What's normal sleep behavior for a toddler?
Most parents would agree that the most delightful toddler sleep behavior is peaceful snoozing. But your toddler might do all sorts of other things while asleep — some of which might seem strange, even alarming. Most are perfectly normal and no cause for concern, but a few are worth checking into.
Snoring, snorting, and mouth breathing
If your sleeping toddler occasionally snores, makes snorting sounds, or breathes through her mouth, it's probably nothing to worry about, especially if her snores have a steady rhythm. Also, many children snore or breathe through their mouth when they have a stuffy nose due to a cold or allergies.
If you think a stuffy nose is to blame, try using a vaporizer or humidifier to make breathing more comfortable. If your toddler has pet allergies, keeping her bedroom free of pets is one step you can take that may help.
If your toddler snores loudly, pauses between breaths, seems to work hard to breathe, or gasps as she tries to catch her breath, she may have a potentially serious sleep disorder known as sleep apnea. The most common cause of sleep apnea in children is enlarged tonsils or adenoids (the glands in the throat just behind the nose). Other factors include being overweight and having certain facial characteristics, such as a receding chin and cleft palate.
Sleep apnea peaks between the ages of 3 and 6, when the tonsils and adenoids are at their largest in comparison to child-sized airways. But younger children can also have this condition.
Because the condition disrupts sleep, you may notice that your child with sleep apnea tends to be sleepy during the day when she should be alert. She's also more likely to be cranky and irritable, and she may have behavior problems.
If you think your toddler may have sleep apnea, mention it to her doctor. He can check for problems and may refer you to a specialist — an ear, nose, and throat doctor or a sleep expert — to assess your child's breathing.
A specialist may suggest removing your child's tonsils or adenoids — a relatively simple operation that may solve the problem.
If your child's sleep apnea is caused by her being overweight, the doctor can help you modify your child's diet.
Some toddlers sweat buckets while they're in the deepest part of their nightly sleep cycle, often ending up soaking wet. While sweating can occasionally be a symptom of sleep apnea (see above), nighttime perspiration is usually nothing to worry about.
Deep sleep is when your toddler is getting the best of what sleep has to offer. His body is restoring itself and getting ready for a new day — so don't worry too much about sweating. Do make sure he's comfortable, though. Put him to bed in light cotton clothes and keep the room a little on the cool side.
If your toddler snores or has pauses in his breathing while he sleeps, in combination with sweating, talk with his doctor to rule out sleep apnea.
You may notice that the rhythm of your toddler's breathing changes during sleep. She might breathe more rapidly for a while, then more slowly, and then pause for up to 15 seconds before resuming a normal breathing pattern.
Breathing pauses — combined with snoring and snorting — may be a symptom of sleep apnea (see above).
But an occasional pause in breathing during sleep can also be perfectly normal. Many children also sigh in their sleep, which may make it appear as if they've stopped breathing for a very brief time. These sighs are also perfectly normal.
Rocking and banging
Body rocking and head banging are normal behaviors in toddlers, who seem to find the rhythmic movements soothing and sleep inducing. It's similar to the way a child may suck his thumb or twirl his hair to fall asleep.
A few toddlers may rock or bang their head to distract themselves from pain — from an ear infection, for example. The behavior usually starts in the first year, and most children outgrow it by age 3 or 4. Your toddler may rock back and forth on all fours or sit up to rock, bang his head on the side of the crib, or both.
Try to take a low-key approach to this behavior. If your child perceives that you're trying to stop the rocking or banging, he may take it as a challenge and persist in it, or the added attention may encourage the behavior.
If your child's rocking is unusually loud or vigorous, try moving his crib or bed away from the wall. Be sure to tighten the screws and bolts on the crib or bed regularly so he can't shake them loose. You can also try putting the mattress on the floor if he's already in a bed.
A soothing bedtime ritual — such as a warm bath, a story while cuddling, or a gentle backrub — may help him unwind without rocking.
If your child starts rocking or banging for the first time after 18 months of age or exhibits similar behaviors during the day, or if the behavior lasts past the age of 4, bring it up with his doctor. Head banging can be associated with developmental disorders like autism, but it's just one of many behavioral red flags.
Unusual sleeping positions
Many toddlers are restless sleepers, changing position numerous times during the night. Some have a favorite sleeping position that they settle into for long periods, but others are all over the place.
One toddler may prefer sleeping on her side or splayed out on her back like a starfish, while another likes to curl up into a ball. Toddlers sometimes sleep folded up on their hands and knees with their bottom in the air.
There are a couple of positions that might signal a problem, though. If your toddler sleeps with her head hanging over the side of the bed or raised on top of a stuffed animal, it could be a sign of sleep apnea, according to sleep expert Jodi Mindell. (Children with sleep apnea do this to keep the airway open while sleeping, since tipping their head back or sleeping in a more upright position helps keep the airway from closing.)
Since most sleeping positions are harmless, just let your toddler be — even if she looks uncomfortable to you. But if you suspect she may have sleep apnea, start by telling her doctor about it. He can help you determine whether your child needs to be evaluated and treated.
There are lots of reasons that your toddler might grind his teeth — including tension, anxiety, or pain (from an earache or teething, for example). Allergies or pinworms may also be to blame.
In most cases, teeth grinding isn't harmful, and it's likely your child will outgrow the habit without your doing anything about it. Mention it to his dentist, though, so she can check for problems. You might also try soothing your toddler at bedtime with a soak in the tub, a little backrub, and extra cuddling in the rocking chair.
If your child walks in her sleep, she may appear to be awake, but she's not. Her eyes will be open, but she'll have a blank look on her face. She may get up and walk around or even engage in activities like getting dressed or playing. If she talks, she won't make much sense. She may sleepwalk for just a few minutes or much longer — even half an hour or more.
Sleepwalking is most common in children ages 4 to 8, but it can happen at any age. Often a child will sleepwalk if she's anxious or overly tired. It's not dangerous to wake up a sleepwalking child, but if you do, she'll be very confused — so it may be best just to gently guide her back to bed.
You'll want to take extra precautions to keep your night rambler safe, because she can easily get hurt while walking around in the dark. Make sure she won't be able to open any doors or windows while sleepwalking, and block off stairways. Also try to keep things she might trip over off the floor, and scan the house for hazards after tucking her in at night.
Sleepwalking usually isn't cause for concern, but if your child does it often, mention it to her doctor at the next visit. Make sure she's getting enough rest, preferably with a dependable sleeping schedule and an early bedtime.
Nightmares can be caused by anxiety and stress. They often happen in the later part of the night, during REM (rapid eye movement) sleep. And they happen more often to children than to adults. A fever, medication, or difficulty sleeping — because of a breathing problem, for example — may also bring about nightmares.
Nightmares are especially common in older toddlers and preschoolers. Children this age have a growing imagination and an increasing understanding that things can cause harm to them.
The nightmare will probably wake your child up, and he'll be frightened or anxious. He'll probably remember the dream. All you need to do when your child has a nightmare is comfort him as best you can and try to soothe him back to sleep.
If he's having nightmares repeatedly, you'll want to think about what kinds of stress he's experiencing in his waking hours and do what you can to reduce it. If you're concerned about your toddler's nightmares, talk with his doctor.
If your toddler sits up in bed and seems terrified, she may be having a night terror, also known as a sleep terror. She may be screaming and sweating. She probably won't remember what happened, and she'll be difficult to wake up or console.
Like nightmares, night terrors can be triggered by fever, overtiredness, and stress. Unlike nightmares, they often occur in the first third of the night during deep sleep. Night terrors are most common in children ages 3 to 5, but they can happen at any age. And most kids outgrow them by age 10 or so.
It can be very upsetting to watch your child experience a night terror. As with sleepwalking, it's best not to interfere. Just let the night terror run its course, says sleep expert Mindell. If you try to comfort your child, she's likely to become more agitated and the episode will last longer.
Not getting enough sleep is often a major contributor to night terrors, so make sure your child heads off to bed early and gets plenty of shut-eye. If your child has frequent night terrors, talk with her doctor, who may suggest stress-reduction techniques. In rare instances, medication may be necessary.
~ Reviewed by the BabyCenter Medical Advisory Board