18-Month Sleep Regression

At 18 months, most toddlers are walking and talking, major milestones that reflect the profound development that occurs as a baby and toddler. Sleep is a key contributor to this development. And by 18 months, most parents have seen their child pass through multiple phases of sleep quality.

Compared to infants, toddlers usually sleep through the night with more consistency. However, their trend toward improved sleep can hit a snag around 18 months – a point when many toddlers suffer a normal sleep pattern called a sleep regression.

A sleep regression can mean problems at bedtime or waking up during the night. While ups-and-downs in sleep patterns are normal, they can be challenging for parents to deal with. In most cases, though, an 18-month sleep regression is short-lived, especially when parents maintain healthy sleep habits.

How Does a Child’s Sleep Change Around 18 Months?

At 18 months, a child is well into the toddler stage of development, bringing notable changes Trusted Source Centers for Disease Control and Prevention (CDC) As the nation’s health protection agency, CDC saves lives and protects people from health threats. See Full Reference in their physical abilities, mental skills, and emotional evolution. Sleep helps power this development, and toddlers need a total of 11-14 hours of sleep per day, according to expert recommendations Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference .

That quantity of sleep is usually made up of one nighttime sleep period and one nap during the day. As this indicates, most 18-month-olds sleep through the night, but individual sleep patterns in very young children can vary significantly Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference .

Part of the reason why there can be differences from one toddler to another is that sleep is tied to other developmental processes. It’s normal for 18-month-olds to gain mobility while becoming more communicative, including a heightened, yet dreaded, ability to harness the word “no.” Emotional reactions deepen, potentially causing or increasing separation anxiety Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. See Full Reference . At the same time, thinking, reasoning, and other cognitive skills expand considerably.

All of these aspects of development create a dynamic context in which to understand sleep regressions. As a child grows physically, mentally, and emotionally, it can affect how much and how soundly they sleep.

What Causes an 18-Month Sleep Regression?

It’s understandable that parents want to know why, often out of the blue, their child has an 18-month sleep regression. Unfortunately, in most cases, it’s tough to isolate one specific reason, but several factors may be involved:

• Resistance to bedtime, which may be tied to an increased sense of independence and/or overstimulation in the evening
• Restlessness related to expanded mobility and physical abilities
• Separation anxiety
• Discomfort from teething Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. See Full Reference
• Nightmares, although they are not common among 18-month-olds
• Adaptation to changing sleep schedules or sleep training

Do All Children Have an 18-Month Sleep Regression?

Many toddlers don’t have a sleep regression at 18 months. Sleep patterns unfold differently for every child, so toddlers may face problems before or after the 18-month mark. It’s even possible for some 18-month-olds to show notable improvement in sleep.

For this reason, it’s best to understand sleep regressions as phases that can occur during the development of any child but not something that is destined to occur for every child at a specific point in time.

What Are the Symptoms of an 18-Month Sleep Regression?

Parents may notice a number of different symptoms of an 18-month sleep regression. Some of the most apparent signs include:

• Greater resistance to going to bed or fussiness at bedtime
• Inability to relax and fall asleep once in bed
• Increased crying out when parents move away from the bed
• Higher number of nighttime awakenings
• Heightened agitation and more difficulty regaining calm after waking up in the night
• Longer and/or more frequent daytime naps

How Long Do Symptoms of an 18-Month Sleep Regression Last?

The symptoms of an 18-month sleep regression rarely last for more than a few weeks. In the same way that their cause may not be clear, sleep regressions may end without an obvious explanation.

The exact length can depend on the toddler, their development, and the underlying issues causing their sleep regression.

Once a child has started sleeping normally again, there’s no guarantee against future sleep regressions. Ups-and-downs are normal, so parents should remain prepared for future episodes of sleep difficulty. Sticking with routines to develop healthy sleep habits, though, can make it less likely that a child will have future sleep problems Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. See Full Reference .

How Can Parents Cope With Sleep Problems in an 18-Month-Old?

No silver bullet exists to rapidly resolve an 18-month sleep regression. Instead, most experts call for a bigger picture view that ensures that parents are promoting positive sleep habits for their toddlers.

An 18-month sleep regression provides an opportunity to reflect on your toddler’s sleep hygiene. Making sure that you’ve cultivated good habits can provide a strong foundation for quality sleep when your child moves past their sleep regression.

Examples of tips and strategies Trusted Source American Academy of Pediatrics (AAP) The AAP and its member pediatricians dedicate their efforts and resources to the health, safety and well-being of infants, children, adolescents and young adults. See Full Reference that can enhance sleep in toddlers include:

• Repeat the same bedtime routine: Keeping a set process to get ready for bed can give your child cues that bedtime is coming and has been shown to improve children’s sleep Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference . The routine should include soothing activity in dimmed light (with no electronic devices), making sure your toddler is comfortable, and saying goodnight in a reassuring way to reduce separation anxiety.
• Set a sleep schedule: Building a regular schedule for both nighttime sleep and naps can subtly reinforce a positive sleep pattern.
• Make their sleep space comfortable: Try to keep the area as dark and quiet as possible with no likely sources of distraction or disruption. Some children benefit from a white noise machine to drown out other sounds, and a dim night light can help toddlers who are afraid of the dark.
• Get active during the day: It will be easier for your toddler to sleep at night if they get out their energy during the day. It’s especially beneficial if they get daily exposure to natural light that can contribute to a healthy circadian rhythm.

These strategies can create a framework for solid sleep for your toddler, but they take time for both you and your toddler to get used to. Be patient and understand that better sleep may not happen right away.

Coping With Separation Anxiety

Separation anxiety is a major contributor to sleeping problems in toddlers. It can make them resistant to going to bed, cry out once they are in bed, or fail to get back to sleep if they wake up in the night.

Some separation anxiety is normal, but it’s best for parents to avoid reinforcing it. A handful of tips Trusted Source American Academy of Pediatrics (AAP) The AAP and its member pediatricians dedicate their efforts and resources to the health, safety and well-being of infants, children, adolescents and young adults. See Full Reference can help deal with your toddler’s separation anxiety:

• Avoid immediately responding when your toddler cries out. Give them an opportunity to self-soothe before going to them.
• Don’t bring your toddler into your bed to sleep with you. It’s better to focus on figuring out how to make them comfortable in their bed.
• If you need to comfort your child, do it while preserving the feel of bedtime. This means keeping the lights low, avoiding stimulation, and not taking them out of bed.
• If your child cries out multiple times, try to soothe them each time from a little further away.
• Provide a small item that reminds them of you that they can see from their crib.
• Allow them to have one favorite toy or stuffed animal in bed, although it’s critical to make sure it’s not a choking hazard.
• Do separation trial-runs during the day so that your child gets accustomed to being with other adults and staying calm when you’re not by their side.

An adjustment period is normal for children to get over separation anxiety. Focusing on a good process for handling their worries can empower them to self-soothe and sleep well on their own.

Managing Sleep Problems From Teething

Teething is an ongoing process that starts during infancy and can last through the toddler years. Because it’s uncomfortable, it may complicate falling asleep or sleeping through the night. You can offer relief to your toddler in a few ways:

• Lightly massage their gums using a washcloth that is damp and cool
• Offer them a soft and cool object, such as a teething ring, to chew on
• Check with your pediatrician about if and when it is safe to provide acetaminophen for teething pain

When Should Parents Talk With a Doctor About Sleep Problems in an 18-Month Old?

While sleep regressions can be frustrating, they usually don’t last for more than a few weeks. However, if sleeping problems continue for a month or more, you should bring them up with your toddler’s pediatrician. It’s also good to check with the doctor if you notice other issues Trusted Source American Academy of Pediatrics (AAP) The AAP and its member pediatricians dedicate their efforts and resources to the health, safety and well-being of infants, children, adolescents and young adults. See Full Reference including:

• Significant snoring or abnormal breathing during sleep
• Stunted growth
• Limited weight gain
• Reduced energy or other daytime impairment
• Longer naps during the day
• Significant changes to appetite, bowel habits, or urination

Parents and Self-Care

For many parents, there’s an impulse to put all of their attention on their child, but this can mean losing sight of self-care. Keeping yourself healthy, including getting needed sleep, allows you to be a more supportive and attentive parent.

Self-care also means remembering that parenting is hard. Some sleep problems are to be expected for toddlers, even for parents who do everything in their power to encourage good sleep. As hard as it is, being patient with yourself and your child can help navigate the ups-and-downs of a young child’s sleep.