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Sleep, Night Owls

I am having trouble with my three-year-old daughter getting to bed before 10:30 p.m. She does not want to go to bed before that and has a lot of energy instead of being tired. She has been fighting sleep for the longest time. I feel that she needs more than 9 hours. Please help.—A.P., a mom of one in East Meadow, NY

Our Mommy MD Guide’s reply: I can understand your concern, and your frustration. When my two youngest sons were toddlers, I really worked hard to get them in bed at 8:00 each evening, or 8:30 at the latest. Of course they wanted to stay up with me and my husband, but that wasn’t good for any of us. The boys would be tired and cranky the next morning when I got them up for breakfast, and my husband and I couldn’t enjoy any time alone in the evenings. I had the greatest success getting my children in bed and asleep on time when I stuck to the routine. We had a little bedtime ritual that we followed pretty much to the letter. Healthy snacks, baths, pajamas, teeth-brushing, and story time. When our children are this young, they really need their parents to participate in the bedtime ritual with them. As they get older, they’re able to wind themselves down and go to sleep on their own.

At age three, most children require about 12 total hours of sleep, generally a one-hour nap and 11 hours of sleep at night. Your daughter is getting close to that, 11 hours. However, the challenges you’re noticing with her wanting to go to bed, and her late bedtime, could certainly be concerning you. A 10:30 bedtime is quite late for a three-year-old.

I’m curious how you set the stage for her to go to sleep. Often having a consistent bedtime routine helps, such as giving her a bath, brushing her teeth, reading her a story, and then saying goodnight. It can help for each stage to get progressively darker and quieter. That bedtime routine probably takes about an hour, so you’ll want to start it about an hour before you wish for her to be in bed. So right now if she’s in bed at 10:30, you’ll start at 9:30. But a 10:30 bedtime is quite late for a three-year-old; 8 pm is preferable. It might help to change her bedtime gradually, by just 15 minutes each week or so until you get her back onto a 8 pm bedtime.

Also, it’s important how a child falls asleep. Does she fall asleep by herself in her own bed? Or does she fall asleep on the couch with you while watching TV? Ideally, she should fall asleep by herself in her own bed. This too can be an abrupt change, to go from falling asleep with company in the living room to falling asleep by herself in her bed. You can ease her into it by making small changes, such as one week letting her fall asleep on the couch with the TV off while you’re in the room, then letting her fall asleep on the couch by herself, then letting her fall asleep in her room with a radio or TV on with you there, then letting her fall asleep in her room with a radio or TV on by herself, then finally falling asleep in quiet all by herself.

You’ll find many great resources for sleep challenges, such as the book Teach Your Child to Sleep. If you are really desperate, you can even hire a sleep consultant. The authors of Teach Your Child To Sleep, Millpond Children’s Sleep Center, offer counseling by phone and email. (They’re located in England.) But of course you can also find sleep consultants here in the United States as well.

Rallie McAllister, MD, MPH, a mother of three sons, family physician, and coauthor of The Mommy MD Guide to Pregnancy and Birth

The information on MommyMDGuides.com is not intended to replace the diagnosis, treatment, and services of a physician. Always consult your physician or child care expert if you have any questions concerning your family's health. For severe or life-threatening conditions, seek immediate medical attention.