#1 Ranked Children’s Hospital by U.S. News & World Report
MyPatients provides referring primary care providers with secure access to their patients’ information.
Boston Children's has launched the world's 1st program dedicated to offering hand transplants to children who qualify.
Innovation insider is a semi-monthly e-newsletter analyzes innovations at Boston Children’s, other academic medical centers and from industry.
Read the latest blog by a Boston Children's doctor, clinician or staff member.
There are many ways you can help children and their families get the care they need.
If you are concerned about your child’s sleep — at any age — know that you are not alone. Here are some of the most common questions we hear, along with our answers.
If you and your child are dealing with any of these sleep problems and you need further help, please call to schedule an appointment with one of our pediatric sleep specialists. Our work is based on decades of research in pediatric sleep medicine.
Sleep in babies
Sleep in toddlers and preschoolers
Sleep in school-aged kids
Sleep in tweens and teens
Q: I’ve heard a lot about sleep training from other parents. How do I sleep train my baby?
Sleep training is helping your baby fall asleep and go back to sleep during the night by himself. Almost all healthy babies can learn to sleep by themselves starting at about 3 months old.
The key to successful sleep training is being consistent and patient. It is also very important that both parents share the goal of helping their baby sleep by himself.
There is no one way to sleep train a baby.Some options parents use include:
Back to top.
Q: Will it harm my baby to let him cry when he wakes up during the night?
A: No, being able to “self-soothe” is an important developmental skill that all babies can learn.
Research on many kinds of sleep training have not found any harmful effects on the baby or on parents from letting your baby cry. It sets the stage for being able to learn to manage their behavior and emotions over time.
Of course, if your baby is sick or in pain, you need to respond if he cries at night.
The major reason babies wake up and have a hard time falling back asleep is that they have learned to fall asleep with their parents’ help (like being rocked or nursed) at bedtime.
Almost all babies do wake up briefly about every hour to hour and a half — this is normal!
Q: Is it okay to let my baby use a pacifier, “lovey” or other comfort object to help him fall asleep?
A: For the most part, sleep “associations” at bedtime like a pacifier or blanket can actually help your baby fall asleep and stay asleep more easily.
It is important that your baby be able to use these comfort objects by herself so that a parent does not need to be there. If your baby is too young to find a pacifier when it falls out of her mouth after falling asleep, it won’t work as a comfort object.
Any objects in a baby’s crib need to be safe.
Learn more about creating safe sleeping environments.
Q: Is co-sleeping dangerous for infants?
A: It is important to know the difference between bed-sharing and room-sharing.
If you decide to have your baby sleep in bed with you, for cultural or other reasons, please talk about it with your child's primary care provider.
After your child turns one year old, bed-sharing does not appear to increase the risk of SIDS.
The decision to have a “family bed” depends on many things. Many parents bring their baby into bed to try to solve his sleep problem. This is often a short-term solution and may cause an even bigger problem (how to get the baby out of your bed) in the long run.
Q: I’ve heard that “once a bad sleeper, always a bad sleeper.” Is this true?
All children can benefit from an individualized sleep treatment plan to improve his/her sleep, even with existing conditions/concerns like,
Q: When should my child stop napping during the day?
A: Most babies go from two naps a day to one nap when they are between 12 and 18 months old.
Most children stop napping by the time they are 5 years old.
There is a big range of how children nap during this transition time. Most children go through a challenging period of “giving up” naps.
Keep in mind:
A: Young children often bang their heads (and rock their bodies) before going to sleep, which can be understandably upsetting to parents. However, there is no evidence to suggest that, in healthy children, head banging results in any harm or injury.
Q: My child sometimes wakes up terrified in the middle of the night and can’t be comforted. But she doesn’t remember it the next morning. Should I be worried?
A: Your child is likely having what are called sleep or night terrors.
These happen during deep sleep, which means that even if your child seems somewhat awake (eyes open, crying out “Mommy!”); she does not recognize or respond to you. She may not want to be held or comforted.
Sleep terrors are common in young children and are related to sleepwalking. Children often have both, usually toward the beginning of the night. They last just a few minutes (but may feel much longer to a parent!).
Because your child is asleep, she does not remember being upset the next morning. Sleep terrors do not mean that your child has had any type of traumatic (upsetting) experience.
The most common trigger for sleep terrors is not getting enough sleep. This is because our brains try to make up for lost sleep by increasing the amount of deep sleep during the night. Since sleep terrors (and sleepwalking) happen during deep sleep, this increases the chances that your child will have a night terror.
Q: My preschooler cries and yells at bedtime and will not go to bed. Is it OK to let him sleep with me?
A: Not wanting to go to bed is common at this age. Whether you let your child into your bed is your choice, but you should know a few things first.
If neither situation above is true, it may help to think about your child’s behavior as a nighttime tantrum.
Just like it is not good to “give in” to your child’s tantrums during the day, giving in at bedtime should not be acceptable either. If you give in, it teaches your child that this bad behavior works and makes it more likely that he will continue this behavior.
Q: My 4-year-old seems hyperactive, not tired. Is this the sign of a sleep problem?
A: Young children often do not act sleepy (yawning, complaining of being tired) and instead “act out” when they are overtired.
Your child may be cranky, frustrated, over-active and have little control and attention span. All of these behaviors could mean that your child is not getting the quality or amount of sleep he needs.
Q: TV helps me fall asleep. So is it OK for my son to fall asleep with the TV or his laptop?
A: There are several problems with falling asleep with electronics, especially electronics with screens (the TV, computer, phone, etc.).
It is also important for parents to be good role models of healthy sleep habits for their children.
Q: My 9-year-old daughter dozes off during the 15-minute car ride to and from school. Is this normal?
A: No. In general, school-aged children who get enough sleep don’t fall asleep during the day, unless they have a sleep disorder (like sleep apnea).
If your child seems to constantly need more sleep or seems sleepy during the day, you should talk to your pediatrician.
Q: My son sometimes complains of “growing pains.” What causes this?
A: Growing pains usually happen during the night and wake children up with symptoms in their legs.
While it is not clear what causes these symptoms, growing pains may be linked with the sleep condition called periodic limb movement disorder. This causes very restless sleep and kicking movements during sleep.
Another cause of leg discomfort can be restless legs syndrome, an urge to move the legs especially at bedtime.
Q: Sometimes my son says he can’t fall asleep because he’s worried. How can I help?
You can encourage your child to keep a “worry journal” that he can write in well before bedtime to “get rid of” anxieties before going to sleep. Or, he can listen to a relaxation app before turning out the lights.
It might help your child to work with a counselor or therapist on his anxiety.
Q: My 8-year-old snores, just like her dad. Is this a problem?
A: Nightly loud snoring can be a symptom of sleep apnea, especially if it happens along with mouth breathing, noticeable breathing pauses, restless sleep, sweating during sleep, snorting or gasping. Conditions that increase children’s risk of sleep apnea include large tonsils, allergies, asthma, being overweight and a family history of sleep apnea.
If your child snores or has any of these other symptoms, talk to your pediatrician. Your child might benefit from an overnight sleep study to look into the problem.
Q: I’ve heard that melatonin helps kids who can’t sleep. Should I try it with my older child?
A: The melatonin that you can buy at the pharmacy or supermarket is a man-made form of the hormone that our brains naturally make to help us sleep. Studies show that relatively large doses (3 to 5 mg) given 30 minutes before bedtime can help, especially in children with developmental disorders such as ADHD and autism.
However, all possible short and long-term side effects of melatonin use in children are not known. Also, if you do not include behavioral strategies to address your child’s sleep problems, melatonin is like a Band-Aid. The sleep problem is likely to come back once your child stops taking it.
If you are thinking about trying melatonin, read more and talk with your child’s pediatrician.
Q: My high school junior gets about seven hours of sleep during the week. Is this enough?
A: Studies suggest that most teens need 8 to 10 hours of sleep a night. Each hour less raises the risk of many long-term health conditions that include
Q: My son stays up late and catches up on sleep over the weekend. Is this a problem?
A: Yes. It's like having permanent jet lag.
Sleeping in on weekends until 12 noon or 1 p.m. does not solve the problem of not getting enough sleep during the week. It may even make things worse, because sleep schedules that vary night to night can interfere with the body’s natural sleep-wake cycle (called circadian rhythm).
Think what it would be like to fly back and forth between Boston to Los Angeles every weekend and expect your body to adjust to that schedule.
Q: My son can’t fall asleep until 2 or 3 a.m. and then can’t get up for school. Help!
A: Around the time that kids go through puberty, their bodies’ circadian rhythms and sleep patterns change and they become “night owls.” This is normal, but some teens shift to a very late bedtime and wake time.
As a result, they cannot fall asleep until very late and cannot wake up at the right time in the morning, because it feels like the middle of the night.
This can lead to frequently being late or even missing school, and can be a serious problem. Fixing it often involves gradual adjustment of sleep patterns, timed exposure to light and melatonin, which usually requires consultation with a sleep specialist.
Q: My teen seems sleepy all the time even after sleeping for 12 hours at night. Should I be concerned?
A: Most teens are sleepy during the day simply because they do not get enough sleep. Others may have a sleep disorder, like sleep apnea, that disrupts their sleep so they don’t feel rested in the morning.
A very rare but important cause of extreme sleepiness (despite getting good quality sleep) is a neurological sleep disorder called narcolepsy. There are special tests that can tell if your child has narcolepsy. A neurologist or sleep specialist should conduct these tests.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”