Q. My little girl is 10 months and in the last few months her night-time sleep has become really disturbed. She could be tossing and turning all night and wakes up tired whereas for her naps during the day she is out for the count with very little movement. Why is there a difference between day and night sleeps?
Restless sleep can be caused by a number of factors with day and night-time sleep differing greatly anyway. Initially I would rule out any reflux, allergies, food intolerances, wind, and constipation with your GP that typically can present with a restless sleeper, specifically at night-time.
I would also want to make sure that it is not pain related, but since it has been going on for a few months I think you would know at this stage.
Then the first area I would look at would be comfort: that you have an appropriate cot and firm mattress and then examine the sleep clothes, bedding and temperature of the room and child. We don’t sleep well if we are too hot or too cold, so assess that this is not contributing to the issue. Maintain the bedroom temperature between 16-20 degrees and ensure that the room is cleaned and aired daily. You may also want to make sure that her sleeping clothes are not too tight and big enough and the bedding is a comfortable, suitable texture for her.
One of the biggest causes of restless sleep in children can be overtiredness from either inadequate or poorly timed naps and/or a bedtime that it too late. That coupled with how your baby goes to sleep can often result in an unsettled presentation throughout the night that you report.
A well-rested child from the day time, with a suitable bed time and of course able to go to sleep without intervention from the parent will routinely sleep better and longer and deeper, than one who is not.
At 10 months your baby requires around three hours of naps during the day-time balanced between two naps, one within two to three hours of waking in the morning and another about three hours later again. Ideally these naps would be equal in duration and if they are not then I would advise that the second nap is the longer of the two.
Furthermore, in this age group it is important that your child is asleep at bedtime within not more than four hours of waking from the second nap. Being awake longer can mean your child is overtired come bed-time, despite having adequate day-time sleep. This normally means that bed time is between 7pm-8pm and maybe earlier if the naps are not long enough or higher up in the day.
Finally, I would ensure that your baby is able to go to sleep without a prop – be it, your presence, a bottle, soother, holding, or rocking, for example. Even if you have the timings right and your child is napping well during the day, if you are involved in the onset of sleep, you may experience a high level of restlessness then too. I hope that helps shed some light on your problem and gives you some areas to work on.
Lucy Wolfe, CGSC, MAPSC, is a paediatric sleep consultant and mum of four young children.