If bedtime takes two hours, your toddler won’t fall asleep unless you’re in the room, or someone ends up in your bed at 2am every night, you’re in very large company. Bedtime problems and night waking are among the most common reasons parents of young children ask for help.
The good news is that this is one of the best-studied problems in child psychology, and the approaches that work are behavioral. They change what happens at bedtime and during the night, and they’re carried out by parents.
What the research says
A task force of the American Academy of Sleep Medicine reviewed 52 studies of behavioral treatment for bedtime problems and night waking in infants and young children. Ninety-four percent of the studies found the treatments effective, and more than 80% of children improved, with the gains holding three to six months later (Mindell et al., 2006).
Many parents worry that sleep training will harm their child emotionally or damage their bond. The trials that tested this directly found no sign of it. In one randomized trial of infants, graduated extinction and bedtime fading both improved sleep, with no increase in stress hormones and no difference in attachment a year later (Gradisar et al., 2016). A five-year follow-up of another infant trial found no lasting harm to children’s emotional health, behavior or closeness with their parents (Price et al., 2012).
Those trials were done with babies, not toddlers, but the methods they tested are the same ones used with older children, adapted for age.
The approaches with the best support
A predictable bedtime routine. The same short sequence every night, in the same order: bath, pajamas, teeth, two books, lights out. Routines help children wind down and know what comes next, and they’re linked to benefits beyond sleep (Mindell & Williamson, 2018).
Graduated extinction. Instead of staying until your child is asleep, you leave and check in briefly at intervals that slowly get longer. Your child learns to fall asleep without you there, while knowing you’ll come back.
Bedtime fading. If your child lies awake for a long time, bedtime is moved later for a while, to when they actually fall asleep quickly, then moved earlier in small steps. Less time awake in bed means fewer battles.
Gradual withdrawal. For a child who needs you in the room, you stay but move a little farther away every few nights: from the bed, to a chair, to the doorway, to the hall.
Consistent responses to night waking. Whatever the plan is, both parents do the same thing, every time. Inconsistent responses teach children to keep trying.
Why it often doesn’t stick
Most parents have tried at least one of these. The common reasons it didn’t work:
- The plan changed from night to night, or from parent to parent.
- It stopped after a rough few nights, just before it would have started working.
- Something else was driving the problem: worry, a big change at home, or a nap schedule that didn’t fit.
- The steps were too big for this child, so the whole household gave up.
This is where help is useful. Not because the method is complicated, but because sticking to it while tired, with a crying child, is hard.
How we help with sleep
For children under 5, the work is almost entirely with parents. Kara builds a written plan with you that fits your child’s age and temperament and your family’s routines. Then she meets with you weekly to adjust it as you go. Your child doesn’t need to come to sessions for this, and parent sessions can be online anywhere in Colorado.
Sleep is often tied up with other things: tantrums at bedtime, separation worries, a new sibling. The same approach covers those too. See how we help with sleep and bedtime, how child therapy works here, or the research behind our approach.
When to talk to your pediatrician first
Talk to your child’s doctor before starting a behavioral plan if your child snores loudly or stops breathing during sleep, seems very sleepy during the day, has a medical condition, or if sleep has changed suddenly. Behavioral approaches are for children who are healthy and need help learning to settle and stay asleep.