Yasmeen Neuman says she made the mistake of rocking and staying with her oldest daughter, Eva Marie, until she fell asleep as a baby. This continued through her toddler years.
“With my first one, I did everything wrong as a first-time parent,” says Neuman, who lives in Tampa, Fla. She says she spent at least two hours at bedtime and naptime with Eva Marie, who is now 4.
With her 2-year-old toddler, Annaliese, and 1-year-old, Celia, Neuman, took the graduated extinction behavioral approach. “I put them to bed when they were 4 months old,” she says. “Then, if they cried, I’d tell them they are OK and set the expectation they could and would be able to go to sleep by themselves. They are great.”
She would check on her daughters every five or 10 minutes the first time they got out of bed. The next time, she would wait 15 or more minutes. By the fifth or sixth night, she says she did not hear any crying. Her children still take two-hour naps during the day, which do not interfere with their sleep at night.
The Techniques
Ralph Downey, a health psychologist, sleep medicine specialist and medical director of the Loma Linda University Sleep Disorder Center in Loma Linda, Calif., says graduated extinction is a softer approach than the extinction technique.
A pediatrics expert for the American Academy of Sleep Medicine, Downey says extinction, a behavioral psychology approach, is also referred to as letting a toddler cry it out. He prefers the graduated extinction approach used by Neuman for her two younger daughters.
“You check on your children and make sure they are safe,” Downey says. “Eventually, you increasingly avoid going into the bedroom. The idea is so they self-soothe instead of depending on a bottle or your presence. Others employ extinction, which is unmodified. It’s just no matter how long it lasts, you don’t go in there other than to make sure they are safe. While both approaches have been shown to work, for some reason I like the graduated extinction better.”
But before trying any psychological strategy, Downey says it is important to cross out the possibility your toddler is ill or has a medical problem. “The thing that we emphasize with kids who can’t seem to settle down at night is the importance of making sure they are healthy,” he says.
Downey says your toddler may be crying because he or she has heartburn. Toddlers also have trouble sleeping when they have a rash or something as minor as an insect bite.
As a general rule, most toddlers need at least 10 hours of sleep, Downey says. Toddlers should sleep enough so they are not cranky, appear well-rested and not sleepy during the day.
They also need daytime naps.
“I think it’s still important to have naps, as long as they are going to bed the same time and waking up the same time every day,” Downey says. “It’s usually not the case the naps are interfering with sleep at night. Usually it’s the curtain calls that are the problem with toddlers.”
The Curtain Calls
Oftentimes, toddlers make repeat appearances after going to bed because they hear activity or are curious about what the older people in the house are doing still awake. “They don’t want to go to bed,” Downey says. “Unlike adults, toddlers tend to not want to go to sleep. It’s something they don’t particularly like to do.”
In addition to not drawing attention to what the adults are doing in the house, such as watching a television show or eating ice cream, don’t pay too much attention to the child. “The more you pay attention to them, the more likely they are to stay awake and participate in playing with you,” Downey says. “The unintended consequences are they stay awake much longer than you would like them to.”
Establishing Bedtime Rituals
Downey says the first step to creating a bedtime ritual is to make the bedroom free of distractions. Don’t put a television in your toddler’s room and place favorite toys in the closet or out of sight.
As part of her family’s bedtime ritual, Neuman says goodnight and then says prayers, sings a song and makes sure her children brush their teeth before bed.
Downey says bedtime routines are important because they signify that it’s time to wind down. “When we think of sleep and sleep medicine, we think of it as a continuum,” he says. “You go from wakefulness into light sleep and into deeper sleep. That’s the way healthy sleep works. In order to do that, we need to prepares ourselves for the transition. It’s not like sleep is a switch. It’s more like a dimmer.”
Instead of demanding your toddler go to sleep, create an environment that is conducive to sleep so they can gradually wind down from a more active to less active state.
Downey says just as adults should not exercise before going to sleep, it’s best not to engage a toddler in strenuous play or exercise before bedtime.
When a Parent Travels
Rochelle Hinds of New Tampa, Fla., says she has a more difficult time getting her children to stay in bed when their father, Steven, an account coordinator, is gone on business trips.
“In the beginning, we started taking them back to their rooms,” Hinds says. “After that, we started telling them to go back themselves. It stopped for a while, but my husband has been traveling a lot. It started up again. They know he is not there. They always act up when one parent is gone.”
Hinds says the rule in the family is that the children can not see their parents again after bedtime until 6 a.m. Her other rule is not eating or drinking after 7 p.m. Hinds says she also tried the graduated extinction approach. Instead of her son getting up every hour, he only gets up once a night.
Her children’s bedtime ritual involves taking a bath and picking out a book to read on the sofa. “Every night my husband and the kids will play outside or play video games or board games,” she says.
Experts say it’s important to keep the bedtime ritual the same even if one parent is gone or if a babysitter or grandparent is visiting.
Sound Sleep Advice for Sleepless Toddlers
- Downplay what the adults and older people are doing in the house when it’s toddler bedtime. Don’t draw attention to adult activities because toddlers don’t like to be left out.
- Put a “progressive alarm clock” in your toddler’s room. Buy one that has a nightlight that automatically dims and may be programmed to play night sounds such as birds and crickets. The sounds will automatically turn off after 15 minutes.
- Put relaxing scents in your toddler’s room, such as lavender, but do not burn a candle or anything that would pose a fire hazard.
- Allow your toddler to eat a snack at 7 p.m. so they are not hungry at bedtime an hour or two later.
- If your toddler gets out of bed, put him back into bed, but don’t show any reaction. After a while, your toddler will get bored with the “game.”
- Plan a bedtime ritual to include activities that are important to your family such as reading, good hygiene, prayer or a creative storytelling time.
- Explain to a babysitter or relative what the bedtime ritual is so your toddler will not be upset by a foreign routine when you are not there.
- Avoid high-energy activities right before bed, as it will put your toddler into a state of high alert. A relaxing stroll after dinner is fine, but no horseplay or strenuous exercise two hours before bed.
- Make sure your child is eating a balanced diet with plenty of fruits and vegetables and whole grains so he or she is not spending an hour in the bathroom at bedtime. Encourage him or her to drink a lot of water, especially early in the day.
- Itches and illnesses can keep a child awake. Be aware of poison ivy, bug bites and rashes that may be keeping your child awake. Consult your family physician for the best treatment.