Are Sleep Regressions Real? A Pediatric Sleep Expert Answers

Your 4-month-old baby has finally gotten into a good nighttime rhythm of consistent sleep. Then, suddenly, they wake up every two hours crying, screaming, and fussing. This common scenario, almost universal for parents, is often dubbed a "sleep regression."

What are sleep regressions? Do they exist? And if so, when can you expect them, and how long do they last?

I recently spoke with Dr. Natalie Barnett, an expert in pediatric sleep, about sleep regressions and other sleep topics. Read on to learn more about regressions and how you can navigate sleep difficulties with your baby or toddler.

What are Sleep Regressions?

Sleep regressions typically refer to a baby or toddler who backtracks on their sleeping skills. For example, your child may have been sleeping through the night, and then suddenly start having frequent night wakings.

In parenting forums and social media, the term "sleep regression" often refers to specific times that babies struggle with sleep. For example, you may see mention of a 4-month sleep regression or a 6-month sleep regression.

This is not an accurate concept of regressions, says Dr. Barnett. "Sleep regressions are very real, but I don’t like to think of them as happening at extremely specific, universal ages. They occur at different times for different babies for various reasons," she asserted.

When Do Sleep Regressions Happen and Why?

Dr. Barnett says that although each baby is different, sleep is often disrupted when children reach different motor milestones. "We see that very clearly in our data. Around the time a baby learns to roll, sit, crawl, pull to stand, or walk, those milestones are often associated with sleep disruptions," she explained.

Because many babies reach milestones around the same time, there are some common sleep regression ages. For example, a regression around 4 months of age is common, especially if your baby starts rolling over.

However, every baby is unique and not all babies follow the same pattern. Your baby may not have sleep problems at 4 months, but instead experience a regression around 5 months. Additionally, other issues aside from milestones may impact your baby's sleep.

Causes of Sleep Regressions

Some other common reasons sleep regressions occur are illness and travel. Both can disrupt sleep routines and schedules, resulting in poorer quality sleep.

Dr. Barnett explained that in either scenario, "...it’s easy to slip into habits you might not want long-term. For example, holding your child until they fall asleep, bringing them into your bed, feeding to sleep, and so on."

As related to travel, Dr. Barnett recommends trying to recreate the home environment as much as possible. This includes following the same sleep schedule, awake times, and routines.

Dr. Barnett also recognizes that during illness or travel, disrupted routines and schedules are common. Getting off track is a normal part of life. "Just keep in mind that toddlers can adopt new sleep habits quickly," she explained. One change for an illness can result in several weeks or months of consistent work to get back to normal.

Signs of Sleep Regressions

What are the signs that your baby or toddler is experiencing a sleep regression? Some signs you'll notice include:

• Fussiness or irritability
• More trouble than usual falling asleep
• More night wakings than usual
• Shorter naps
• Resisting sleep
• Recently achieving a developmental milestone
• Other new behaviors related to sleep that differ from past patterns
  

These signs indicate a deviation from your child's baseline or normal.

How Long Do Sleep Regressions Last?

Depending on the cause of your child's sleep regression, they usually last between a few days and a few weeks. According to Dr. Barnett, "A disruption around a milestone should only last a couple of days. If it lasts longer, talk to your pediatrician or healthcare provider."

Regressions caused by illness or travel may clear up when things are back to normal. However, disrupted sleep may last longer depending on how you manage the regression.

For example, if your routines and schedules remain inconsistent, it may be harder to get back on track. Following a consistent schedule and routine can help shorten disruptions. Additionally, consistency sets clear expectations for your little one, helping them build their sleep skills.

How to Manage Sleep Regressions

What should you do if you think your baby is experiencing a regression? Dr. Barnett recommends ruling out illness first. "If you’re seeing sleep disruptions, absolutely go in and check your child. Check  to see if they have a fever or are feeling unwell."

Then, she recommends following up with your general sleep practices. "For a good independent sleeper, I want to give them the opportunity to get themselves back to sleep," she explained.

As a general rule, consistency around sleep routines is the first step to take. "We’ve done a lot of work on bedtime variability. We see that when kids have inconsistent bedtimes, they sleep less and worse than when bedtimes are consistent," Dr. Barnett says.

If you're considering sleep training or making a change to your routine, Dr. Barnett suggests making a firm commitment. When making a change with toddlers, Dr. Barnett says it's helpful to talk with them about it first.

"They do understand what's going on," she explained. " It’s important to communicate with them during the day about what is going to happen. Be clear about expectations so you’re not springing a new expectation on them at night."

Need help managing bedtime with your toddler? Read this Q&A with Dr. Barnett for more tips and strategies. Also, check out our expert tips for transitioning from a crib to a toddler bed.

As the VP of Clinical Research at Nanit, Dr. Natalie oversees research on pediatric sleep and parental health and well-being. She holds a Ph.D. in Genetics from the University of New England in Australia and a Postgraduate Certificate in Pediatric Sleep Science from the University of Western Australia. Natalie was an Assistant Professor in the Neurogenetics Unit at NYU School of Medicine before joining Nanit.