Sleep & Naptime Q & A With Sleep Specialist Jason Coles, MD–The Dr. Answers Your Sleep-Related Questions







“Parents love them. Kids – not so much, especially as they get older. Naps, however, are important to a young child’s health and well-being. But what if your child simply won’t fall asleep during the day?


Jason Coles, MD, a sleep specialist with Spectrum Health Medical Group and Helen DeVos Children’s Hospital states that “Children need naps as they grow and develop. Parents and caregivers need to make time in a child’s day for a nap because most children will just keep going until they drop. Without stopping for some rest during the day, kids get way too tired which quickly spirals into crankiness and that’s trouble for the whole family.”


Most children stop napping when they turn five-years-old or begin full-time schooling. “If a school-age child still requires naps or frequently falls asleep in car rides despite getting the recommended sleep at night, parents should let their family doctor know,” he cautions. “This can be a sign of sleep apnea or another disorder.”

As a general guideline:


Infants require about 16 to 20 total hours of sleep per day, including frequent naps.

Babies from six to 12-months-old sleep about 11 hours at night, plus two daytime naps.

Toddlers require 10 to 13 hours of sleep, including an afternoon nap. Young toddlers might still take two naps a day.


With all of this in mind had an opportunity to ask Dr. Coles some of your sleep & nap related questions in regards to your children. He was kind enough to answer several of them. Here’s what he had to say:





Harmony asks:  How can I help my 9 month old sleep longer than 45 – 60 mins at nap time??? This doesn’t seem long enough. (He has 3 naps a day).

A: 45-60 minutes is a normal nap length at this age, especially if he is still napping 3 times per day.


Maria asks: How do I get our 6 month old son to nap longer than 20 minutes?

A: If your baby only can nap this long, it might be a sign of a problem that needs further investigation.  I would recommend talking about this with your pediatrician. 


June asks: 6 month old can only sleep for an hour+ if someone is holding him during the day. Daycare, he’s a terrible napper. A good day at daycare is a total of 2 hour nap. How do we train him to sleep better without us during the day? He sleeps like a champ through the night.

A: Babies need to learn how to fall asleep independently.  Holding them until they fall asleep can help in the short run, but makes them dependent on you in the long run.  They don’t learn how to self-soothe, causing them to struggle to fall asleep on their own, or cry out to parents in the middle of the night. Start putting your baby to bed when drowsy but still awake, and try to be very consistent with this.


Brianna asks: My 2 1/2yr old son still wakes up multiple times per night and during his nap. He will wake up crying from his naps still tired usually until either my husband or I hold him and he will fall back asleep on us for a little until we can lay him back down. At night he wakes up and plays with my hair to fall back asleep or whenever I am nursing our 4mo old back to sleep he will climb into the rocking chair with us and fall back asleep on me. It seems as if its separation anxiety? I always had trouble with night terrors and wonder if this has anything to do with it? He will be 3 in Jan.


A: Certainly some children can develop separation anxiety.  A clue that this is happening is if he is anxious in other separation situations (non-sleep related).  If so, I would recommend speaking with your pediatrician.  Some children will develop “sleep-onset association insomnia,” meaning that they cannot fall asleep without physical parental presence.  When they naturally wake up at night (which is normal) they immediately seek out parents for comfort, in order to return to sleep.  This is a learned behavior, and can be treated with behavioral changes.  The goal of treatment is to teach your child to fall asleep on his own, without parents physically being present.  It is important to leave the room before your son falls asleep.  When he wakes at night, it is OK to provide comfort, but then leave again before he falls back asleep.  I don’t recommend allowing him to sleep with you, because this perpetuates the problem.  Once you start making behavioral changes, it is important to not give in despite his protests, or the problem will get worse. 


Lolobuy asks: My 17 month old refuses to nap in his crib. He naps for 2 hours in my bed. Bed time is no issue he goes down after story and song falls asleep on his own. What can I do to get him to nap in his crib in his room.

A: If it is not OK for him to sleep in your bed, I would not allow him to do so any longer.  One reason he may refuse to nap in his crib is that he prefers to sleep in your bed, so he is behaving in a way to achieve that wish.  If this is no longer allowed, and the crib is always the nap “routine,” the protesting behavior will lesson when he understands you will not give in to his behavior.



Jaimie asks: How do you get a baby to nap better without doing cry it out method OR letting them sleep with you? Isn’t there a middle ground?


A: There is a middle ground for sure.  The “cry it out” method is one of many approaches to teaching your child to fall asleep on his or her own, without parental presence (which is a very important goal).  The best interventions are often gradually done.  The physical space between parent and child can gradually increase over time, for instance.  Start next to each other, but on successive bed times, gradually move farther and farther away.  Keep all other parts of the “routine” predictable and consistent. 



Marisa asks: My 4 month old sleeps all night, but only if he is in bed with me. If I lay him in his crib it is a constant battle all night to keep him asleep. He naps alone during the day! How can I transition him to the crib without having to let him “cry it out”?


A: See above


Heather asks: I just started sleep training on my 7 month old. Is it ok to have different nap times during the day? Because he wakes up at different times in the morning.


A: Consistent schedules are best, if possible, but certainly if he is napping well, it is OK to follow his lead. 



Erica asks: Why do some babies only nap for 30 mins at a time? Why do some babies know how to get to sleep on their own from the beginning and others do not?


A: There will be natural variation from baby to baby, just like some adults are better at sleeping than others.  Parent involvement and response to sleep troubles can help or worsen the problem, as we discussed.  Sometimes factors like feeding time/volume consumed and what they eat (formula vs breast milk) and affect nap time.  Breast fed babies sleep shorter periods of time because they eat more frequently.  



Sara asks: I have a two and a half year old who fights both nap and bed times. She had her tonsils and adenoids out and we thought that would help but she is still fighting sleep, especially for nap. She can tell me she’s tired and yawn but as soon as she starts relaxing, its like she forces herself to get hyper. She also wakes up during the night still and we give her melatonin but she is able to fight that off as well. I would like to get her sleeping before the next baby is born in a couple months but we are at a total loss of what to do. She is constantly active during the day from the time she wakes up, up until she finally falls asleep at bedtime. I just can’t believe she is able to fight the melatonin. We have tried the cry it out and it never did work for her


A: This sounds like a big problem at this point. I would recommend speaking with your pediatrician if you have not already done so.  It may be time to see a sleep physician and/or a child behavioral therapist.  There are treatable sleep disorders that can sometimes affect sleep, and additional evaluations may be helpful. 



Elizabeth asks: My son is 9 months old and still isn’t sleeping at night and fights taking a nap for hours. At night he only sleeps for 2-3 hours at a time and then wants to be awake for 2 hours. We have tried EVERYTHING! At his 9 month appointment I brought it up to his pediatrician who advised me to give him Benadryl in the evenings before bed to get him to sleep. I haven’t done this yet because I would rather not have to medicate him. He said if he’s not sleeping by 12 months then they will check for overactive thyroid. Is there any natural sleep remedies other than full belly, warm bath, night time soaps/lotion, massage therapy, or medication that ACTUALLY works?


A: Medications are often our last line of defense after behavioral approaches have been fully implemented.  We sometimes use melatonin, which is “natural” but still comes with some potential risks. 



Dianna asks:  My 17 month old is still waking up at night anywhere from 2-3 times crying and wont go back to sleep on his own. I need advice asap please ? I just had my second son yesterday at 35 weeks by c-section and I got to get my 17 month old’s sleeping down straight so I don’t get too wore out. He eats at 6pm, bed by 8 pm and will wake up at 12, 2 and 3:30-4 o’clock. thank you.


A: It is completely normal and natural to wake up multiple times a night.  What we want is for him to fall back asleep on his own, without waking you and the rest of the house up. Likely your response to his crying is the thing that needs to change.  I would recommend going to him to check on him, but then leaving the room.  If he continues to cry, check back on him at increasing intervals.  Don’t stay with him until he falls asleep, in the middle of the night or at the beginning of the night. 


Jessica asks: My 5 year old began wetting the bed shortly after moving into a new home. She was previously trained through the night for many many months. September will be a year! He is still wearing pull ups and even when we have tried to eliminate the pull ups she goes in her bed! He does not drink water after dinner she pees before sleep. Aaaaaaand no luck. In ADDITION, she began sleeping with us every night after sneaking in out bed when we rent aware! Holy moly it’s been a rough year!


A: Bedwetting that “comes back” after initially going away can be a sign of a sleep disorder such as sleep apnea.  I would recommend speaking with your child’s pediatrician.  I don’t recommend allowing your child to sleep with you.



Cindi asks:  We have an 11 month old who sleeps better on the couch then she does her crib, how do we change this? she sleeps from 8 or til midnight or so in her crib then wont sleep in her bed she wants to sleep on the couch


A: I don’t recommend allowing your baby to sleep on the couch at all.  The couch is potentially dangerous, more open to disruptive environmental noise/activity.  All sleep should be done in the crib.  She should be put in her crib before falling asleep at night, and put back in her crib after waking up at night, even if this happens multiple times. 


A big thank you to Jason Coles, MD, Sleep Specialist. You can find him at the Spectrum Health Medical Group and Helen DeVos Children’s Hospital in Grand Rapids, Michigan.


Image credit: 123RF

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