Is Your Child Struggling with Napping? Here’s Help0

If your child is struggling with napping, I recently wrote an article for the New York Times called, Your Kids Refuse to Nap? There’s Hope. In it, I cover what to expect from your child at different ages, how to deal with nap strikes, and what it looks like when your child (gulp) drops a nap. Nap problems are common.

I recently did an Instagram Live and it’s clear that many parents are seeing a lot of sleep disruption, especially around daytime sleep, with the whole family home, all day, every day, in the COVID-19 era. The novelty of having older siblings, Mom or Dad home full time (or being home from day care) has resulted in missed naps, irritable children, and stressed parents.

As always, the work you read in the Times is carefully edited by the skilled team at NYT Parenting. Here, I’m presenting some extra content that you might find useful.

Naps are often painful: Here’s Why

“‘Donald won’t take his nap any more,’ wailed one weary mother. ‘I put him down to rest just as I always have, but he won’t stay. He keeps popping up and wanting to play. What shall I do with him?’”

This mother wrote to an advice columnist in 1929 about her challenges with her son’s naps. Although we don’t know how old her son was, any parent can relate to the desperation she is expressing.

Naps are less predictable than nighttime sleep, making them more difficult to plan for and troubleshoot. . For example, all children sleep at night in a similar window (generally between 7pm and 7 am). However, nap time, duration, or even the number of naps is quite variable. To understand why, we need to talk about sleep physiology.

Dr. Sarah Honaker, a sleep psychologist at Indian University, notes that, “it can be frustrating for parents when their child drops their nap or takes only short naps, whereas their neighbor’s child takes a daily 3-hour nap. There truly is a wide range of normal in napping patterns. It is important to remember that nap patterns are not predictive of any issues in the future, as long as the child is getting enough sleep overall.”

“One thing that can be frustrating is how much variability there is in nap consistency and length. It’s important to remember that nap quality or quantity is not predictive of any issues in the future.”

In 1982, a sleep physiologist named Alexander Borbeley described a “Two Process Model” which explained the timing of sleep and wakefulness.. The first process known as Process S, is better known as sleep drive.

Essentially, sleep drive accumulates the longer that you are awake and dissipates during sleep. In humans, sleep drive increases most quickly in infancy but gradually starts to increase more slowly with maturation. That is why children nap every few hours at birth, and gradually progress through three daily naps, then two, then one and finally stop napping. Sleep drive can also be assessed by how deep nap time sleep is when measured by electroencephalography. As children get older, naps are also comprised of shallower sleep. The second process, Process C, is the circadian drive and is best understood as a wakefulness drive. This gradually increases during the day along with sleep drive to stabilize wakefulness. There is a slight decrease after lunch so that is why naps often occur after midday (for children and tired adults alike).

The age at which naps are dropped varies significantly from child to child. Moreover, often the timing of a nap is not often determined by a child’s intrinsic sleep needs, but by other factors (such as day care center nap schedules, or the schedule of an older child). Like many families, our schedule revolved around the sleep schedule of our first child when he was born. When our second child was born, our schedule still revolved around the schedule of our older boy. My younger son was forced to adapt, which resulted in some missed naps.

Napping is not as well studied as night time sleep practices. Thus, we know much more about behavioral interventions for night time sleep (also known as sleep training) than we do about napping.

What are the typical nap schedules by age?

Age Total sleep needs per 24 hours Nap Pattern
Newborn (0-3 months) 14-17 hours but can be more or less Every 1-2 hours
Infant (4-11months) 12-15 hours Two to three naps per day

If taking a third nap, usually dropped between 6-15 months

Toddler (1-2 years of age) 11-14 hours Morning nap usually dropped between 18-24 months
Preschooler (3-5 years of age) 10-13 hours of sleep Usually eliminated during this age period
School age (6-13 years of age) 9-11 hours of sleep None. If your child needs naps, he is either not getting enough sleep at night, or could have a sleep disorder

More napping tips

As always, I could not fit everything I would like in the Times piece (as it is, it ran long). Here are some other tips which did not make the cut.

Avoid napping after 4pm once your child is napping once or twice per day

Generally, your child will not be ready to fall asleep until three or four hours from the end of her last nap. So babies who are taking three naps often go to bed at 9 or 10 pm. Once you are down to two naps, you likely want the nap to end by 4 pm if you would like your child asleep by 8 pm. Bear in mind that really short accidentally naps (think 15 minutes in the car or stroller) before dinner may also interfere with bedtime.

Dealing with a napping kindergartener

Some children are still napping when they start kindergarten. In the era of all-day kindergarten, this can be challenging if your child really needs that nap. If your child is near the age cut off for starting school, you might consider waiting a year before you start school. Alternatively, you may be able to compensate by a significantly earlier bedtime on school days.

More on giving up the nap

Dr. Honaker says, “There is a transitional period during which kids still need some daytime sleep but are not consistently tired at an appropriate nap time (e.g., after lunch). They may resist afternoon naps, but then unravel in the early evening. This may also result in napping some days but not others. When this happens, it’s helpful to be flexible about bedtime, using a later bedtime on nap days. This is contrary to the typical sleep advice of keeping a consistent bedtime, but can help manage this transitional phase.”

What if your child cries when waking up from the nap?

This is common. As Dr. Honaker says, “This can occur when children are not getting enough sleep overall. However, sometimes children just take a bit longer to wake up.”

“Similar to the morning, we would expect kids to feel more wakeful and ready to go within 30 minutes of waking.” I would agree that you don’t need to be concerned if your child is back to full power after 30 minutes.

When to worry about napping

Night time sleep should be your number one priority, Signs that your child is sleeping too much during the day include an excessively late bedtime or early wake time in the morning. If your child is having prolonged late afternoon naps which are interfering with falling asleep by 9 pm, you probably need to wake your child up before 4pm.

Tracking sleep diaries for a few days can give you a feel if your child’s sleep needs are within the normal range for age. If your child seems to be sleeping significantly more than expected for age, it is worth talking to your doctor to see if there might be a medical problem which is causing your child’s sleep to be non-restorative. For example, snoring may be associated with obstructive sleep apnea, a condition where the airway narrows intermittently at night.

Likewise, if your child is sleeping significantly less than expected, it’s worth investigating to see if there could be a medical cause, especially if your child is very irritable.

What questions do you have about napping? Leave them in the comments below:

The post Is Your Child Struggling with Napping? Here’s Help appeared first on Craig Canapari, MD.

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