Cincinnati Family Magazine

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February 3, 2023

Sweet Dreams

Two-year-old Bella has a nightly bedtime ritual that includes a couple of stories, prayers and four or five hugs. It’s a pattern that helps her fall asleep easily, according to her mom.

   Not all toddlers are so easy. It can be exhausting to put a toddler to bed — and keep him there. What’s a parent to do when their child’s sleep — and their own — is disrupted? Danielle Graef, Ph.D., and assistant professor of pediatrics at Cincinnati Children’s Hospital Medical Center has helpful insights.



Why do toddlers resist bedtime, even when they’re clearly exhausted? “Bedtime refusal — stalling — is most common in toddlers and preschoolers with the transition out of the crib,” Graef says. “As they begin to learn what elicits a parent response (asking for an extra hug or saying they need to go to the bathroom, etc.), they assert their independence.”

   Bedtime refusal is also related to a parent’s expectation about bedtime and what is developmentally appropriate for the child. If parents are inconsistent with bedtime setting or if a child naps too late in the day, night time sleep gets challenged. And sleep “timing” plays a role, too, Graef says.

   “There is a natural time in the evening for a peak in alertness (sometimes called the ‘second wind’),” says Graef. “Bedtimes at this time result in difficulties settling down and bedtime resistance,” she adds. Graef says to observe when your child is slowing down and showing familiar sleep cues, like yawning. That’s a great indicator for the start of the bedtime ritual. But it’s not always as easy as a routine. Bedtime refusal can go on and on. If it’s persistent, severe, or altogether disruptive to your child’s functioning, evaluation and treatment with a specialist may be in order.



Many moms and dads commiserate about their toddlers who wake in the middle of the night and wander into their parents’ room. It’s a part of life.

   While some little ones can fall back asleep on their own, many others may cry or call out.

 “Night awakenings are a normal part of sleep rhythm and can occur several times per night,” says Graef. “Waking is a concern when the child cannot return to sleep independently, requiring parent intervention,” Graef says. But rocking or holding little ones back to sleep can result in a repeated need for those things. Instead, attempt to build up the desire for a different comfort item such as a favorite blanket, “lovie,” or stuffed animal.

   Also, Graef says that parents should leave their child’s room when the child’s drowsy so he can learn to fall asleep on his own.

While preschoolers may struggle with sleep because of various fears (being alone in the dark, “monsters,” etc.), school-aged kids might be sleepless over grades or extended social media use at night, Graef says. And, with the holidays here, sheer excitement can keep kids up at night.



Try to keep your family sleep routines on track, but recognize that life is always ready to throw a curveball.

   “Keeping a regular schedule can be challenging during the holidays,” Graef says. So, do try to aim for consistency in bedtime routines and wake times. Also, fine-tune your child’s bedtime ritual so he can become used to what’s expected of him at night.

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