What causes toddlers to wake excessively at night?

What doesn't cause excessive night waking in toddlers

This might sound weird, depending on what you've heard, but excessive night waking in our toddlers is not typically caused by

• Wind or gut pain or gut dysbiosis

• Allergy

• Teething.

Your toddler also doesn't wake excessively at night because she

• Feeds to sleep, discussed here if your toddler is breastfed, and here if your toddler isn't breastfed

• Shares your bed. You can find out about this here

• Has started walking. Although researchers have measured a slight increase in frequency of night wakings when an infant develops new motor skills, there is also no evidence to suggest that changes in motor development impact upon parents' quality or amounts of sleep. You can find out how best to support your toddler's motor development here.

It's common to have the odd bad night or a short run of bad nights when we have a baby or toddler. You can find out about normal toddler night waking here. But it's the pattern of sleep over time that's important for parents. Excessive night waking is a very fragmented pattern of toddler sleep.

The most likely causes of excessive night waking in toddlers

Occasionally, a true medical or health condition can cause your toddler to wake excessively at night. Does your toddler snore? Sometimes, snoring due to enlarged tonsillar tissue can interfere with your little one's sleep, and requires medical intervention. If you have concerns about your toddler's health, please see your family's GP for an assessment.

Here are the things that do cause toddlers to wake excessively at night. These reasons might also sound weird to you, again depending on what you've heard, so I'd ask you to please explore The Possums Sleep Program in greater detail so it all makes sense.

Toddlers wake excessively at night due to

1. Disrupted body clock settings. For example

   • Toddlers who nap for too long during the day may gradually end up with excessive night waking. You can find out more here.

   • Toddlers who go to bed too early in the evening may gradually end up with excessive night waking. You can find out more here.

   • Toddlers who start the day very late may gradually end up with excessive night waking. You can find out more here.

2. A dialled up sympathetic nervous system, which gets in the way of easy sleep. In toddlers, this is usually caused by a hunger for richer sensory motor experience (which might happen in the night because parents are advised not to pick their little one up, or to delay responses. But the kind of sensory experience toddlers need in the night, from a biological perspective, is contact with a loving carer's body, which dials them down. You can find out more here). If you're breastfeeding, a breastfeed dials your toddler down easily in the night. If you're not breastfeeding, you can find out more about the use of milk to dial your toddler down in the night here.

When you see this list of causes for the first time, you might think of all the things that led you to try spacing out feeds or delaying responses, or to try to get your toddler to bed early at the evenings and to have long daytime naps. You've been experimenting, which is a very important part of resilient, healthy parenting. After all, you know your toddler best, and you'll try out all sorts of things to see what works for your unique family.

I hope to show you different ways of thinking about what's been going on, and give you some new strategies to try out.

Selected reference

DeMasi A, Horger MN, Scher A, Berger SE. Infant motor development predicts the dynamics of movement during sleep. Infancy. 2023;28:367-387.