The Ferber Method for Sleep Training

What Is the Ferber Method?

The Ferber Method is a type of sleep training designed to help infants and young children learn to fall asleep on their own 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 at bedtime and after night wakings. Also called “Ferberizing,” this method was made popular by Dr. Richard Ferber in his 1985 self-help book, Solve Your Child’s Sleep Problems. A revised and updated version of the book was published in 2006. 

The Ferber Method treats behavioral insomnia 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 —a condition that, for children, often involves protesting bedtime, taking a long time to fall asleep, and waking in the night. For infants and toddlers, this condition can occur when children become reliant on caregiver actions Trusted Source American Psychological Association (APA) APA is the leading scientific and professional organization representing psychology in the United States, with more than 121,000 researchers, educators, clinicians, consultants and students as its members. View Source —like patting, rocking, or bottle feeding—to fall asleep. The Ferber Method and other behavioral interventions have shown success in treating childhood insomnia.

What Is the Goal of the Ferber Method?

The goal of the Ferber Method is to train young children to self-soothe 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 , allowing them to fall asleep without attention or intervention from a caregiver. It also is intended to be more parent-friendly than the classic cry-it-out method, which sometimes requires caregivers to listen helplessly as a child cries for long stretches of time.

Unmodified vs. Graduated Extinction in Sleep Training

The Ferber Method is aimed at graduated or modified extinction — a type of sleep training intended to eliminate a child’s association between sleep onset and their caregiver’s actions or presence. Unmodified extinction training, commonly known as the “cry it out” method, involves leaving a child in their crib or bed from bedtime until morning, regardless of crying or protests.

Some caregivers find this approach to sleep training difficult and stressful Trusted Source Medscape Medscape is on online destination for healthcare professionals worldwide, offering expert perspectives, drug and disease information, and professional education. View Source . Graduated extinction methods like the Ferber Method offer some relief to both caregivers and children by allowing carefully timed check-ins.

How the Ferber Method Works

The Ferber Method offers guidelines for how often to check-in on crying children and how long to provide reassurance. Caregivers must monitor and progressively increase the time between each check-in, and on successive nights, they must lengthen the time between check-ins.

According to Ferber, during check-ins, caregivers should reassure the crying child for fewer than two minutes. The point is not to stop the child from crying or to get the child to fall asleep, since this would likely deter the child from learning to self-soothe and fall asleep on their own.

Ferber offers exact intervals between check-ins in his book, Your Child’s Sleep Problems but also states that these intervals can be slightly modified to fit caregivers’ needs.

If a child falls asleep but wakes up later in the night, the intervals between check-ins can restart. If sleep training is necessary past day seven, Ferber advises that the intervals between reassurances continue to lengthen with each progressive day. He also advises that if children show no signs of improvement in sleep after seven days, caregivers should stop and reevaluate their approach to sleep training. 

At What Age Should Children Begin Sleep Training?

During their first months of life, infants have irregular sleep schedules. That said, they tend to spend increasingly less time awake at night as their bodies settle into a 24-hour sleep-wake cycle called a circadian rhythm. At 6 months old, about half of infants are able to fall back asleep 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 after waking at night without the involvement of a caregiver.

However, despite being biologically capable of sleeping through the night—or settling themselves when they do awaken—not all children over the age of 6 months do so. In fact, between a quarter and a half of them still have trouble going back to sleep after waking up. 

For these reasons, sleep training—including the Ferber Method—can start once a child is 6 months old 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 . Caregivers can also use graduated extinction approaches with older children, though some modifications may be necessary. For example, caregivers may see better results if a condition of reassurance is that the child stays in bed.

How Can “Ferberizing” Affect Babies?

Numerous studies have shown sleep training, including the Ferber Method, yields positive sleep outcomes 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 for healthy, typically developing children. Evidence shows that using these behavior-focused strategies reliably increases children’s willingness to go to bed and decreases the number of times they wake in the night—and these changes tend to stick. In the long run, however, most children eventually outgrow sleep issues 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 whether or not they undergo sleep training. 

Research has also shown that behavioral interventions like graduated extinction can reduce stress for some caregivers. Caregivers who are chronically sleep deprived due to a child’s frequent nighttime crying are more vulnerable to depression, so the improvements brought about by sleep training can also have a positive effect on caregivers’ well-being.

Some caregivers are hesitant to employ any extinction method of sleep training. They may find it distressing to hear a child crying without being able to provide comfort. Additionally, some have concerns that excessive crying without comfort could harm the child’s health or lead to attachment issues.

These concerns are understandable—and researchers continue to study how extinction methods affect children. Currently, however, no research has demonstrated problematic stress responses in the short-term for children who have undergone sleep training. Additionally, these children appear to experience no long-term negative effects 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 on their mental health or their relationships with their caregivers.

What Are Keys to Success With the Ferber Method?

The key to success with the Ferber Method is consistency. A single lapse in consistency may reinforce the child’s dependance on the caregiver’s presence for sleep. Caregivers should also be aware that children can experience “post-extinction bursts,” suddenly reverting to behaviors that appeared to be gone. This is normal, and caregivers should continue sleep training until the undesirable behaviors disappear again.

What Are Other Ways You Can Help Your Baby Sleep?

In addition to the Ferber Method, there are many other ways to help your baby sleep at night.

• Establish a bedtime routine: Establish a consistent bedtime routine that lasts between 20 and 45 minutes and includes a few calming activities, such as taking a bath, reading a story, or giving the child a light massage. A consistent routine and bedtime that aligns with the child’s natural circadian rhythms will help them fall asleep more easily.
• Create an environment conducive to sleep: Make sure the child gets plenty of exercise during the day. Avoid electronic devices and highly stimulating activities before bedtime. Ensure the child’s room is dark, quiet, and free from distractions.
• Look for signs of sleepiness: If you notice the child rubbing their eyes or getting fussy, they are likely sleepy and ready for bed.

Be aware that as babies grow older, their sleep needs change. Newborns sleep for 10 to 18 hours a day, and their wake and sleep times are sporadic and based on feeding needs. As infants age, they begin to sleep for longer stretches, and by the time they are 9 months old, they should be sleeping for 8 to 10 hours at night in addition to their daily naps. Because of these changes, caregivers should expect to alter routines and strategies for getting a child to sleep over time.

When Should the Ferber Method Be Avoided?

The Ferber Method is designed to address behavioral sleep problems in children. However, behavioral interventions like the Ferber Method are not sufficient to address sleep issues in children with:

• Certain chronic diseases, such as anemia 
• Excessive snoring, which may indicate a breathing disorder such as obstructive sleep apnea 
• Restless legs syndrome 
• Health conditions that cause pain or disrupt 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 , such as abdominal pain or allergies 
• Neurodevelopmental disorders, such as Down syndrome and autism spectrum disorder 

Additionally, there are certain psychological and environmental conditions that can contribute to childhood insomnia 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 . Children whose sleep problems are linked to these issues are likely to need more than behavioral training: 

• Depression or anxiety
• An unstable home environment
• Frequent nightmares 

When To Get Help With Your Baby’s Sleep

If you think a physical or mental health condition may be causing sleep problems for a child in your care, talk to a medical professional. Additionally, if you try the Ferber Method and see no improvement in the child’s sleep within a week, you should talk to your pediatrician or a sleep specialist. 

Caring for an infant or child who doesn’t sleep well can be a stressful and exhausting experience. Whenever possible, take steps to ensure that your own needs for rest and relaxation are met. Options may include:

• Seeking support from friends or family members so that you can nap or get a good night’s sleep
• Talking to other caregivers who can empathize 
• Limiting activities and outside responsibilities that may cause additional stress 
• Engaging in mind-body practices, such as yoga and meditation, that can help alleviate the physical and mental symptoms of stress 

Whether or not you decide to try the Ferber Method, it can be helpful to keep in mind that in most cases, there are steps you can take to help a child sleep better, so that you too can get a good night’s sleep.