Case Study: Why has my 13 month old toddler been waking up at 5am?
By: Dr Sarah Mitchell
Tags: Sleep, Toddlers, Waking Up, Baby Sleep

I recently worked with a family who was stuck in a rut with 13 month old waking at 5am. On our intake conversation, I learned that their toddler was napping at 10:30 am for 45 minutes and then more often than not missing the afternoon nap. On days he did nap in the afternoon. It had to be while being pushed in the stroller, and even that was becoming hit and miss. His bedtime was around 7:30 pm, where he was nursed to sleep. I felt for this family, as Mom had older kids to take care of with drop offs, and pick ups, which made schedules challenging.

My analysis of why this 13 month old toddler was waking at 5am

This toddler is OVERTIRED because he’s not getting enough sleep for his age. When a child is overtired it is harder for a child to fall asleep, and then stay asleep. This explains his difficultly taking an afternoon nap and the 5 am wake up. He wasn’t getting enough nap hours during the day. Toddlers need 11–12 hours of uninterrupted overnight sleep.

In addition, his bedtime was too late. Most kids will wake up between 6 and 7 am because of the circadian rhythm. So when he’s asleep for 7:30- 8:00 pm, he’s already cutting into his night time sleep hours, ideally 11–12 hrs, and putting him in the overtired zone.

He needs to disassociate nursing and sleeping. When 13 month old wakes at 5am, he thinks he needs the boob to help him fall back asleep. He needs to learn how to self soothe and he needs to start learning this at bedtime.

SOLUTION:

Disassociate nursing and sleeping. This means, no nursing within 30 minutes of any sleeping. Nursing when baby wakes up for the day and wakes up from naps, and then one “top up” after dinner but not part of the bedtime routine.

A toddler of this age has an “awake time” of 3.5–4 hrs. That is the time between sleep periods that he can comfortably be awake for. Once he has been awake longer than this, it becomes more difficult for him to fall asleep, and stay asleep. He was up at 5 am and then not napping until 10:30 which is over 5 hours, and then had a very long awake time of about 8 hours before bed. If he is waking up at 10:30 am from his 1st nap, he must be back asleep (not in the crib) around 2:00–2:30 pm. Generally naps at this age should be around 9:30 am and 1:30 pm, assuming waking sometime around 6:30 am for the day.

Bed timing: Like many families, his 7:30 pm bedtime was more based on when Dad got home from work. However, to make sure he gets enough overnight sleep, and to cure his early wake ups. We needed to base his bedtime on when he woke up from his last nap. If he is waking up at 3:00 pm, then we need him back ASLEEP between 6:30 and 7:00 pm.

OUTCOME:

The first night Mom tried the earlier bedtime, with no nursing and he fussed for 10 minutes before he fell asleep. This guy has a lovely disposition, it is not always that quick. He woke up at 5:30 am, but she went in and told him it is still sleeping time and he fussed for a bit and then went back to sleep until 7:00 am.

That day, she made sure he had his 2nd nap and put him in the crib 3.5 hrs after waking up from his morning nap.

On the 2nd morning, he slept in until 6 am and we had broken the 5 am wake up pattern that had been going on for over a month and created a new afternoon nap habit.

Moral of the Story

The thought of change can be overwhelming, especially when you are tired and have other things on your plate. The fear of the unknown often holds us in the same pattern, even if it obviously isn’t working for us. Most change comes when you are so exhausted. You just can’t take it anymore and know that something has to change. In all the cases I work with, the anxiety of preparing for change is worse than the act of implementing change. Be aware of timing, believe it is possible and Be brave.

If you want to improve things quickly and are interested in personalized sleep help. I offer free 15 minute calls to discuss your situation and how I can help. Contact Me!