sleep issues too shall pass. “I have two kids as well,” says Dr. Super, whose children are now ages 4 and 6. “We’ve been through some struggles, and now they sleep great.”

Meet Dr. Super

A member of the general pediatric team at OHSU Doernbecher Children’s Hospital in Portland, Oregon, Dr. Elizabeth Super has a strong interest in sleep and pursued fellowship training in Sleep Medicine. When she’s not caring for children in her job, she enjoys exploring the outdoors with her husband and her two young children.

Read more articles by Dr. Super. 

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