Frequently Asked Questions | Overview
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
- I've heard a lot about sleep training from other parents. How do I sleep train my baby?
- Will it harm my baby to let him cry when he wakes up during the night?
- Is it okay to let my baby use a pacifier, "lovey," or other comfort object to help him fall asleep?
- Is co-sleeping dangerous for infants?
Sleep in toddlers and preschoolers
- I've heard that "once a bad sleeper, always a bad sleeper." Is this true?
- When should my child stop napping during the day?
- My child bangs his head on the bed before he falls asleep. Is this harmful?
- 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?
- My preschooler cries and yells at bedtime and will not go to bed. Is it OK to let him sleep with me?
- My 4-year-old seems hyperactive, not tired. Is this the sign of a sleep problem?
Sleep in school-aged kids
- TV helps me fall asleep. So is it OK for my son to fall asleep with the TV or his laptop?
- My 9-year-old daughter dozes off during the 15-minute car ride to and from school. Is this normal?
- My son sometimes complains of "growing pains." What causes this?
- Sometimes my son says he can't fall asleep because he's worried. How can I help?
- My 8-year-old snores, just like her dad. Is this a problem?
- I've heard that melatonin helps kids who can't sleep. Should I try it with my older child?
Sleep in tweens and teens
- My high school junior gets about seven hours of sleep during the week. Is this enough?
- My son stays up late and catches up on sleep over the weekend. Is this a problem?
- My son can't fall asleep until 2 or 3 a.m. and then can't get up for school. Help!
- My teen seems sleepy all the time even after sleeping for 12 hours at night. Should I be concerned?
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:
- “Cry it out approach”: Parents leave the baby’s room at bedtime and do not come back until morning, even if their child is crying.
- “Checking method”: Parents allow their baby to cry, but check in at regular times until he falls asleep.
- Start out the night in the baby’s room and slowly move out of the room to change habits gradually.
Will it harm my baby to let him cry when he wakes up during the night?
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.
Is it OK to let my baby use a pacifier, “lovey,” or other comfort object to help him fall asleep?
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.
- Do not put pillows in your child’s crib if he is under age 2.
- Do not put a pacifier attached to a string around your baby’s neck.
Is co-sleeping dangerous for infants?
It is important to know the difference between bed-sharing and room-sharing.
- The American Academy of Pediatrics (AAP) does not recommend bed-sharing until a baby is 1 year old due to the risk of sudden infant death syndrome (SIDS) or suffocation (lack of oxygen).
- The AAP does support 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 1, 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.
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:
- medical concerns, including reflux (frequent spitting up) or ear infections, that make sleep problems more likely
- developmental issues, such as language delays that can also make treating sleep problems more difficult
- challenging behaviors and personalities
When should my child stop napping during the day?
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:
- The total amount of sleep your child gets in a 24-hour period is just as important — and perhaps more important — than “nighttime sleep” and “daytime sleep.”
- What matters as much as how much sleep your child gets “by the numbers” is that your child seems happy, alert, and well rested during the day. However, flip-flopping between napping and not can increase sleep difficulty so it is better to choose one schedule.
- If your child needs an early morning nap (before 10 a.m.), she may be waking up too early; that nap is actually the last part of their nighttime sleep.
- A late afternoon nap (after 4 p.m.) can get in the way of falling asleep at bedtime. Children usually need to be awake for at least four hours before they’re ready to fall asleep again.
My child bangs his head on the bed before he falls asleep. Is this harmful?
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.
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?
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.
My preschooler cries and yells at bedtime and will not go to bed. Is it OK to let him sleep with me?
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 a child is not ready for sleep at his scheduled bedtime, he may fall asleep more easily if bedtime is set a little later.
- Sometimes the amount of time children are expected to be in bed is longer than the amount of time they actually need to sleep. As a result, they have trouble falling asleep, wake up too early, or stay awake during the night.
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.
My 4-year-old seems hyperactive, not tired. Is this the sign of a sleep problem?
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.
FAQ: Sleep in school-aged kids
TV helps me fall asleep. So is it OK for my son to fall asleep with the TV or his laptop?
There are several problems with falling asleep with electronics, especially electronics with screens (the TV, computer, phone, etc.).
- The light (especially blue light) from computer, TV, and e-reader screens can lower the release of melatonin, the body’s “sleep hormone.” This can make it hard to fall asleep.
- The content of what your child watches may be too stimulating, keeping him from the relaxed and calm state of mind he needs for sleep.
- It is common to become dependent on screens to fall asleep. This can make it hard to get back to sleep during the night without the help of a TV or computer.
It is also important for parents to be good role models of healthy sleep habits for their children.
My 9-year-old daughter dozes off during the 15-minute car ride to and from school. Is this normal?
If your child seems to constantly need more sleep or seems sleepy during the day, you should talk to your pediatrician.
My son sometimes complains of “growing pains.” What causes this?
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.
Sometimes my son says he can’t fall asleep because he’s worried. How can I help?
A common reason older children have a hard falling asleep is anxiety.
This may start out as worrying about school, friends, or family. But it can also turn into worrying about falling asleep itself: “If I can’t fall asleep, I won’t be able to wake up in the morning, then I’ll be late for school and then I’ll get detention and everybody will be mad at me.” This can cause a vicious cycle of more worrying, leading to more problems sleeping, leading to more worrying. And so on.
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.
My 8-year-old snores, just like her dad. Is this a problem?
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.
I’ve heard that melatonin helps kids who can’t sleep. Should I try it with my older child?
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.
My high school junior gets about seven hours of sleep during the week. Is this enough?
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
- mood changes (such as depression)
- cognitive issues (limited attention span, poor reaction time, and reduced decision-making and problem-solving skills)
- safety concerns, such as car crashes due to fatigue
- type 2 diabetes
- heart disease
My son stays up late and catches up on sleep over the weekend. Is this a problem?
Yes. It's like having permanent jet lag.
Sleeping in on weekends until 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.
My son can’t fall asleep until 2 or 3 a.m. and then can’t get up for school. Help!
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.
My teen seems sleepy all the time even after sleeping for 12 hours at night. Should I be concerned?
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.