Toddlers Growth & Development Coping With the 18-Month Sleep Regression What to Do When a Toddler Won't Sleep By Chaunie Brusie, RN, BSN Chaunie Brusie, RN, BSN LinkedIn Chaunie Brusie is a registered nurse with experience in long-term, critical care, and obstetrical and pediatric nursing. Learn about our editorial process Updated on October 05, 2022 Medically reviewed by Sarah Rahal, MD Medically reviewed by Sarah Rahal, MD LinkedIn Sarah Rahal, MD is a double board-certified adult and pediatric neurologist and headache medicine specialist. Learn about our Medical Review Board Print istockphoto Table of Contents View All Table of Contents What Is Sleep Regression? Signs of a Sleep Regression Why Do Sleep Regressions Happen? How to Handle a Sleep Regression When to Call a Doctor Imagine this scenario: You have been blessed with a baby who, miraculously, sleeps through the night. Sure, there may be the occasional rough night of teething or unexplained wake-ups, but overall, you have escaped that extreme sleep deprivation that seems to haunt so many parents. You may be patting yourself on the back for a job well done; you may be thanking your lucky stars that you haven't had to deal with months of no sleep, or you may just be wondering what all of the fuss from other parents is all about. And then, something changes. Your baby turns into a toddler, and around 18 months, your great little sleeper won't go to sleep at bedtime, wakes often during the night, or both. Welcome to the 18-month sleep regression. Here's how to handle it. What Is Sleep Regression? Although the common stereotype is that infants don't sleep, most babies are actually sleeping through the night by three months old, according to a study published in Pediatrics. However, sleep patterns can change as babies grow, and sometimes that means sleep regression. A sleep regression is when a toddler who is normally a great sleeper suddenly refuses to go to sleep, has frequent nighttime awakenings, or wakes up during the night and will not go back to sleep. It may happen at 18 months old, 24 months old, or another time. Sleep regressions can happen at many different points in a child's life, often during periods of rapid growth and brain development. This growth can temporarily disrupt the hormones that regulate sleep in the brain. Your toddler's brain is basically resetting itself, and as a result, sleep might be disrupted. Sleep regressions are usually temporary, and they can also be brought on by external factors. Teething, travel, stress, a change in routine, or sickness can also cause temporary sleep disruptions in toddlers. Signs of a Sleep Regression Sleep regression might look different in different kids. Some will struggle at bedtime and refuse to stay in their room. Others won't protest but you'll hear them singing and babbling to themselves long after you have put them to bed. Waking up in the middle of the night and staying awake or waking up extremely early in the morning could also be signs that your toddler is regressing. How Long Will It Last? Sleep regressions generally last for a few weeks, if you are consistent in your expectations. However, if you make a change, such as allowing your child to come into your bed in the middle of the night, this habit may stick until you actively work to change it. Why Do Sleep Regressions Happen? The 18-month sleep regression may happen somewhere around the age of 18 months and even as late as age 2. You may see this regression around the time that your toddler starts to become more mobile and test limits. They realize they can walk out of their bedroom if they decide to, and they want to see what you'll do about it. Sleep regression may also be related to a new milestone. If your toddler is just starting to learn to walk, you might notice sleep disturbances. They might even decide to practice their new skill in their crib during the wee hours of the night. How to Handle a Sleep Regression Sleep is very important for infants and toddlers because it allows brain growth and development to happen. A toddler's brain is even more active during sleep than it is during awake times. By two years old, a toddler needs about 12 to 14 hours of sleep per day. When toddlers and preschoolers don't get enough sleep early in life, it can have long-term negative consequences on their health. Poor sleep early in life has been linked to complications such as behavior problems and cognitive deficits. And of course, when your child isn't sleeping, you aren't either. So you'll want to help them get through this phase quickly. The key is consistency. Your child's brain needs to relearn how to go to sleep, how to stay asleep, and how to go back to sleep during periods of nighttime awakening. It may help to keep in mind that sleep regression is temporary. If your toddler suddenly starts waking up at all hours of the night at 18 months old or refusing to sleep altogether, it doesn't necessarily mean all hope is lost and you will never sleep again. Having the mindset that sleep regression is normal and won't last forever might help you stay more calm and patient as you deal with it. Stay Consistent The best thing you can do through your toddler's sleep regression is to stay consistent with your bedtime routine and nighttime behavior. Remember that this is a confusing and probably overwhelming time for your toddler too. Maintain your typical bedtime routine, such as a bath and a story or a special blanket or stuffed animal cuddle time, to cue your little one that it's time to get ready for sleep. The key is to create and keep a simple, predictable bedtime routine. Stay Calm In addition to consistency, it's important to stay calm when you're dealing with your toddler's sleep regressions. Keep the message clear: When it's time to sleep, it's time to sleep. Comfort your child, reassure them, and then repeat as necessary. All parents have a different level of comfort for how they would handle nighttime awakenings. For example, some might believe in co-sleeping, while others prefer to encourage their toddler to sleep on their own. Just know that whatever strategy you use during a sleep regression might be something your toddler will want to continue. So if co-sleeping is not something you want to do in the long term, avoid using it as a short-term solution for helping your toddler sleep. Consider a Sleep Consultant Hiring a sleep consultant or specialist is not something that only celebrities do. Many families have benefited from outside professionals who are able to help them get the rest they all need. The truth is, learning to sleep is a skill, and sometimes, skills need to be taught and learned, even in toddlers. Limit Screen Time Screen time has been associated with sleep disturbances in children, so if your toddler is having difficulty falling asleep and/or staying asleep, consider what role screen time might be playing in that. Avoid screens within two hours of bedtime, and don't keep a TV in your child's bedroom. How Parents Can Help With Toddler Sleep Challenges When to Call a Doctor Although every child is different, a sleep regression should only last a few weeks. But sleep disturbances are more common in children who have psychiatric or medical conditions. Distinguishing a normal, temporary sleep regression from sleep disruptions that are more typical for children with conditions like autism is challenging. A 2011 study noted that most sleep disturbances among 18-month-olds resulted from environmental factors and parental behavior. However, about 25% to 30% of children and adolescents do have sleep disorders. If your child is sleeping significantly less than the recommended 12 to 14 hours a night or is having other symptoms, such as behavior changes or physical changes, speak to your doctor to rule out a sleep disorder. A Word From Verywell Many toddlers go through sleep regressions at different points during their growth and development. If your 18-month-old suddenly has trouble falling asleep, starts resisting naps or sleep, or has frequent nighttime awakenings, they may be experiencing a sleep regression. The best way to deal with any type of sleep disturbance is to maintain a consistent bedtime routine and to minimize any major changes. In many cases, a sleep regression is temporary and will not last longer than a few weeks. However, some children might need to see a doctor or a professional who specializes in sleep if the regression persists. What Are Toddler Night Terrors? 12 Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Henderson JM, France KG, Owens JL, Blampied NM. Sleeping through the night: the consolidation of self-regulated sleep across the first year of life. Pediatrics. 2010;126(5):e1081-7. doi:10.1542/peds.2010-0976 Wolfe L. The Baby Sleep Solution: The Stay and Support Method to Help Your Child Sleep Through the Night. Gill Books. Callahan AG. The Science of Mom: A Research-Based Guide to Your Baby's First Year. Johns Hopkins University Press. 2015. U.S. National Library of Medicine. Bedtime habits for infants and children. Centers on Disease Control and Prevention. Important milestones: Your child by 18 months. Cleveland Clinic. Sleep in toddlers and preschoolers. Stanford Health Care. Pediatric sleep disorders. National Sleep Foundation. Children and sleep. Nemours KidsHealth. Sleep and your 1 to 2 year old. Genuneit J, Brockmann PE, Schlarb AA, Rothenbacher D. Media consumption and sleep quality in early childhood: results from the Ulm SPATZ Health Study. Sleep Med. 2018;45:7-10. doi:10.1016/j.sleep.2017.10.013 Boston Children’s Hospital. Pediatric sleep disorders. Brescianini S, Volzone A, Fagnani C, et al. Genetic and environmental factors shape infant sleep patterns: a study of 18-month-old twins. Pediatrics. 2011;127(5):e1296-302. doi:10.1542/peds.2010-0858 Additional Reading El Shakankiry HM. Sleep physiology and sleep disorders in childhood. Nat Sci Sleep. 2011;3:101-14. Kocevska D, Rijlaarsdam J, Ghassabian A, et al. Early childhood sleep patterns and cognitive development at age 6 years: the Generation R Study. J Pediatr Psychol. 2017;42(3):260-268. doi:10.1093/jpepsy/jsv168 Taveras EM, Rifas-shiman SL, Bub KL, Gillman MW, Oken E. Prospective study of insufficient sleep and neurobehavioral functioning among school-age children. Acad Pediatr. 2017;17(6):625-632. doi:10.1016/j.acap.2017.02.001 By Chaunie Brusie, RN, BSN Chaunie Brusie is a registered nurse with experience in long-term, critical care, and obstetrical and pediatric nursing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit