Night wakings: a decision tree

First question: is it new?

A child who has always woken has a habit to change. A child who has started waking has a reason to find: illness, a growth spurt, worry, a change at home or school, a new medication, or a bedroom that has got noisier, lighter or colder. New wakings are a message. Look for the cause before you change the routine.

Second: what happens when they wake?

If they wake and need you to fall back to sleep, the issue is usually how they fell asleep in the first place. A child who falls asleep with a parent in the room, a hand on the back, or the television on, wakes in the night (as everyone does) and finds the conditions gone, and needs them back to return to sleep. The fix is at bedtime, not at 2am: the same conditions at the start of the night as they will find in the middle of it.

Third: are they frightened?

Nightmares happen in the second half of the night, the child wakes and remembers, and comfort is the right response. Night terrors happen in the first half, the child is not really awake and will not remember, and the right response is to keep them safe and not try to wake them. Terrors are alarming to watch and usually harmless. They are more common in over-tired children, so an earlier bedtime often reduces them.

Fourth: sensory and medical

Itching, snoring, restless legs, reflux, a full bladder, being too hot or cold, a scratchy pyjama seam. Autistic and ADHD children are more likely to be woken by things others sleep through. A quick check of the room and the body is worth doing before any behavioural plan.

Educational content, not medical advice. Concerned about your child? Speak to your GP.