What's normal sleep behavior for a toddler?
Most parents would agree that the most delightful toddler sleep behavior is peaceful snoozing. But your toddler might do all sorts of other things while asleep – some of which might seem strange, or even alarming. Most are perfectly normal and no cause for concern, but a few are worth checking into.
Snoring, snorting, and mouth breathing
If your sleeping toddler snores, snorts, or breathes through her mouth, let her doctor know. If she snores once in a while or only when she has a cold or a stuffy nose, most likely she's fine. But snoring can signal other problems, and the American Academy of Pediatrics says it's a good idea to have her doctor check it out.
If a stuffy nose is the cause, try using a vaporizer or humidifier to make breathing more comfortable. If your toddler has seasonal allergies, take steps to minimize her exposure to pollen and mold.
If your toddler snores loudly, pauses between breaths, seems to work hard to breathe, or gasps as she tries to catch her breath, she may have the potentially serious sleep disorder sleep apnea.
Enlarged tonsils and adenoids (the glands in the throat just behind the nose) are the most common causes of sleep apnea in children. Other factors include being overweight and having certain facial characteristics, such as a receding chin and cleft palate.
Sleep apnea in children peaks between ages 3 and 6, when the tonsils and adenoids are at their largest in comparison to child-size airways. But children younger than 3 can also have this condition.
Some toddlers sweat buckets while they're in the deepest part of their nightly sleep cycle, often ending up soaking wet.
Deep sleep is when your toddler is getting the best of what sleep has to offer. His body is restoring itself and getting ready for a new day, so don't worry too much about sweating. While sweating can occasionally be a symptom of sleep apnea, nighttime perspiration is usually nothing to worry about.
Do make sure he's comfortable, though. Put him to bed in light cotton clothes and keep the room a little on the cool side.
If your toddler snores or has pauses in his breathing while he sleeps, in combination with sweating, talk with his doctor to rule out sleep apnea.
You may notice that the rhythm of your toddler's breathing changes during sleep. She might breathe more rapidly for a while, then more slowly, and then pause for up to 15 seconds before resuming a normal breathing pattern.
Breathing pauses – combined with snoring and snorting – may be a symptom of sleep apnea, but an occasional pause in breathing during sleep can also be perfectly normal.
Many children also sigh in their sleep, which may make it appear as though they've stopped breathing for a very brief time. These sighs are also perfectly normal.
Rocking and banging
Body rocking and head banging are normal behaviors in toddlers, who seem to find the rhythmic movements soothing and sleep inducing.
Your toddler may rock back and forth on all fours or sit up to rock, bang his head on the side of the crib, or both. Although this can be upsetting to watch, think of it as being similar to a child sucking his thumb or twirling his hair to fall asleep. Some toddlers rock or head bang to distract themselves from pain – from an ear infection, for example.
Rocking and head banging usually start in the first year, and most children outgrow these behaviors by age 3 or 4. Head banging can be associated with developmental disorders like autism, but it's just one of many behavioral red flags. Head banging alone rarely signals a serious problem.
Read our article on head banging in toddlers to get tips on what to do if your child's rocking is unusually loud or vigorous and how to help him unwind without rocking.
Twitching, jerking, and restlessness
Some children twitch and jerk while sleeping or when falling asleep. These movements usually last just a few seconds and happen a couple of times a minute. They can go on for anywhere from a few minutes to a few hours.
Your child's legs may twitch or jerk, or she may flex her ankles. The movements aren't painful, but they can keep your child from getting a restful night's sleep. Inadequate levels of iron or folic acid can cause this, so mention it to your child's doctor.
Some kids have a related condition called restless legs syndrome, in which their legs feel tingly or uncomfortable, or they feel an overwhelming urge to move around. If you suspect that twitching, jerking, or restless legs syndrome is causing your child's sleep problems, give her doctor a call.
Unusual sleeping positions
Many toddlers are restless sleepers, changing position numerous times during the night. Some have a favorite sleeping position that they settle into for long periods, while others are all over the place.
One toddler may prefer sleeping on his side or splayed out on his back like a starfish. Another may like to curl into a ball. Some toddlers sleep folded up on their hands and knees with their bottom in the air.
There are a couple of positions that might signal a problem, though. If your toddler sleeps with his head hanging over the side of the bed or raised on top of a stuffed animal, it could be a sign of sleep apnea, according to sleep expert Jodi Mindell. (Children with sleep apnea do this to keep the airway open while sleeping because tipping their head back or sleeping in a more upright position helps keep their airway open.)
Most sleeping positions are harmless, so just let your toddler be – even if he looks uncomfortable to you. But if you suspect he may have sleep apnea, start by telling his doctor about it. She can help you determine whether your child needs to be evaluated and treated.
There are lots of reasons that your toddler might grind her teeth – including tension, anxiety, misaligned teeth, or pain (from an earache or teething, for example). Allergies may also be the cause.
In most cases, teeth grinding isn't harmful, and it's likely your child will outgrow the habit without you having to do anything about it. It's a good idea to ask the dentist to check for problems, though. You might also try soothing your toddler at bedtime with a soak in the tub, a little back rub, and extra cuddling.
If your child walks in his sleep, he may appear to be awake, but he's not. His eyes will be open, but he'll have a blank look on his face.
He may get up and walk around or even engage in activities like getting dressed or playing. If he talks, he won't make much sense. He may sleepwalk for just a few minutes or much longer – even half an hour or more.
Sleepwalking is most common in children between ages 3 and 7, but it can happen at any age. Often kids will sleepwalk if they're anxious or overtired. Kids with sleep apnea are also more likely to sleepwalk.
Sleepwalking usually isn't cause for concern, but if your child does it often, mention it to his doctor at the next visit. Make sure he's getting enough rest, preferably with a dependable sleeping schedule and an early bedtime.
Find out whether it's a good idea to wake a sleepwalking child and how to keep your night rambler safe in the dark in our article on sleepwalking.
Nightmares can be caused by anxiety and stress. They often happen in the later part of the night, during REM (rapid eye movement) sleep. And they happen more often to children than to adults. A fever, medication, or difficulty sleeping (from a breathing problem, for example) may also cause nightmares.
Nightmares are especially common in older toddlers and preschoolers. Children this age have a growing imagination and are starting to understand that things can cause them harm.
The nightmare will probably wake your child, and she'll be frightened or anxious. She'll probably remember the dream. When your child has a nightmare, all you need to do is comfort her as best you can and try to soothe her back to sleep.
If she's having nightmares repeatedly, think about what kind of stress she's experiencing in her waking hours and do what you can to reduce it. If you're concerned about your toddler's nightmares, talk with her doctor.
If your toddler sits up in bed and seems terrified, he may be having a night terror, also known as a sleep terror. He may scream and sweat. He probably won't remember what happened, and he'll be difficult to wake up or console.
Like nightmares, night terrors can be triggered by fever, being overtired, and stress. Unlike nightmares, they often occur in the first third of the night during deep sleep.
Night terrors are most common in children 4 to 12 years old, but they can happen at any age. Most kids outgrow them as their nervous system matures.
Not getting enough sleep is often a major contributor to night terrors, so make sure your child heads off to bed early and gets plenty of shut-eye. If your child has frequent night terrors, talk with his doctor, who may suggest ways to reduce stress. In rare instances, medication may be necessary.