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Expert Advice

Good night, sleep tight – please!

Are your toddler's nocturnal antics keeping you awake at night?

Finding your toddler thrashing about in his sleep or wandering the house, zombie-like, late at night can be a disturbing discovery, but you needn't lose sleep over it.
Sleep psychologist Dr Sarah Blunden says many parents tend to become anxious about this kind of behaviour, but it's perfectly normal. "Most of us will experience restless sleep at some point in our lives, but it's especially common in this age group," she says. "Children between the ages of two and four get more deep sleep than at any other time in their lives, and it's during the transition from deep to light sleep that many of these incidences occur."
According to Sarah, an associate professor and head of paediatric sleep research at Central Queensland University's Appleton Institute, toddlers have two, maybe three blocks of deep sleep in one 24-hour period – one at the start of their sleep period at night, one in the middle of their night sleep and possibly one during their nap. Gradually, around the age of four, a toddler's sleep consolidates into an adult's sleep pattern, in which there is only one block of deep sleep, at the beginning of the sleep period.
Most night-time incidents are a physiological response, that is, they are based in the body. Called parasomnia, they include sleep talking, sleepwalking and night terrors. Other behaviours, such as dreaming and nightmares, can be caused by behavioural or psychological factors. While most of these diminish with age, if they persist or become problematic, consult your family doctor for more advice.
Nightmares
It's hard to know exactly when babies start dreaming, but nightmares are common in youngsters and peak around three to six years of age. One in four kids have them weekly. Dreams occur during rapid eye movement (REM) sleep, usually in the second half of the night, when the muscles are paralysed but the brain remains active. When dreams become unpleasant children can wake up very distressed with a vivid memory of the dream. Some experts believe nightmares can be triggered by stressful events, illness and some medications. Sarah says temperament may play a part, which is why a scary story might affect one child and not another. The key is to eliminate triggers and teach children to self-soothe.
Night terrors
More physical than nightmares, night terrors are episodes of extreme terror where a child screams and thrashes about while he is still asleep, then remembers nothing when he wakes up. Only 5 percent of children experience them, usually between 18 months and six years of age. They can happen several times a night (usually in the first half), last five to 15 minutes and be distressing for parents as there is little they can do to alleviate them. Genes often determine whether a child experiences night terrors, but other factors that can play a part include overtiredness, illness, anxiety, stress and certain medications.
Sleepwalking
A third of all kids aged about four to eight will at some stage sit up or wander around the house while asleep. Sleepwalking tends to be genetic, but can also be triggered by overtiredness, illness or anxiety. Some kids do it often, others just once, and they may also do strange things, like urinate in a cupboard or get undressed. Their eyes are usually open and glassy and they may not react to you. They may also get upset if you wake them, so it's best to just steer them gently back to bed without a fuss or you may increase their sleep anxiety. Also, ensure your house is safe by clearing hallways and securing doors and windows.
Sleep talking
From the time they can start talking, children may chat away in their sleep, and half of all kids aged three to 10 do this (compared to just 5 percent of adults). It might be a quick outburst of words, a few giggles or long rambling sentences, and most children won't remember it the next day. Sleep talking is often genetic behaviour or set off by worry or stress.
WATCH: How to get your baby to sleep longer. Continues after video ...
Sleep apnoea
While there are different types and causes of sleep apnoea (breathing problems during sleep), the condition afflicts about 2 percent of children, most commonly aged three to six, when tonsils and adenoids are large and prevent air from getting to the lungs. Obvious symptoms include snoring, noisy breathing, snorting and occasional pauses and gasps for breath in the night. Sleep apnoea can also be linked to sweating, strange sleep positions, headaches and obesity, and can cause tiredness and irritability. Most kids outgrow it, but it can cause long-term issues around growth and behaviour so always seek help.
Rocking/head banging
It seems contradictory, but some children like to soothe themselves before or during sleep by rhythmically rocking and/or banging their head. Head banging is particularly prevalent in boys between the ages of six months and three years, but they'll rarely do it hard enough to hurt themselves. The behaviour can also be triggered by teething or an ear infection. Make sure their cot/bed is safe and offer an alternative sleep soothing ritual.
Sweating
Some children will drench their beds with sweat at night. In most cases, this is not necessarily a problem. Ensure they're not overdressed and their bedding is light. If accompanied by snoring and gaps in breathing, this could signal sleep apnoea.
Twitching
If your child regularly jerks his body about while sleeping, don't fret. He's not usually in pain, although this may be a sign he needs more iron or, if he twitches his legs before sleep, has restless leg syndrome.
Strange sleeping positions
Some children end up settling themselves into odd sleep positions through the night, such as lying on their front and thrusting their bottom into the air or hanging their head over the side of the bed. While these positions can be perfectly normal, it may also be a sign your child has sleep apnoea.
Teeth grinding
Grinding away during sleep may be a sign of teething problems or earache, so if it persists, seek help. Anxiety and allergies can also cause it, but the condition is not usually harmful and most kids outgrow it.
Bedwetting
Most toddlers urinate during the night and this is not an issue unless they continue long after they've been toilet-trained and are at primary school. It may signal a hormonal imbalance, physical issue or an emotional/psychological problem.
Quick tips to calm an unsettled child
While it's important to soothe a restless sleeper, you should also teach your little one tools to self-soothe, so he is not dependent on you to fall back to sleep. Reassurance is the key, says sleep psychologist Dr Sarah Blunden, especially when children are young. "You might pat them on the head or stand by the door and say, 'You're fine, baby, I'm here.' You don't have to do that as they get older because they get braver." You could also offer them a cuddle toy or night-light and let them know you'll be back later to check on them.
Here are some other ways to ensure your child's sleep is event-free.
  • Settle your child into a regular sleep routine, which might include a bath and book before bed, then lights out at the same time each night.
  • Don't include stimulants like spices, caffeine or food additives in his diet.
  • Avoid exposing your child to scary books, movies and other media that can cause him distress, including news reports and documentaries (screen-sized critters can be spooky!)
  • If your child is struggling to get back to sleep, offer a cup of warm milk, which contains sleep-inducing tryptophans (amino acids).
  • Studies show positive imagery works, so ask your child to imagine a happy place as he falls asleep.
  • If your toddler's sleep problems persist, speak to your family doctor.
Pillows for Toddlers
Little ones can use pillows from the age of two years if they have moved into a bed, when they will start sleeping on their side and back. Choose a pillow of appropriate size.

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