Is your child waking up at night and unable to get back to sleep alone? Why 1-5-year-olds wake often, sleep habits that matter and step-by-step solutions.
It is just past two in the morning. Once again you are woken by crying from the hallway. The third time tonight. Your two-and-a-half-year-old only falls back to sleep when rocked in your arms or when you lie down next to them; when you go back to your own bed, an hour later it all starts again. The tired face you see in the mirror before going to work in the morning bears the marks of months of sleeplessness. "Babyhood is over, so why are they still waking up?" you wonder. If you have a child waking up at night and this has been going on for months, behind it there are often learned sleep habits, developmental stages, separation anxiety or medical causes. In this article we look at the causes of night waking in children aged one to five, how the family is affected by this process, and step-by-step solutions you can put into practice.
Child Waking Up at Night: When Is It Considered Normal?
Night waking is extremely common in infancy and early childhood. In infancy, frequent waking is expected because of feeding needs and a still-developing sleep pattern. After the age of one, many children become able to sleep through the night for longer stretches; but this transition does not happen at the same pace in every child.
Occasional night waking between the ages of one and five is usually temporary, especially when it follows changes such as an illness, teething, a holiday, moving house or starting nursery. The routine recovers by itself within a few days or a few weeks.
What needs attention is when the waking lasts for months, happens several times a night, and the child can only get back to sleep each time with a particular intervention from a parent. If this picture is noticeably affecting the daytime lives of both the child and the family, it is time to take a closer look at the sleep routine. For a general framework on sleep problems in children, you can also read our article on sleep problems in children.
Sleep Cycles: Every Child Wakes at Night, So Why Can't Some Get Back to Sleep?
One fact that many parents don't know is this: in fact every child, and indeed every adult, wakes briefly several times during the night. Sleep moves in cycles made up of light and deep stages. When a cycle ends, there is a brief moment of wakefulness. Adults often don't even remember these moments; they straighten the pillow, turn over and carry on sleeping.
In children, what matters is what happens in that brief moment of wakefulness. The child checks whether the conditions present when they fell asleep are still there. A child who fell asleep in their mother's arms, while feeding, while being rocked or holding their father's hand becomes unsettled if they can't find these conditions when they wake in the night, and asks for them back. This is called a sleep association.
Let's say a child falls asleep every evening breastfeeding at their mother's breast. When a sleep cycle ends in the night, they find themselves alone in their bed. For them this means "The thing I need to sleep is missing", and they call for their mother. When the mother comes and feeds them, the child falls asleep again; the cycle repeats several times every night. In this case it can be thought that the child wakes not out of hunger or fear, but because they need their way of falling asleep to be recreated.
This information matters, because the way to reduce night waking often lies not in the night itself, but in how the child falls asleep in the evening.
If Your Child Is Waking Up at Night: Possible Causes
Sleep associations
As described above, the child being able to fall asleep only with a particular kind of help is one of the most common causes of night waking. Breastfeeding, a bottle, rocking, a parent lying beside them or being driven around in the car to fall asleep are examples of this help.
Separation anxiety
Separation anxiety, which starts around the age of one and comes and goes through the pre-school years, can also show itself at night. A child who finds it hard to separate from their mother during the day may want to see her beside them when they wake at night too. Starting nursery, the mother returning to work or a new carer can increase this anxiety.
Developmental leaps
Big developmental steps such as starting to walk, rapid language development or toilet training can temporarily disrupt the sleep pattern. While the child's mind is busy with what they have learned during the day, they may wake more often at night.
Changes within the family
The birth of a new sibling, moving house, parents separating, the loss of someone close or increased tension at home can shake the child's sense of security. This disruption often shows itself most clearly at night.
Nightmares and night terrors
From around the age of three, as imagination develops, nightmares and fear of the dark may also appear. A child who has a nightmare wakes up, can tell you they were scared and wants comfort. In children who scream and cry in their sleep but don't fully wake up and remember nothing in the morning, however, night terrors may be involved; the two need different approaches.
Medical causes
Problems such as teething, ear infections, reflux, allergies, constipation, itching from eczema, or snoring and pauses in breathing during sleep can lead to night waking. In particular, if your child snores loudly, sleeps with their mouth open or has pauses in their breathing while asleep, you should definitely consult a paediatrician.
Daytime routine
Daytime naps shifting too late, being put to bed very late in the evening, not getting enough movement during the day or being exposed to screens before bed can lower the quality of night-time sleep. Surprisingly, children who are put to bed overtired may also wake more often.
How Does Night Waking Affect the Family?
If your child is waking up at night and it has been going on for months, it is not only the child who is affected. Sleep-deprived parents may experience impatience, forgetfulness, a drop in work performance, tension in the relationship and, over time, emotional exhaustion. Between partners, arguments of the "You get up" / "I got up yesterday" kind can turn into a silent competition over who is more tired.
Living conditions in Turkey also affect this process. In apartment flats, worry that the child's crying will disturb the neighbours can lead parents to rush in the moment the child makes the first sound and to hesitate over taking steps that would change the sleep routine. In families where a grandmother lives in the same home or stays as a guest for long periods, differing views such as "Pick them up, don't let them cry" or "We never had things like this in our day" can make it harder for parents to stay consistent. In crowded homes, the child not having a separate room can also make it difficult to establish a new sleep routine.
All of this shows that night waking is not only a "sleep problem", but a situation that affects family life as a whole. That is why the solution should also be planned with the family's circumstances in mind.
Step-by-Step Solutions to Reduce Frequent Waking
1. Keep a two-week sleep diary
Note when the child goes to bed, how they fall asleep, how many times and at what times they wake in the night, how you respond and what time they get up in the morning. Record daytime naps too. This diary lets you see patterns and track progress.
2. Set fixed bedtimes and wake-up times
Going to bed and getting up at the same times as far as possible, on weekdays and at weekends, regulates the child's internal clock. A fixed morning wake-up time in particular supports night-time sleep.
3. Create a calm, predictable bedtime routine
A routine repeated in the same order every evening, such as bath, pyjamas, brushing teeth, a book, a short chat and "goodnight", tells the child's body that it is time to sleep. The routine should not last more than twenty to thirty minutes, and screens should be switched off at least an hour before bed.
4. Put them to bed drowsy but awake
One of the most effective steps for reducing night waking is for the child to learn to fall asleep in their own bed, on their own, in the evening. When the routine is over, put the child to bed drowsy but still awake. That way, when they wake in the night, they find the same conditions they were in when they fell asleep.
5. Withdraw gradually
If your child can't fall asleep without you lying beside them, plan a gradual transition rather than stopping suddenly. For the first few nights, sit next to their bed; then every few days move your chair a little further towards the door. Eventually you will be at the doorway, and then outside the room. This method protects the child's sense of safety while developing the skill of sleeping independently.
6. Keep night-time responses brief, calm and boring
When the child wakes in the night, go to them and settle them briefly; without turning on the light or getting into play or long conversation, repeat the same short sentence: "It's night-time, time for sleep. I'm here." The aim is for the child to know they are safe, but also to learn that night is not a time to be spent awake.
7. Increase closeness during the day
It is important for a child who finds separation hard at night to spend enough one-to-one time with their parent during the day. Fifteen minutes of uninterrupted play after nursery can reduce night-time demands by meeting the child's attachment needs during the day.
8. Share the same plan with all the adults
It is very important for the change to last that the mother, father and other adults caring for the child at home all take the same approach. Discussing the plan in advance also prevents arguments in the middle of the night.
9. Protect your own sleep too
It is very hard for a sleep-deprived parent to stay consistent. Taking turns to get up at night, letting one parent catch up on sleep in the morning at weekends, or asking a trusted relative for a few hours of help are necessary for you to be able to keep up the plan. Caring about your own rest is not selfish; it is the condition for being able to accompany your child as a calm adult.
Sleep is a skill; a child learns it not by force, but by feeling safe and by repetition.
With any change to the sleep routine, the first few nights may be challenging; the child protests when they notice that the routine they are used to has changed. When consistency is maintained, many families see a clear improvement within a few weeks. For steps such as reducing night feeds, however, it is best to talk to your paediatrician first.
When Should You Seek Professional Support?
It may be helpful to get support from a professional in the following situations:
- If night waking has not decreased for months despite a consistent sleep routine
- If the child snores loudly, stops breathing during sleep or sweats a lot (first, an assessment by a paediatrician)
- If night waking is accompanied by intense restlessness, outbursts of anger or marked attention problems during the day
- If the child experiences intense fear at night, or is extremely afraid of the dark or of being alone
- If the sleep problems started after a loss, a separation or a traumatic event
- If you notice that, as a parent, you are exhausted, helpless or low because of lack of sleep
When a medical cause is suspected, the first step is an assessment by a paediatrician. Where emotional causes are to the fore, psychological support can lighten the load on both the child and the family.
How Are Sleep Problems Approached in Therapy?
In child and play therapy, night waking is addressed by assessing the child's emotional world and the family's sleep routine together.
Parent guidance: With young children, a large part of the work on sleep problems is carried out with the parents. The sleep diary is reviewed together, a plan suited to the family's circumstances is prepared and how to put this plan into practice is discussed step by step.
Working with anxiety: For children experiencing separation anxiety, nightmares or fear of the dark, play therapy offers a safe space for the child to express and work through their fears. With slightly older children, age-appropriate cognitive behavioural techniques can be used, such as stories about coping with fear and calming skills.
Family dynamics: The effect on the child's sleep of situations such as the birth of a sibling, separation or tension at home is addressed. The parents' own tiredness and the factors that make it hard to stay consistent are also discussed as part of the process.
Frequently Asked Questions
When should I stop breastfeeding my child to sleep?
There is no single right time for everyone. If breastfeeding to sleep isn't causing problems for the child and the mother, there is no need to rush; but if the family's load is growing along with frequent night waking, moving the feed to the start of the bedtime routine and putting the child to bed awake can provide a gradual transition.
Is letting a child cry it out harmful?
Leaving a child to cry alone and without comfort for long periods can be hard, especially for children with separation anxiety. Gradual methods in which the parent stays with the child, or goes in at short intervals to settle them, both protect the child's sense of security and support the skill of sleeping independently.
If I drop the daytime nap, will they sleep better at night?
Not always. In a child who still needs a daytime nap, dropping it can lead to overtiredness and more frequent night waking. Rather than dropping the nap completely, moving it to earlier in the afternoon often works better.
When they wake at night they keep asking for water or milk. Should I give it?
Most children over the age of one who are growing healthily don't need to feed at night; the request is usually a habit. Even so, consult your paediatrician before making changes, and then reduce the amount gradually.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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