Changes in sleep in children aged 0-5 years. The causes of awakenings and solutions for teaching good sleep

Sleep is essential for your baby's growth and development . During pregnancy the fetus spends most of its time sleeping, but after birth, sleep patterns and needs change dramatically in the first years of life.

The main changes in sleep occur within the first 5 years of life and involve the circadian rhythm and dream activity , i.e. the natural cycle of sleep-wake and dreams. Experts recommend that pregnant women get enough rest during pregnancy (8-10 hours of sleep are the hours necessary to allow the body and our mind to regenerate) to avoid repercussions on their health and that of their unborn child.

Fetal sleep during pregnancy

Already in the womb, the fetus does not yet have a regular sleep-wake rhythm. Studies show that the fetus is awake for 20-35% of the time, and this percentage increases as the pregnancy progresses. Towards the end of gestation the fetus has longer and less fragmented sleep periods.

Furthermore, the seventh month of pregnancy is indicated as the period during which the first dreams begin and the baby responds to external stimuli, such as the mother's voice or music. ( source: Niguarda Hospital studies in Milan).

The first months of life: irregular sleep and very few dreams

In the first month of life the newborn has not yet developed a clear sleep-wake rhythm. He sleeps on average 16-18 hours a day but wakes up every 2-4 hours to eat. Sleep cycles are short, 1 -3 hours and fragmented. In this phase there is little dreaming activity, the child dreams very little or not at all. Between 2 and 6 months, children's amount of sleep drops slightly and a primitive circadian rhythm begins to establish, with longer naps during the day and prolonged sleep at night (14-15 hours). Nocturnal awakenings are still frequent.

Baby's sleep and the main reasons for waking up babies from birth to 1 year and the solutions to get them back to sleep

• hunger
• dirty diaper
• gastrointestinal illnesses or discomfort
• teething discomfort, first teeth
• Infectious diseases, colds and respiratory diseases
• Lowering of body temperature
• Difficulty regulating sleep

The most frequent disorders that cause awakening from sleep in the first 3 months are hunger, dirty diaper, colic or digestive difficulties. Parents soon learn to recognize their child's needs and resolve them with regular routines, which are also useful for getting them used to sleeping again. At night it is best to keep the environment quiet, with a temperature between 18-20°C and soft lights during changing or breastfeeding

Satisfy the baby's physiological needs at night without stimulating attention

It is best to satisfy physiological needs gently: changing diapers and feeding should take place almost in silence without stimulating too much attention as we can do during the day when interacting with the baby. In this way we will help the child to distinguish day and night and develop the circadian rhythm.

Colic can be a frequent problem (although not all babies suffer from gaseous colic) with different levels of complexity but it tends to resolve naturally by the fourth month. In the meantime, there are several solutions to adopt as suggested in the article on this blog.

Baby's sleep after 3-4 months: the discomfort of baby's teething

After 3-4 months, the period of discomfort related to teething begins, the gums become inflamed due to the first teeth that emerge, the incisors. At these times the child may sleep little or not at all. The solution in these cases is to gently massage the gums with a finger wrapped in sterile gauze or to use an anesthetic cream (which must always be prescribed by the pediatrician) to alleviate moments of crisis and help the necessary relaxation that will accompany the child to fall asleep.

From 6 to 12 months: consolidation of night sleep

Between 6 and 12 months the circadian rhythm consolidates : children's sleep lengthens to 10-12 consecutive hours and the REM (Rapid Eye Movement) phase increases with dreams. During the day, naps are shortened to 1-2 hours, concentrating on 2-3 regular naps. On average at this age he still sleeps a total of 14 hours a day.

How to change your nighttime feeding schedule to improve your circadian rhythm

Up to 5-6 months the baby can request night feedings, then he will tend to space them spontaneously over the 24 hours. For example, it may happen that the last feeding takes place at 10 or 11 pm and the next one at 6 or 7 the following morning, to the great happiness of the parents who will be able to rest a little more. Some children instead decide to feed at night, maintaining the longer interval between the two feedings during the day. For example, they don't ask for milk from midday to 7pm and then ask for it during the night. The secret is to help the child change the schedule by bringing forward the time of night feeding without waiting for his request. For example, if he usually wakes up at 2 am to eat, you can offer him the breast at midnight and slowly reverse the cycle by moving his schedule. It is important to always satisfy his needs and if it still doesn't work, wait some time before trying again.

Gradually after 9 months, unless there are problems related to seasonal ailments or infectious diseases, many children also learn to go back to sleep on their own without requiring their parents' intervention; this obviously happens in the case of reasons not related to physical discomfort but for example putting the pacifier back in the mouth if it falls from the mouth during sleep. According to some studies, during these periods the child dreams for an average of 8% of his total sleep time and the dreams are short and simple.

1 year to 3 years: the beginning of the transition to adult sleep and full dreams

Starting from the second year of life, the total amount of sleep drops to 11-14 hours and daytime naps are further reduced to 1-2 per day. At night the baby sleeps 10-12 hours in a row and awakenings and night feedings become increasingly rare. A study by the Bambino Gesù Pediatric Hospital in Rome indicates that at 2 years old, most children have vivid, detailed dreams. Bizarre images and childhood fantasies appear and dreams reflect real experiences, fears, desires and emotions.

From 2 to 3 years of age, sleep is reduced to 10-13 hours, with naps in the early afternoon which disappear around 4 years of age. Children's sleep lasts 10-12 hours. Fears and difficulty falling asleep may occur, with awakenings more linked to emotional aspects.

Often the reasons for awakening from 1 to 3 years include

• nightmares
• separation anxiety
• diseases and infections
• changes in routine or new environments

Experts recommend reassuring children by letting them express their fears by expressing them through stories. Using a night light and leaving a familiar object in the room can prevent separation anxiety.

From 3 to 5 years: stable sleep needs and evolved dreams

Between 3 and 5 years of age, children's sleep needs remain stable, with 10-12 hours of night sleep and 1-2 hours of afternoon nap. The circadian rhythm is now similar to the adult one, with night sleep consolidated into 10-12 hours. Some people stop napping as early as 4 years old.

According to the Italian Sleep Medicine Association, in this phase dreams have elaborate, sometimes distressing contents and children distinguish between dream and reality upon awakening.

Evening routines are essential to help you fall asleep independently. Difficulties and awakenings can still occur due to stressful events or changes in routine.

In the first years of life, children's sleep is very variable

Children's sleep in the first years of life is very variable and is closely linked to physiological needs and evolving circadian development. We move from short and irregular cycles to a more consolidated structure that adheres to the day-night cycle. After the first year the total amount of sleep is reduced and night sleep consolidates until it resembles adult sleep around the age of 5.

Evening routines are important

Evening routines, i.e. the same actions to be repeated every day before bedtime, are fundamental: such as bathing to relax, putting on pajamas, feeding, brushing teeth, reading the fairy tale and going to bed, where perhaps the sleeping puppet awaits them.

One cause of awakening: inadequate temperature. Why use a baby sleeping bag?

An inadequate temperature can disturb sleep : the cold for the little ones, who have difficulty thermoregulating and the excessive heat and summer mugginess for the older ones (although in this case the heat and mugginess can interrupt sleep at any time). age).

On average, excessive cold and heat can be responsible for between 5% and 15% of awakenings in young children; These are rough estimates but it is possible to prevent this type of sleep disorder by using a sleeping bag for 0-36 months or 1-4 years, recommended by sleep experts as the best way to make children sleep safely and well-being because it maintains body temperature

Other environmental factors that affect night awakenings are noise, light, uncomfortable beds, poorly darkened rooms. To prevent awakenings and ensure uninterrupted sleep, it is a good idea to make sure that the temperature of the child's bedroom is also suitable for the season, neither excessively hot nor cold with the air neither too dry nor too humid. In winter the use of a humidifier like AriaSana is important to promote good breathing especially in case of coughs and colds.

Every child has his own sleep history and the reasons for waking up evolve with age. They are often related to physiological needs, discomfort, psycho-emotional evolution and the ability to self-regulate sleep. Inquiring and following the advice of experts at different stages helps parents to immediately promote healthy sleep for their children by creating a comfortable and welcoming environment. A child who learns to sleep well will enjoy better physical health , have a greater ability to concentrate and learn and develop a more stable emotional balance; essential factors for tackling school too.