How to get your child to sleep

To sleep, perchance to dream...or something

Welcome to Techno Sapiens! I’m Jacqueline Nesi, a psychologist and professor at Brown University and mom of two young kids. If you like Techno Sapiens, please consider sharing it with a friend today. Thanks for your support!

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15 minutes

While in my final year of training for my PhD in Clinical Psychology, I rotated through a pediatric sleep clinic, seeing children (and their very tired parents) with concerns like frequent night wakings, insomnia, and daytime tiredness. I have one particularly haunting memory of an exhausted mom describing sleeping on the floor of her 6-year-old’s room every night for years.

The rotation was only a few months long, but it was dually effective in: (1) teaching me about pediatric sleep, and (2) making me question whether I ever wanted children of my own.

On the former: today, we’re talking about evidence-based tips for improving young kids’ sleep (ages 1 to 7, or so).¹ We’ll be drawing primarily on this (excellent) paper and the official practice parameters of the American Academy of Sleep Medicine.²

On the latter: you know how that turned out.³

This post is a longer one, so please feel free to scan to the sections that are relevant for you, and save this post to return to one night after your child’s just woken you up for the fifth time.

Here’s what we’re going to cover:

• What sleep problems look like in kids (ages 1-7)

• How to increase sleep behaviors we want to see, and decrease ones we don’t

• What to do if your child is falling asleep too late

• How to make bedtime easier

• What to do if your child will only sleep with you in their room (or bed)

• How to address night wakings

• Other tips and tricks

Let me also say up front: as is always the case here at Techno Sapiens, this advice is not meant to be blame-y, judgmental, or to imply that children’s sleep problems are somehow parents’ fault. This stuff is hard! We’re all figuring it out as we go. There’s also a ton of variability in kids’ sleep, and what works for one kid won’t work for another.

The goal here is simply to give you research-backed information on kids’ sleep, and hopefully make nights a little bit easier for everyone.

Let’s get snoozy!

Okay, let’s start at the beginning. Here is a helpful guide to sleep for kids of various ages:

Source: American Family Physician

Behavioral sleep problems in children typically include one or more of the following:

• Child has difficulty falling asleep.

• Child stalls or refuses to go to bed

• Child refuses to stay in bed or go back to sleep after night waking

• Parent has trouble setting limits around bedtime

• Child requires highly specific conditions to fall asleep, which are problematic or demanding for the parent⁴

• Child requires parental intervention to fall back asleep after night wakings

Sound familiar?

This all occurs on a spectrum. Most children have difficulty falling asleep sometimes, or go through phases of frequently waking up at night, or want their parent to rock them to sleep when they’re sick or had a bad day.

The key is that these sleep problems are defined by the parent. In other words: if whatever you’re doing is working for you and your child, great! If not, there are things you can do.

And of course, if your child is having significant sleep problems, you should consult your pediatrician.

Kids are not rats (or are they?)

We will get into very specific tips later, but because I’m the type of person who eases their parenting anxieties by writing a newsletter every week for 3 years, I like to come in with an overarching framework.

The framework here is operant conditioning. Remember learning about those psychology experiments where, when rats press one lever, they get food, and when they press a different lever, they get an electric shock? That’s operant conditioning. Specifically:

• Behaviors that are followed by a good consequence are more likely to happen in the future.

• Behaviors that are followed by a bad consequence are less likely to happen in the future.

The frequency and schedule of consequences matters, too. When good consequences are intermittent (i.e., unpredictable), the behavior is especially likely to continue. Think of a slot machine: sometimes you get rewarded, sometimes you don’t, and you can’t predict it. This keeps you playing longer.

And what does this have to do with my kid sleeping?

When it comes to our kids’ sleep, there are many behaviors we want to happen more often (e.g., falling asleep independently, staying in bed), and many behaviors we want to happen less often (e.g., asking for one last drink of water before bed, getting up at night, screaming when we leave the room).

For our kids, our attention is the ultimate positive consequence. Even if we are yelling or negotiating, our kids are still seeing this as a positive (especially if it’s delaying their bedtime longer).

So, the basic idea is to ignore behaviors we want to stop, reward behaviors we want to see more, and to do this with extreme consistency.

To illustrate: let’s imagine your child is in the habit of repeatedly yelling for you to come back into their room after bedtime. You tell them you’re not going to do this anymore. That night, they scream for 20 straight minutes until, eventually, you give up and go back in. What have they learned? All they need to do is scream for 20 straight minutes, and they will get the desired outcome.

The next night, you hold out longer, but after 40 minutes of their screaming, you’re back in there. This is intermittent reinforcement in action.

On the other hand, if you succeed in ignoring the screaming until they eventually fall asleep, they learn something different: I guess mom and dad are serious about this whole “going to bed” thing. They also learn that they’re capable of falling asleep on their own.

One final point: a well-known phenomenon in operant condition is what’s called an extinction burst. When you start ignoring an unwanted behavior, you should expect that it will get worse before it gets better. Your child’s protests may get louder, last longer, or become more extreme. This is the point when many of us give up, but it’s actually the most important time to stay consistent. Knowing it’s coming can help.

JUST HELP ME I’M EXHAUSTED

Alright! Let’s get to it. What follows are a number of common sleep concerns in young kids, and what the research says about how to address them.

Of note: these approaches sound straightforward, but they are not easy! They require some trial and error, and significant commitment. They may even lead to less sleep for the parent in the short-term (boo!), but in the long run, they can pay off.

My kid is going to bed way too late!

Try to pick a bedtime (for many young kids, this could be somewhere between 7-8:30pm), and stick to it most nights. A consistent nap schedule is also a good idea. Try to make sure naps are over by 3 or 4pm.⁵

But what if your child is going to bed very late? Or getting into bed early, but lying awake sing-shouting the Trick or Treat song for hours? [just my child?]

You can try what’s called bedtime fading. Here’s how it works:

1. Figure out when your child is actually falling asleep most nights

2. Pick a bedtime close to that time, and stick to it consistently.

3. Once they’re falling asleep quickly at this later time, start moving up the bedtime 15 minutes every 2 or 3 days.

Along with bedtime fading, you can also try something called response cost. This just means that if they’re not asleep after a certain amount of time (say, 30 minutes), you get them out of the bedroom to do some other relaxing activity (e.g., read, play quietly) for a while (45-60 minutes) and then try again.

Bedtime is such a battle!

Use a consistent bedtime routine. Ideally, it should be somewhat short (30 minutes or less) and involve two to three relaxing activities (e.g., PJs, read two books, sing a song).

A few ideas to make this go smoothly:

• Offer quick warnings as bedtime approaches (e.g., 5 minutes until bed or One more story, and then it’s time for bed)

• Try a bedtime chart with a picture of each activity in the routine, and have the child mark off each activity as it’s done. Do not deviate from the chart (i.e., if the chart says two books, don’t give into requests for another).

• Try a positive routine. Incorporate at least one of your child’s favorite activities into the bedtime routine. Praise and encourage them when they’re sticking to the routine. If they don’t stick to the routine (e.g., protests or tantrums), the fun activity ends and they go to bed right away.

• Over time, make yourself as useless as possible in the bedtime routine. You do not want the routine to involve, say, rocking them to sleep or lying in bed next to them until they fall asleep. This is because, if they wake up in the middle of the night, guess what [who] they’re going to need to fall back asleep?

• I would be remiss in my Techno Sapiens duties if I didn’t also mention: keep screens out of kids’ bedrooms. If they fall asleep to TV at the beginning of the night, for example, it will be very difficult for them to fall back asleep in the middle of the night without TV.⁶

My kid will only fall asleep if I’m in the room!

Helping kids learn to fall asleep independently is incredibly important, and also, so unfair. We feed them, we clothe them, we take care of them all day, and now they need our help figuring out how to fall asleep on their own? For God’s sake.

Well, I’ve got good news and bad news. The good news is that this is a very fixable problem. The bad news is that fixing it is hard.

You’ve got basically two options here:

Option 1: “Cry it out”

Option 1 is unmodified extinction, more commonly called “cry it out.” We’re familiar with this approach for babies, but it works for young kids too. Here’s how to do it:

• Put kid in bed while awake

• Ignore all protests and cries until the child falls asleep

• Do this every night until the problem goes away

If only it were so simple, right?

Amazingly, if you can actually stick to this approach, most kids will be falling asleep independently within just one week.

The problem is that it’s extremely difficult for many people to listen to their children cry and scream for hours, however short-lived it may be (in the academic literature, they say it is not “well-tolerated” by most parents. You don’t say…).

If you do want to give it a try, a few things to keep in mind:

• Get a video monitor so you can keep an eye on safety

• Explain the plan to your child beforehand, especially if it’s a significant deviation from your typical nighttime situation

• It will get worse before it gets better, likely on the second or third night (remember the extinction burst?)

• Some kids get so upset that they vomit. Have a plan in case this happens. For example: have a second set of sheets on the bed for an easy switch, change their PJs, give a quick second kiss good night, and you’re out of there again.

• Easier said than believed, I know, but there is absolutely zero evidence of long-term psychological harm due to using “cry it out.” Instead, it should quickly lead to kids getting more, much-needed sleep at night—which is essential for healthy growth and development.

Option 2: Take it slower

Option 2 is what’s called graduated extinction. Similar concept to unmodified extinction but more tolerable for many families. Here’s how this one works:

• Put kid in bed while awake

• Wait to check on them over progressively longer periods. For example: on a given night, you could check in after 1 minute, then 3 minutes, then 5 minutes; or over the course of a few nights, you could check in every 3 minutes the first night, then every 5 minutes the second night, etc.

• Make each check-in as short, boring, and consistent as possible. A 5-second poking your head in the room and saying “Time for sleep! I love you!” is plenty.

This typically takes longer than the cold turkey approach above, but can be equally as effective (and less painful for parents). The goal is for the child to fall asleep while you’re not in the room.

Just make sure the check-ins aren’t accidentally encouraging the child to stay awake (this is more likely if they’re turning into long negotiations, or opportunities for the child to ask just one more question). Keep it boring!

My kid only falls asleep if I’m lying next to them!

Your move here is fading of parental presence. This is another “graduated” approach. Again, two options here:

Option 1: Take breaks

Take increasingly longer breaks from lying next to them, with the goal of having your child start falling asleep during those breaks:

• Start the night by laying next to your child

• Take a short break (e.g., 3 minutes)

• Come back and stay until the child falls asleep.

• The next night, make the break 5 minutes, then 10 minutes, etc.

Option 2: Slowly back away

Gradually move further from the bed. Every 3 to 7 nights, inch away slightly more. One option for this progression:

• Lying next to the child

• Sitting on the bed next to the child

• Sit in a chair next to the bed⁷

• Sit in a chair halfway between the bed and the door

• Sit in a chair in the doorway

• Sit in a chair outside the room, where the child can’t see you

My kid keeps getting up in the middle of the night!

One way to address night wakings is to just play it by ear. Start by addressing bedtime issues (described above), and wait to see if night waking improves on its own. For many kids, once they’re falling asleep independently at bedtime, night wakings will improve within 2 weeks.

Alternatively, you can try applying whatever approach you’re using at bedtime to night wakings, too, whether that’s simple “cry it out,” or a more gradual approach. This is, obviously, harder and will result in less sleep for you, but could mean things get better faster.

As a general rule, once kids are in a good sleep routine, try to address night wakings with our favorite mantra: short, boring, consistent. If they come into your room, try to remain neutral, give them a quick kiss or hug, and lead them back to their bed with minimal fanfare.⁸

Final tips and tricks

• Give choices when possible. For example, Do you want to read Buffalo Fluffalo or Ada Twist, Scientist? Would you like to wear your elf pajamas or your Sesame Street pajamas?

• Use commands. When there is no choice, use commands instead of questions: It’s time to brush your teeth, not Do you want to brush your teeth?

• Try a sticker chart. Create a chart where your child can earn stickers for each bedtime behavior and, eventually, get a reward

• Have the sleep fairy visit. Reward staying in bed with the sleep fairy. Each night the child stays in bed all night, the sleep fairy comes and leaves a little sticker or token (which they can eventually trade for a reward). Do this every night to start, then space it out.

• Try bedtime passes. At the start of the night, give them 2 or 3 passes. They can trade each pass for a trip out of bed (e.g., for a drink of water, to ask parents a question). Once the passes are used up, ignore any requests. Unused passes can be traded in for a sticker in the morning. Reduce the number of passes given over time.

• Ensure safety. If they’re using a crib and keep climbing out, try a crib tent. If they’re older, consider a baby gate in the doorway to their bedroom.

And one final tip: hang in there! When kids are struggling with sleep, it is hard on parents, emotionally and physically. Things will get better. In the meantime, I enjoyed this cathartic “bedtime book for adults,” whose title perfectly captures the experience of putting a young child to bed: Go the F*** to Sleep.

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A short survey

We’re running into some technical challenges with our usual end-of-post survey, so if you have feedback on this post (Things you liked? Things you hated? Follow-up questions?), please reach out. You can comment, or reply directly to this email. Thanks!

1. Note that most of the advice in this post does not apply to infants. If you’re looking for help with baby sleep, I found the Taking Cara Babies online course to be very helpful. (It’s also my favorite gift for new parents who, like me, are the kind of people who love an online course).

2. For those who care about this sort of thing, some of the above suggestions are “Standard” recommendations (highest level of evidence), and some are “Guidelines” (slightly lower level of evidence, but still have support). If you want to get into the weeds, check out the American Academy of Sleep Medicine section on “Treatment of Bedtime Problems and Night Wakings.” The detailed Guidelines and Evidence Review are available to all, but the “Guidelines-at-a-Glance,” it seems, are for members only. Rude.

3. I do have two children now, and can confirm that they’ve ruined my sleep. They are the absolute best! But the sleep. For God’s sake.

4. “Special conditions for falling asleep” are only problematic when they are excessive or highly demanding for the parent. For example, it’s common for kids to need a special pillow or stuffed animal (in our house, it’s a stuffed dog wearing a Christmas sweater, because why not?). Examples of conditions that may be too demanding for parents would include things like: needing to nurse to sleep, needing the sound of the vacuum cleaner to sleep, or needing to be in the car driving around to sleep.

5. The science specifically advises that naps should end by 3 or 4 pm, unless you are very tired and your kids are finally sleeping and you are trying to finish this week’s Techno Sapiens post, in which case naps should end at whatever time you want.

6. Official guidance is to avoid screens entirely in the hour before bed. If your child is having trouble falling asleep, this is something to note. In my house, we currently watch 15 or so minutes of Daniel Tiger on the family room TV as part of my sons’ bedtime routine, and it’s worked out great for us. Though after about a year of this, I think we need to move onto a new show before the Beautiful Day in the Neighborhood theme song slowly destroys me from the inside out.

7. In the academic literature, the “gradual move to away from the bed” typically includes the parent sitting on the floor, but I’m suggesting sitting in a chair instead because, c’mon, our backs! What are we, yoga instructors?!

8. In terms of night wakings, there is also some evidence for something called “scheduled wakings.” Basically, you figure out how many times and when a child is typically waking up at night, and then wake them up 15 to 30 minutes before those times. Over days and weeks, you spread those wake-ups farther apart. To be honest with you, I cannot see myself ever doing this (and the literature describes this approach as “less acceptable” to parents because of course it is!), so I didn’t go into detail above.