Night Wakings and Sleep Hygiene in Children

Getting up three times in one night, waiting for your child to settle back to sleep, is one of the most tiring parts of parenting. The question “why does our child wake at night?” is what keeps night waking in children on the agenda, because in most cases the cause is not an illness but the way the surroundings are arranged to wake them up.

Below I look at when night waking is considered normal, how sleep hygiene is built up, how to behave when your child wakes, and which signs deserve a doctor’s attention.

Is night waking normal?

Most night waking in children is a natural part of development. In the newborn period it is usually linked to the need to feed. As the baby grows, the reasons change: a child who has started walking may fall during the night, separation anxiety may appear, and night terrors or night sweats may occur.

How, then, do we draw the line between “normal” and “a problem”? Three things are usually considered:

• How easily does the child settle again? A child who cries briefly or needs a little reassurance and then goes back to sleep is generally not a cause for concern.
• How are they during the day? A child who sleeps enough is cheerful, curious and hungry during the day. Daytime sleepiness or restlessness suggest that sleep is insufficient.
• Is growth and development affected? If weight gain and developmental milestones are following the expected course, and there is no pain or itching, the picture is reassuring.

It is also worth distinguishing frequent waking from waking early. A child who wakes in the early hours and is sleepy during the day is short of total sleep, and this is often linked to a bedtime set too early.

Sleep hygiene: preparing the bedroom

Sleep hygiene refers to the environment and the habits that make falling asleep easier:

• A fixed routine: the same sequence runs every night. A bath, teeth, a book, a cuddle and then bed will do; consistency matters more than the order.
• A fixed wake-up time: keeping the difference between weekdays and weekends as small as possible helps the biological clock stay balanced.
• A simple bedroom: the room should not be filled with things that raise alertness; large toys, strong lights and screens can all delay sleep.
• Darkness and quiet: if possible the only light source should be a night light; darkness helps a child feel safe.
• A cool room: a room that is too warm can lead to sweating and disturbed sleep.
• The bed is for sleeping: no food, no phone and no games in bed, so the child codes the bed as a place of sleep.

The routine of the parent matters too: when your own sleep is irregular, your response to night waking becomes irregular as well.

Daytime naps and the rhythm of the day

A daytime nap does not replace night sleep; the two complete each other. The timing of daytime sleep, which changes with age, has a direct effect on the night. In some children, frequent night waking sits on top of a nap that runs late into the afternoon, and an early bedtime in that situation can itself produce very early morning waking. Two further factors strengthen the rhythm of the day: daylight and movement.

What to do, and what not to do, when your child wakes

The most important question when your child wakes is this: what does your response teach them for the next time? A calm and consistent response tells the child that getting up at night does not set anything off.

1. Keep the response brief and calm: a soft voice, a light touch or a short cuddle is usually enough. Keep the light as low as you can.
2. Make it easy to return to sleep: repeating the same ritual — a drink, a cuddle, a quiet song — shows the child that the night can be crossed calmly.
3. Do not turn on a screen: a video opened at night is the most effective way to keep a child awake, and it teaches nothing about settling.
4. Think about night feeding according to age: small babies may genuinely need a feed at night, while an extra food or drink in older children can delay the return to sleep.
5. Do not change the rules on one night: struggling for a long time on one night and behaving differently on the next leaves the child unsure what to expect.

Managing your own tiredness matters as well. Treating a night waking as an examination to be passed, rather than as part of a routine, protects both the child and the parent.

Mistakes that are easy to make

• Falling asleep on the sofa or in the parent’s bed and then being carried to bed: the child never learns to fall asleep in their own bed.
• Watching screens in bed: the bed becomes coded as a place for entertainment.
• A bedtime that is too early: moving bedtime earlier can lead to very early morning waking and daytime sleepiness.
• A different routine at the weekend: waking early on weekdays and much later at the weekend shifts the biological clock.
• Sweet or “sleep-inducing” foods: sugar in the evening can make the transition into sleep harder.
• Treating night waking as a reward: if a child is waking to get your attention, giving it every time keeps the behaviour going.

When to see a doctor

Night waking can go beyond a normal feature of development and deserves assessment in these situations:

• Loud snoring, pauses in breathing, or laboured breathing during sleep.
• Excessive daytime sleepiness, restlessness, poor concentration or difficulty at school.
• Sweating during sleep, restless leg movements, or waking because of itching.
• Slower weight gain, or a delay in growth and development.
• Waking in a frightened state at the same time on repeated nights.
• Difficulty falling asleep, or being unable to return to sleep once awake, when this gets in the way of daily life.

Medicines and supplements used for sleep are not a routine solution for children; that decision belongs to a doctor. If there is daytime sleepiness or snoring, changes to sleep hygiene alone may not be enough.

In brief

• Most night waking is developmental; how easily your child settles matters more than how often.
• Sleep hygiene rests on a fixed routine, a fixed wake-up time, a dark bedroom and keeping the bed for sleep only.
• The timing of daytime naps, daylight and movement all affect the night.
• A brief, calm and dim response to night waking is the most useful approach.
• Falling asleep on the sofa, screens in bed and sweets in the evening prolong the problem.
• See a doctor for snoring, breathing pauses, daytime sleepiness or poor growth.

If you are worried about your child’s sleep, a face-to-face assessment is very useful. You can book at Elit Istanbul Medical Center in Florya and share your sleep diary during that visit. For appointments and information, call 0212 599 11 16.