Handling Sleep Disorders among 4yr olds


Some of the steps that can be taken for handling sleep problems of toddlers through controlled comforting include developing positive and consistent bedtime, tucking in your toddler in the bed, let your toddler settle for himself, etc.

The Internet is loaded with unlimited blogs for sleep training and learning how to make infants sleep through the night. However, it is not only infants who need sleep training. There are certain toddlers and preschoolers who have sleep problems. There are parents who will tell you their toddlers wake up during the night, either to look for the parents or for almost no reason. The 2 am call is really dreadful. And, there are also toddlers and preschoolers who are capable of sustained sleep.

Waking up at night indicates a problem if it occurs for more than a few minutes multiple times. Another outcome of disturbed, problematic sleep is significant irritability during daytime. It can be for the child or even parents.

A research submitted by Dr. Abdullah Al Mamun, Longitudinal Studies Unit, School of Population Health, University of Queensland, revealed that the young adult BMI and the existence of obesity were higher in kids who have had sleeping problems at age 2-4 years as compared to those who didn’t have any sleep-related issues. As per this study, these associations were vigorous to adjustment for various potential confounders or extraneous variables, including maternal mental health, offspring’s sex and BMI along with other variables, like adolescent television watching and dietary patterns. These findings also provided evidence for long-term impact of sleeping problems during childhood on the development of obesity later in life.

Handling Sleep Problems in Toddlers With Controlled Comforting
Handling Sleep Problems in Toddlers

Causes of Nocturnal Awakenings in Toddlers

Some of the possible causes for nocturnal awakenings in toddlers and preschoolers are listed ahead:

  • Learned Hunger: This is a justified cause for toddlers who are still fed on bottle, either milk or nursing formula, for prolonged durations at night. These kids wake up at night looking for food as they are conditioned for this. If your preschooler or toddler is a healthy kid and feeds multiple times during the night along with the need for a diaper change at frequent intervals, this indicates a problem. Also, your child might have problematic sleep association if he falls asleep while eating or nursing. It is wise to cut down the volume of bottles by small quantities. Or, you can also reduce the number of feedings by increasing the duration between consecutive feedings. However, don’t be too rigid if your child is still hungry. Be flexible with your techniques to make the child comfortable for sleep.
  • “Inappropriate” Sleep Onset Associations: This is the most specific sleep disorder observed in toddlers and pre-schoolers. Here, inappropriate refers to those conditions that help the child sleep but are not present later during the night. Some examples include rubbing or patting the back, a pacifier in the mouth or nursing to sleep. As the night grows deeper, the child cycles through lighter sleep, deeper sleep and then waking up for a minute or two at an interval of a few hours. If the conditions he slept with are not there, for instance, you are not beside him, there will be loud crying that ends with you picking the child up. The solution for this problem is to make your preschooler or toddler learn to sleep with them. Put them into bed when drowsy but still awake. One easy way is to delay the bedtime by about 30 minutes to ease the process. Your child may be fussy for a day or two, but gradually the nightly awakenings will go away.
  • Environmental Factors: Disturbed sleep is common due to environmental factors. These include change in room temperature or sound levels. If there is a TV that is left on in the room, make sure to switch it off before the child sleeps.
  • Medical Disorders: Sleep disruption can also be a result of certain medical disorders. Common ones include frequent cough at night, which can be due to asthma, acid reflux resulting in stomach ache and vomit at night, or snoring resulting from obstructive sleep apnea. If you notice these symptoms, it is advisable to consult your pediatrician.

Why is Sleep Important?

A rested mind, builds a healthy individual. Your child’s way of sleeping can impact his behavior to a great extent. This again impacts the way of sleeping. This implies, if the child is not getting sufficient sleep, it will reflect in other areas of life. Unlike adults, who tend to experience drowsiness and fatigue due to lack of proper sleep, children tend to show hyperactivity or lack of attention in case of sleeplessness or disrupted sleep.


As stated by Dr. Rafael Pelayo, “Your life is a reflection of how you sleep, and how you sleep is a reflection of your life.”

Handling Disrupted Sleep through Controlled Comforting

Controlled comforting is one of the techniques to handle problems related to sleep disorders. The technique involves comforting, settling and walking away to make the baby learn to sleep without assistance.

About Controlled Comforting: Controlled comforting refers to a strategy of behavioral management that deals with persistent settling and waking issues among toddlers and young children. The basic idea behind the technique is to help the kids learn how to settle themselves to sleep instead of being fed, cuddled or nursed to sleep. This technique involves checking quickly and then reassuring the baby during the process of learning to settle. Many recent research and studies have revealed that babies who are dealt through controlled comforting were likely to sleep better in the near future and also adjust as well as their peers in terms of sleep and behavior. Moreover, the technique also helps reduce symptoms of depression in parents of kids, who suffer from disrupted sleep.

Steps for Controlled Comforting

The main steps involved in the process of controlled comforting are listed ahead.

  1. Develop a positive and consistent bedtime routine.
  2. Put your baby in the cot and tuck him in while saying Goodnight. You can take a minute or two to help your baby to settle by patting him till he is quiet.
  3. As you notice the baby getting quiet, leave the room while saying Goodnight. Make sure you leave the room before the baby is asleep.
  4. Make sure you stay out of the room and ignore grizzling. This would give your baby a chance to settle by himself.
  5. If you hear crying, don’t enter the room instantly. Rather wait for a few minutes before you enter the room. For instance, you can begin waiting 2 minutes.
  6. Set intervals based in time thinking how long you can manage.
  7. After every time interval is over, visit your baby briefly. However, this is only if the crying is persistent. Talk to him and pat for a minute or two. Continue patting till the baby gets quiet again. The results can be even more effective if you soothe the baby while in bed instead of picking him up.
  8. Leave the room again as soon as the baby is comforted and quiet but still awake. Wait for the next set interval of time and then take a round of the room again. This way, not only the child will get an opportunity to settle by himself, but also make him feel assured of your presence around his room and the house.
  9. Continue the process until the baby falls asleep.
  10. You can follow the same routine if your baby wakes up during the night.

Caution Tips for Controlled Comforting

  • It may take 2-14 days for the controlled comforting technique to show results.
  • It is better to use a timer or mobile phone to set the time intervals. You may find four or five minutes to be quite long a time.
  • Turn off baby monitors. This would ensure proper hearing of your baby’s cry.
  • It is wise to discuss with your partner and have mutual consent on what you are doing. Even better is to work out on your individual roles. For instance, who would help with timing the intervals or resettling? You can take turns alternate nights.
  • It is suggested not to wait outside the baby’s room. Instead, go to another room and try to keep yourself busy or distracted. Making yourself a cup of tea or watching TV is a good way to keep yourself distracted and busy. Go to check only after the set interval time is over.
  • After you begin with the process of controlled comforting, avoid making important commitments for the initial few days. This is because you need to be around and see it through without bringing about major changes to the baby’s routine.
  • Most importantly, it is recommended to leave the room before the baby falls asleep. This is because if the baby sleeps, seeing you, he would expect the same when he wakes up at night and has to fall asleep.

The strategy of controlled comforting can be implemented to daytime sleep, as well. Doing so would reduce the level of confusion between you and your baby.


As revealed by research and studies, infancy and childhood are the periods to lay the foundation for healthy sleeping patterns. Therefore, it is important to address any problem your baby experiences with sleeping. You also need to formulate some type of approach or plan to improve quality of sleep in children.