Newborns spend around 70% of their time asleep, sleeping often, but in short periods. When they’re awake, they need feeding, changing and lots of TLC, which leaves parents exhausted. As this sleep routine is very different to parents’ sleep, many worry over whether their baby is sleeping well. There are then extra concerns when the baby goes through phases of change in their sleep pattern.

So, it’s understandable that your child’s sleep can add to your worries, but it’s also important that you’re getting enough sleep yourself. Our previous post in this series looks at the importance of sleep for parents and the first post looks at the importance of sleep during pregnancy. In this post we’ll be focusing on where it all starts: the first year of your baby’s life. We’ve taken a look at the science behind what affects babies’ sleep and the importance of good sleep for their development, along with some tips on how you can improve and encourage it.

Keep an eye out for more posts in this series, in which we’ll be looking at the importance of sleep as your little one grows.

How much should my baby sleep?

The chart above shows how much, on average, babies sleep during a 24-hour period. Of course, every baby is different and each baby’s individual pattern will change and evolve. Some babies can get by on less, and some may need more, so don’t worry if they aren’t sleeping for the average amount of time, or if their daytime and night time sleep patterns aren’t balanced in this way – they will gradually get into a rhythm as they grow. It is advised that at 0-3 months, they should sleep for more than 11 hours but less than 19, and at 4-11 months they should sleep for more than 10 hours but less than 18. If you think that your baby is sleeping too much or not enough, you should contact your healthcare professional.

A baby’s sleep cycle is different to that of an older child or adult. We looked at the sleep cycle of adults in the first post in this series: 4 stages of REM and non-REM sleep in 90 minute cycles, where only 20-25% of sleep is REM. Infants, on the other hand, have sleep cycles of around 50 minutes (for the first 9 months), and around half of it is REM sleep. REM sleep is used to consolidate memories and is critical to a baby’s development.

Shorter sleep cycles mean that they may wake more often, but they will normally just stir and fall back to sleep. They will wake up properly when they need to feed. In the first few weeks they may wake every 2-4 hours, but as their stomach gets bigger, they will take more in at each feed and only need to wake every 4-5 hours. It’s normal for your baby to have lots of night wakings when they are young, but then they learn to self soothe and fall back to sleep on their own as they adjust to the world. Remember to follow safe sleep advice  when it comes to your baby’s sleep environment.

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From around 6 months, your baby could stop needing night feeds so may wake up less often and eventually sleep through the night. According to Thiedke, “Children who previously slept through the night can sometimes resume night awakening, usually because of social factors rather than maturational ones.” It may take a while and they may even regress, but don’t panic if your baby is taking their time to get settled into their routine. It may be difficult, but by not responding to your baby straight away, they can learn to self soothe and fall back to sleep by themselves (although you shouldn’t leave them to cry).

Baby sleep problems

Around 20% of babies in the UK are reported to have sleeping difficulties in their first year – so if this is happening in your family, you’re not alone. Erratic, disrupted sleep can just be temporary while your baby gets used to things, but there may also be underlying issues for these problems. If your baby is having sleep problems that are concerning you, you may need to contact your healthcare professional.

Baby sleep problems include:

Excessive sleepiness or insomnia

Although your little one will sleep a lot, they generally should not sleep more than 19 hours at 0-3 months, or 18 hours at 4-11 months. If your baby is sleeping for an excessive amount of time, it may be due to a growth spurt, teething or illness, but it can also be a sign of an underlying condition (discussed below).

It is possible that things can go in the other direction, and you baby may suffer from infant insomnia, which can also be a sign of teething or illness, or other underlying problems such as colic.

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Disruptive sleep apnoea

Sleep apnoea is often thought of as a problem that arises as we get older but, although it is rare, it can occur in infants. This may be because of airway abnormalities that can cause the airway to collapse, obstructing their breathing. It has been found that infants have “both anatomical and psychological predispositions toward airway obstruction and gas exchange abnormalities.”

Sleep apnoea is more prevalent in premature babies. It affects 84% of infants who weigh less than 2.2 pounds, and 25% who weigh less than 5.5 pounds. Research shows that it also correlates with gestational age – it affects nearly all infants born at 29 weeks or less, 54% born at 30 to 31 weeks and 15% born at 32-33 weeks.

Look out for the signs of obstructive sleep apnoea:

• Pauses in breathing lasting for 20 seconds or more
• Patterns of repeated breathing pauses that last for less than 20 seconds
• Related problems like low oxygen or a slow heartbeat

Other underlying medical conditions

If your baby is suffering from sleep problems, they may not be environmental or behavioural; it is possible that they have an underlying medical condition, such as:

• A fever
• An infection (ear, yeast, urinary tract, parasitic or respiratory)
• Abnormal reflux

Sleep problems can also be caused by underlying psychiatric conditions such as mental health conditions(which are difficult to diagnose in babies but will become more apparent later in life) or ADHD. A study by Thunström found that around 25% of children with sleep problems in infancy will later qualify for the diagnosis of ADHD.

Separation anxiety

If you move your baby into their own room after 6 months, they may experience separation anxiety. It is completely normal, but it can be a difficult time. At around 4-7 months your baby will develop object permanence, which means that they can understand that objects (i.e. mum or dad) still exist even when they can’t be seen. This may lead to fussing or crying (instead of sleeping) when they’re left in their own room, but they will learn (over time) that this doesn’t mean you’re gone forever. This type of anxiety has been found to be more prominent in infants between 8 and 12 months. See the tips section below for advice on dealing with separation anxiety.

Genes

Some sleep problems may simply be down to your baby’s genes. We previously discussed how gene mutations in adults can affect sleep duration, and this is also an issue for some infants. Research by Touchette et al found that genes can have a big impact on whether children sleep through the night (specifically at night time rather than day time). It is also thought that if a parent suffers from insomnia, it can make their baby more predisposed to it.

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Environmental factors

A study by Jian and Douglas looked at the relationship between mothers’ emotional availability and infant temperament and sleep. They found a correlation between parent-infant interactions and infant sleep problems, and that “high level of parental involvement, short response latency to infant awakenings, and active soothing at bedtime have been related to frequent infant night wakings in correlational and experimental studies.” Of course, it’s important to be there for your child and to make them feel safe, but too much involvement may lead to more disrupted sleep.

Being emotionally available at bedtime without overdoing it can make your baby feel secure and allow them to rest easier. Research by Jian and Teti looked at babies between 1 and 6 months and found that this emotional availability (interpreting and responding to a child’s signals, supporting them, interacting peacefully while not restricting or interfering with the child’s exploration of their environment) resulted in increased sleep time. Another study by Teti et al found that “parents’ emotional availability to children in sleep contexts promotes feelings of safety and security and, as a result, better-regulated child sleep.” So it’s important to find the right balance of emotional availability.

Moving your baby into their own room may also impact their sleep, but it’s important to stick with it rather than move them back and confuse them. It may seem like a mean thing to do, but not responding to their every noise and allowing them to self soothe can help to regulate their mood, help improve the quality of their sleep (and yours) and make them calmer and better at concentrating in the future. Other environmental factors may include noise, lighting, temperature and hunger.

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