4-Month Sleep Regression

What Is the 4-Month Sleep Regression?

At around 4 months, a baby’s brain and body are developing rapidly , and the process of forming and linking different areas of the brain and nervous system may create instability in 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. View Source , referred to as a sleep regression.

A newborn needs between 16 and 18 hours of sleep per day Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source , which typically comes in one to three hour segments Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source throughout the day. This starts to change by around 3 to 4 months of age when a baby’s sleep starts to consolidate, meaning that they begin to sleep for longer periods at a time. While multiple naps are still the norm, they may have longer nighttime sleep sessions and sleep fewer total hours. From the age of 4 to 12 months, it is recommended that infants get 12 to 16 hours of sleep per day 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. View Source , including naps.

This process of sleep consolidation varies significantly from child to child. Some babies experience a smooth transition through sleep patterns, while others may have disruptions to their sleep duration and quality. 

What Causes a 4-Month Sleep Regression?

A 4-month sleep regression can occur because babies are in the midst of a major transition away from a newborn sleep pattern. That transition is not always smooth, and may have plateaus or setbacks like sleep regressions. There is typically no single cause for a 4-month sleep regression, but some contributing factors may include: 

• Separation anxiety
• A greater awareness of their surroundings, which can result in overstimulation
• An uneven transition into consolidated sleep
• Disturbances in the infant’s sleep environment

Do All Babies Have a 4-Month Sleep Regression?

Not all babies have a 4-month sleep regression. Research has shown that there is a considerable amount of individual variation in infant 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. View Source . Some babies may have no detectable sleep regression at 4 months, while others may have difficulty sleeping at this age or a few months earlier or later.

What Are Signs and Symptoms of a 4-Month Sleep Regression?

At about 4 months, some babies show signs of worsening sleep. Your baby may display some sleep-related symptoms that can indicate a sleep regression. 

• Difficulty falling asleep: It may take longer for your infant to initially fall asleep. They may also appear restless around the time they normally settle down for bed.
• Frequent nighttime awakenings: After putting your infant to bed, they may wake up more often during the night. These nighttime awakenings may be accompanied by crying or fussiness. 
• Irritability upon waking: Disrupted sleep during a 4-month sleep regression may cause irritability or crying when the infant wakes up. 
• Reduced total sleep time: You may notice that your baby is sleeping less overall, both at night and during the day. It is also common for feeding schedules to be disrupted during a 4-month sleep regression due to this shift in sleeping patterns. 

Caregivers may wonder how long the symptoms of a sleep regression will last. In most cases, sleep problems only last for a few days to a few weeks, but this may depend in part on fostering good sleep habits that promote better infant sleep.

How Can Caregivers Cope With Sleep Problems in 4-Month-Olds?

There is no single solution to a 4-month sleep regression. Instead, caregivers are encouraged to cultivate healthy sleep routines and habits for their baby. These tips can help in the short-term and also create a framework for healthier sleep as your baby grows.

Adhere to Safe Sleep Guidelines

As you consider making changes to your baby’s sleep habits, make sure to review guidance for safe sleep Trusted Source National Institutes of Health (NIH) The NIH, a part of the U.S. Department of Health and Human Services, is the nation’s medical research agency — making important discoveries that improve health and save lives. View Source and reducing the risk of sudden infant death syndrome (SIDS). Some risk reduction techniques for SIDS include removing soft items from the baby’s sleep space and putting the infant to bed on their back. 

Create a Sleep-Wake Routine 

Establishing distinct routines during both waking and sleeping hours can help adjust your baby’s internal clock and encourage nighttime sleep. During the day, keep your baby active with playtime and provide access to natural light. 

At night, allow your child to experience falling asleep in bed, as opposed to falling asleep somewhere else and then being put in bed. This can help them associate their bed with sleep and get them accustomed to falling asleep in bed on their own, which can help with self-soothing during nighttime awakenings. Feeding your baby shortly before bed can ensure they can stay asleep longer before their next feeding. 

Your baby’s bedroom should be dark, quiet, and calm so that there are fewer sources of stimulation, distraction, or disturbance.

Help Your Baby Get Sleepy

Relaxing activities like cuddling or rocking can promote sleepiness. Try to identify signs like fussiness or eye rubbing that can indicate that your baby is tired. This can be a cue to start your bedtime routine so that you can put them in bed while drowsy.

How Can Caregivers Manage Nighttime Awakenings? 

If your infant wakes up during the night, it is important to gently encourage a return to sleep.  You may want to wait a minute before comforting them to see if they are able to self-soothe and fall back asleep. If you need to feed your baby during the night, try to do so as quickly as possible while keeping the room dark and quiet. As soon as they are fed, avoid playing with them or stimulating them and put them back to bed to return to sleep.

If your baby cries from separation anxiety when you put them in bed, resist the urge to pull them back out of their crib. Try being comforting and reassuring, lightly rubbing their head while talking in a soft, soothing voice until they calm down, at which point you can quietly walk away and let them fall asleep.

When Should Caregivers Talk With a Doctor About Sleep Problems in 4-Month-Olds?

Talk to your doctor if you have concerns about your baby’s sleep or increased nighttime awakenings. It is important to consult with your pediatrician 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. View Source if you also notice:

• Lack of growth or weight gain
• A reduced number of feedings
• Changes, especially reduction, in urination or bowel movements

Parents should also discuss any abnormal breathing during sleep with their pediatrician.

Self-Care For Caregivers

Self-care is an important part of parenting, and that includes recognizing that nighttime awakenings or sleep regressions are common in babies.

Caregivers should set realistic expectations and remember that it takes time for babies to develop stable sleep patterns. Many babies do not sleep through the night even at 12 months 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. View Source , so caregivers should avoid blaming themselves if their infant wakes up in the night. Self-care also includes considering tips to help parents get the sleep they need to feel more rested despite their baby’s sleep schedule.