Baby sleep deprivation:

How to tell if your baby is overtired or underslept

© 2008 - 2014, Gwen Dewar, Ph.D., all rights reserved

Is there such a thing as baby sleep deprivation?

It's obvious that babies can cause sleep deprivation in others. But whether or not babies themselves suffer from sleeplessness is less clear. In my search for published studies about infants with insomnia, I've come up with almost nothing.

Researchers acknowledge all sorts of infant sleep problems, including too-frequent night wakings, sleep-disordered breathing, and diseases that can interfere with sleep, like GERD.

They also recognize the existence of behavioral insomnia in toddlers and older kids.

And, as I note below, a few studies have tested the effects of brief, experimentally-induced episodes of sleep disruption on babies.

But when it comes to insomniac babies, I haven't found any scientific accounts.

Maybe that's a good thing, evidence that chronic sleep restriction in babies is very rare. If you take an evolutionary perspective--and consider how many babies have learned to sleep in slings while their parents went about their daily chores--this seems quite plausible. Babies may be able to regulate their own sleep very well, even amid hustle and bustle.

Still, you may have questions. How much sleep does your baby need? How can you tell if your baby isn't getting enough sleep? Here I review what the available evidence tells us.

Gauging baby sleep requirements

Healthy babies may vary significantly in the amount of sleep that they need. So merely sleeping less than average does not imply that your baby has a problem. This article about the normal range of sleep times in infants may help put your concerns about baby sleep deprivation in perspective.

But it’s possible for things to go wrong. Some parents may inadvertently over-stimulate their babies, making it harder for them to fall asleep. In other cases, babies may suffer from medical conditions or behavioral problems that interfere with their sleep. Parents may also overestimate how much sleep their babies need, causing babies to resist bedtime.

How can you tell if your baby isn’t getting enough sleep?

Pediatricians and experienced parents have noted these signs of baby sleep deprivation or "over-tiredness" in the very young:

  • A noted lack of interest in people and the environment
  • A tendency to look away from stimulating things
  • Hand-to-face gestures: Pulling ears, rubbing eyes
  • Fluttering eyelids
  • Yawning

For older babies and toddlers, signs may also include:

  • Becoming more accident prone
  • Becoming more “clingy”
  • Becoming ever-more active as the night wears on

I’ve also culled several possible markers of baby sleep deprivation from the scientific literature: 

  • poor recovery from negative emotions
  • feeding troubles
  • being hard to awaken

Baby sleep deprivation and negative emotions

Adults aren't the only people who get moody then they are tired. In one experimental study, researchers deliberately disrupted the sleep of 14-month-old babies during a single laboratory "sleepover." The following day, these babies showed poorer emotional regulation--i.e., they had difficulty recovering from negative emotions (Montgomery-Downs and Gozal 2006).

Did sleep loss cause emotional problems? Not necessarily. Babies prone to bad moods might have had a harder time adapting to, and sleeping in, a lab environment. But either way, we've got evidence that sleeplessness and negative emotions go together, even for babies. If your baby seems to have special trouble bouncing back from upsets, he may be more likely to suffer from sleep difficulties.

Sleep complaints and feeding problems go together

Here's another story of a correlation that's not yet well-understood: Researchers studying over 600 American babies, aged 6-36 months, found that babies with feeding difficulties (e.g., refusing to eat) fell asleep later at night and slept for shorter intervals. They were also more likely be diagnosed with insomnia (Tauman et al 2011).

Baby sleep deprivation and difficulty awakening

In an experiment on 8-week-old infants, researchers subjected babies to brief episodes of sleep deprivation and then attempted to awaken them with blasts of white noise (Franco et al 2004). Compared to well-slept babies, sleep-deprived infants required louder noises before awakening (Franco et al 2004). A earlier study of three-month old infants yielded similar results (Thomas et al 1996).

Does this matter? It might. Another experiment found that babies subjected to short-term sleep deprivation and then allowed to sleep experienced more sleep apnea, especially obstructive sleep apnea (Canet et al 1985), which has been linked with a variety of health problems (Jennum et al 2013) and an increased risk of SIDS.

More generally, research suggests that sleep-deprived people spend more time in deep sleep, a state characterized by fewer arousals and greater difficultly awakening. Babies appear to fit this pattern as well, and it, too, might contribute to the risk of SIDS. In one experiment, researchers found that babies experiencing breathing problems were less likely to wake up during "quiet sleep," the infant equivalent of deep sleep (Parslow et al 2003).

The bottom line?

If you suspect your baby is routinely overtired and seems unusually hard to awaken, it's worth discussing your concerns with your physician. He or she may want to screen your baby for signs of irregular breathing or sleep apnea.

If your child also has feeding problems, or seems to have difficulty handling disappointments, frustrations, and other negative emotions, you might be coping with a package of troubles that often go together. While researchers haven't yet established the root cause of these interrelated troubles, it makes sense for concerned parents to take some common-sense steps:

  • Talk with your doctor about your baby's symptoms. Is there reason to think a medical condition might be interfering with her sleep?
  • Show sensitivity to the baby's emotional problems and insecurities at bedtime. Parents who do so report fewer sleep problems (Teti et al 2010)
  • Watch out for your own negative emotions. Caring for a seemingly sleepless baby is stressful. But if your baby detects your distress, he may become even more restless, creating a vicious circle.

References: Baby sleep deprivation

Anders TF. 2003. Sleep-wake states and problems and child psychosocial development. In: RE Tremblay, RG Barr, and RDeV Peters (eds). Encylopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood Development 2003: 1-6. Available at http//www.child Accessed 1.6.08.

Bolten MI. 2012. Infant psychiatric disorders. Eur Child Adolesc Psychiatry. 22 Suppl 1:S69-74.

Canet E, Gaultier C, D'Allest AM, and Dehan M. 1989. Effects of sleep deprivation on respiratory events during sleep in healthy infants. J Appl Physiol. 66(3):1158-63.

Franco P, Seret N, Van Hees JN, Scaillet S, Vermeulen F, Grosswasser J, and Kahn A. 2004. Decreased arousals among healthy infants after short-term sleep deprivation. Pediatrics 114: 192-197.

Jenni OG, Borbely AA, and Achermann P. 2004. Development of the Nocturnal Sleep Electroencephalogram In Human Infants. Journal of Physiology - Regulatory, Integrative and Comparative Physiology 286: R528-R538.

Jennum P, Ibsen R, and Kjellberg J. 2013. Morbidity and mortality in children with obstructive sleep apnoea: a controlled national study. Thorax. 68(10):949-54.

Kuhn BR, Mayfield JW, and Kuhn RI. 1999. Clinical assessment of child and adolescent sleep disturbance. Journal of Counseling and Development 77: 359-368.

Montgomery-Downs HE and Gozal D. 2006. Toddler behavior following polysomnography: effects of unintended sleep disturbance. Sleep 29: 1282-1287.

Teti DM, Kim BR, Mayer G, and Countermine M. 2010. Maternal emotional availability at bedtime predicts infant sleep quality. J Fam Psychol. 24(3):307-15

Tauman R, Levine A, Avni H, Nehama H, Greenfeld M, Sivan Y.  2011. Coexistence of sleep and feeding disturbances in young children. Pediatrics. 127(3):e615-21.

Thomas DA, Poole K, McArdle EK, Goodenough PC, Thompson J, Beardsmore CS, and Simpson H. 1996. The effect of sleep deprivation on sleep states, breathing events, peripheral chemoresponsiveness and arousal propensity in healthy 2 month old infants. European Respiratory Journal 9: 932-938.

"Baby sleep deprivation" last modified 2/2014

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