Ask the Doctor - Answers to your Parenting Questions

Hi Erin,
It's true that when they're over-tired, they're a mess. They just don't have the inner resources to handle anything. And if that's your only time of the day to be with him, it can be hard to keep your patience because you may begin to think of him as whiny and cranky.

But it is also true that sometimes kids are difficult when we get home from work simply because all day without us is too much for them. They depend on us to help them regulate their emotions. When we aren't there, they try hard to hold it together, but when we appear, they just fall apart. So it is possible that he falls apart when he sees you simply because the effort of being without you all day is so challenging, especially when you get home from work so late.

But let's start with his sleep pattern, which is presumably easier to change than your work schedule. First, let's thank your lucky stars that he sleeps well at night. That would make many moms envious even if he never napped. But I understand your desire to help him get through his day better-rested, so let's consider some interventions that might work.

It's true that by 20 months most kids are down to one nap, so I think you have to assume that promoting a second nap is a losing proposition. But he is going to bed late for such a little guy, so it is certainly possible that he needs a longer nap, unless he is a late riser. Of course, all kids are different in how much sleep they need. I've known power nappers who routinely slept for three to four hours a day and other kids who barely slept during the day and made it up at night.

But let's assume he needs the sleep, he just can't stay asleep. The challenge with keeping them asleep for longer naps is that they go through sleep cycles that take them to a very light sleep -- almost waking -- on a regular basis.  In most kids it's about every 45 minutes to an hour. If they are tired enough when they get to that point in the sleep cycle, they just turn over and go back into deep sleep. If not, they wake soon after. This means that many kids sleep for three of those cycles, which is roughly two hours and 15 minutes, or even four cycles, which is about three hours.

But here's the rub. Many kids wake after one or two sleep cycles, not because they're fully rested, but because of some other factor, like noise, or light, or being too pumped with adrenalin or other stress/excitement hormones to stay asleep.

So those are the factors we can address in our effort to get your little energizer bunny to drift back into dreamland instead of waking.

1. Make sure that he gets outside and runs around for plenty of sunshine, fresh air and exercise every single day, both in the morning and afternoon. It really does help them sleep better, possibly because it reduces the level of stress hormones circulating in their body.

2. Speaking of stress hormones, don’t wait too long for his nap. Put him down at the first sign of tiredness. If he’s tired and isn’t napping, then he’s having to pump himself up with cortisol and adrenaline, which is what why over-tired kids don't sleep well.

3. Be aware of stress hormones. I assume from your letter that he’s with a babysitter rather than in daycare, but you should know that most kids in daycare have high levels of stress hormones by the afternoon, from the stress of being away from home and over-stimulated. Naturally, that can make it hard for them to relax into sleep.

4. Pay attention to how he's falling asleep.  A relaxed slide into sleep, with stories and cuddling, will usually keep a toddler asleep longer than being put down and left to cry. That’s because once he gets into fight mode, even if he drops off into exhaustion, the adrenalin is still coursing through his system and once he gets a little recharge, he wakes up ready to fight again.

On the other hand, if he is being rocked or cuddled to sleep (by a babysitter?), and then put down, he may well wake up looking for his cuddler. Imagine you were used to having your favorite pillow and someone took it away when you were sleeping. The next time you got to a very light sleep, you would notice the pillow was missing and wake up to look for it. So while it is fine to cuddle him to sleep, the babysitter might need to lie there and read a good book while she snuggles him. That way when he wakes slightly he’ll feel her presence and go right back to sleep. If he’s in a crib, she can make sure he’s cuddled with his stuffed animals, and keep her hand on him, at least during the “light sleep windows” when he’s most likely to wake up.

He's also old enough to very gradually get used to falling off to sleep by himself.  If you do this without crying, you're not building up adrenaline.  And because he is falling asleep without someone holding him, he won't go looking for them every time he gets to a light part of his sleep cycle.  For more info on how to do this, see Helping Your Toddler Learn to Put Himself To Sleep.

5. Reduce stimuli while he's sleeping.  Just because a noise doesn't wake him while he's sleeping soundly doesn't mean he isn't filing it away under the category of "Wake up and see what that noise was as soon as you finish this dream." Many parents swear by white noise machines, because normal day noises can feel like little alarm clocks to a toddler who doesn’t want to miss anything.

6.  Reduce light. I highly recommend blackout curtains. When a room is bright, it’s a signal to our bodies to wake up. Removing this signal with blackout curtains has repeatedly been shown to prolong sleep in babies and children (and hotel patrons!).

7. "Wake to Sleep." This may seem counter-intuitive, but if you gently stimulate him out of deep sleep just BEFORE he gets to the light sleep stage of his sleep cycle, it resets his sleep cycle and starts it again so he skips the light sleep stage. Don’t actually wake him, just rub him gently until he stirs slightly, about 5-10 minutes before he would usually wake up. This works well with younger babies, but it can also work with toddlers.

8. Move toward an earlier bedtime.  Toddlers are notorious for refusing to nap, which is why they traditionally have early bedtimes. 8:30pm is late to expect a 20 month old to stay up, regardless of his nap schedule. I usually recommend 7 or 7:30pm.  Letting him stay up so late almost certainly means he is pumping himself full of stress hormones to stay awake, and that means that the next day it is harder to stay asleep at nap time.  I know it can be hard when you work such long hours to get him to bed any earlier, but it would make a big difference in how rested he is.

Good luck, and let me know how it goes.