Newborn sleep patterns
A survival guide for the science-minded parent
© 2008 - 2017 Gwen Dewar, Ph.D., all rights reserved
As every parent knows, the world of newborn sleep is exotic and strange. Newborns doze at odd times. They seem oblivious to differences between night and day. They awaken frequently.
It's a recipe for exhaustion, but understanding the science of sleep can help you cope, and avoid mistakes that can delay your child's development of more mature sleep rhythms.
In this article, you'll learn about
- fundamental differences between newborn sleep and adult sleep;
- circadian rhythms, and how you can help your baby get in sync with the natural day;
- sleep cycles in the newborn, and how to work around them;
- tips for preventing newborns from waking up; and
- advice for improving your own sleep.
Throughout, I focus on babies under four weeks of age. For information about older infants, see my article on
baby sleep patterns.
If you are looking for information about
newborn sleep safety, see these science-based tips for reducing the risk of SIDS.
Newborn sleep patterns: Are there any?
To the sleepless parent, newborn sleep might seem totally disorganized. For example, consider these points.
1. Newborns never sleep for long. Newborns sleep in short bouts—typically ranging from 30 minutes
to 4 hours—at seemingly random times throughout the day and night.
2. Newborns awaken easily. In part, this is because they spend a large portion of their sleep time in "active
sleep," a light sleep state characterized by fluttering eyelids; rapid,
irregular breathing; occasional body movements; and vocalizations
(grunts or brief cries).
3. Newborn sleep times can vary widely. In the first few days, the average newborn sleeps
between 16-18 hours a day (Iglowstein et al 2002). By four weeks,
newborn sleep averages about 14 hours. But the range is considerable.
Some four-week-old babies sleep as little as 9 out of 24 hours. Others
sleep for 19 hours a day (Iglowstein et al 2002).
If your baby is one of these atypical sleepers, does that mean
something is wrong?
Not necessarily. Some babies suffer from medical
conditions that influence the way they sleep, so if you have concerns
you should discuss them with your medical provider. But it appears that
many healthy, normal newborns deviate several hours from the average
duration of sleep.
Newborn sleep rhythms: Why newborns seem to sleep—and wake—around the clock
The timing of adult sleep is governed by circadian
rhythms--physiological changes that follow a 24-hour cycle. Many of
these changes are influenced by your exposure to light.
For instance, when you expose yourself to sunlight during the day, you are helping your body calibrate it's internal clock. Even if you are sleep-deprived, morning
light helps ensure that you will be more alert during the day
than you are at night.
Conversely, the absence of light at night helps your body wind down. When darkness falls, your brain interprets this as a signal to start producing melatonin, a hormone that triggers relaxation, paving the way for sleep.
You can easily disrupt this process by exposing yourself to artificial light sources in the evening -- especially sources of blue light (Wahnschaffe et al 2013). But as long as you stick with the program -- bright light during the day, and darkness at night -- you will likely find yourself in sync with the natural, 24-hour day.
And of course most adults are. But it's different for newborns. Newborn sleep is not governed by strong circadian rhythms.
It doesn't start that way. During pregnancy, fetuses are tuned
into their mothers' physiological cues about day and night.
and respiratory rates speed up when Mom is active and slow down when she
is sleeping (Mirmiran et al 2003). Such changes may be influenced by
maternal hormones, particularly melatonin. Maternal melatonin passes
through the placenta, and may direct the fetus' internal clock
(Torres-Farfan et al 2006).
But after birth, this intimate hormonal connection is broken. Newborns must develop their own circadian rhythms of hormone production.
Unfortunately for us, this takes time (Kennaway
1996), and the process is complicated by the fact that newborns need to feed every few hours. As a result, newborn sleep
episodes tend to be brief, and spaced at fairly regular intervals around the
When does it end?
Most infants take about 12 weeks to show day-night rhythms in the
production of melatonin (Rivkees 2003). Circadian
changes in cortisol, a hormone that helps regulate alertness, may take even
longer to emerge (Rivkees 2003). And, overall, babies may take 3-5
months before they "settle" at night--meaning that they sleep for more
than 5 hours at a stretch (Jenni et al 2006; Pinilla and Birch 1993).
Nevertheless, newborn sleep isn't completely divorced from the
natural rhythms of the 24-hour day. Studies show that circadian rhythms
begin developing in the first days after birth.
For example, German and Japanese studies have reported that
newborns sleep more at night than they do during the day (Freudigman and
Thoman 1998; Korte 2004; Matsuoka et al 1991).
And scientific evidence suggests that even newborns are receptive
to environmental cues about time. You can take advantage of this fact
to help shape newborn sleep patterns.
How to help babies adapt to the 24-hour day
• Make your baby a part of your daily routine. When parents
include their newborns in their daily activities, newborn may adapt more rapidly to the 24-hour day (Custodio et al 2007; Lorh et al 1999). One study took continuous
measurements of mother-infant activity patterns for four months after
birth. Newborns who were active at the same time of day as their mothers were quicker to develop mature circadian rhythms (Wulff and Siegmund 2002).
• Reduce stimulation at night. When your baby wakes for
night time feedings, keep activity to a minimum. Make as little noise as
possible, and avoid moving your baby around. Ideally, you want to avoid
waking her "all the way up." But if that isn't possible, at least try
to minimize the hustle and bustle. You want the baby to learn that nighttime is for sleep and quiet.
• Expose your newborn to natural lighting patterns. Light
cues might not instantly synchronize newborn sleep patterns, but they help. In a
study of preterm infants kept in hospital wards, babies exposed to
natural lighting patterns--brighter during the day, darker during the
night--adapted to the 24-hour cycle more quickly than those exposed to
constant, low levels of light (Rivkees et al 2004). In another study of
full-term infants, babies exposed to more sunlight during the afternoon tended to sleep better at night (Harrison 2004). And time spent outdoors might make an important difference. Babies who go outside
experience much higher light levels than those kept indoors all day, and may develop stronger circadian
rhythms as a result (Tsai et al 2012).
• Try infant massage. A recent, randomized experiment found that mothers assigned to massage their newborns with lotion at bedtime experienced better newborn sleep outcomes than mothers who massaged without lotion and mothers in a control group who didn't massage at all. After one month, newborns massaged with lotion were falling asleep faster, staying asleep longer, and awakening at night less often. Mothers using lotion actually massaged their infants more frequently, which may explain the results. The researchers found that more frequent massages were linked with fewer night wakings and longer sleep times (Field et al 2016), a result consistent with a prior study (Ferber 2002). More research is needed on this topic (Bennett et al 2013),
but given the soothing nature of gentle, affectionate physical contact,
it seems worth a try.
• Consider keeping track of the time of day you extract breast milk for future use. Breast
milk contains tryptophan, an amino acid that is used by the body to
manufacture melatonin. Tryptophan levels rise and fall according to
maternal circadian rhythms, and when infants consume tryptophan before
bedtime, they fall asleep faster (Steinberg et al 1992). It's therefore
possible that breastfeeding helps newborn sleep patterns synchronize
with the 24-hour day (Cubero et al 2005). This hypothesis was tested by
feeding infants formula fortified with varying concentrations of
tryptophan. When infants were given low levels of tryptophan during the
day and high concentrations at night (mimicking the natural fluctuations
of breast milk), infants fell asleep faster at night and got more sleep
overall (Cubero et al 2007).
Newborn sleep cycles: Why newborns are light sleepers
When adults first fall asleep, we pass through a couple of light sleep stages, and then plunge into a bout of deep sleep.
Afterwards, we switch into REM, or "rapid
eye movement" sleep, a sleep stage famous for its association with dreaming, and the loss of muscle tone. We don't move much during REM.
When REM is over, we either awaken, or return to light sleep and begin the cycle again. For the average adult, a single sleep cycle lasts about 90-100 minutes. We may partially awaken many times during the night. But we're more likely to wake up "all the way" during transitions between stages, during light sleep, and during REM.
Newborn sleep is also characterized by sleep stages and cycles, but there are crucial differences.
First, babies typically begin their sleep bouts in the newborn equivalent of REM (sometimes called "active sleep").
Second, newborns in REM don't usually experience muscle atonia. Unlike us, they may thrash around, stretch, twitch, and even vocalize. The results can fool parents into thinking their babies are waking up, when they are actually experiencing normal REM sleep.
Third, newborn sleep cycles are shorter -- around 50-55 minutes for the average infant -- and REM makes up a much bigger proportion of sleep. It's not unusual for newborns to spend more than half their total sleep time in REM (Grigg-Damberger 2016). Indeed, several studies suggest that, over the course of a 24 hour day, some newborns spent may spend as much as 75% of their sleep time in active sleep (e.g., Poblano et al 2007; Sadeh et al 1996).
Fourth, while newborns do experience something roughly analogous to deep sleep, this stage, called "quiet sleep," is potentially dangerous. Characterized by slower, more rhythmic breathing, quiet sleep appears more restful (Grigg-Damberger 2016). But it's harder for babies to awaken from quiet sleep, which can cause trouble if the baby isn't getting enough oxygen.
This may explain why newborns don't oblige exhausted parents by lapsing into long periods of deep sleep. It's too risky. Instead, the typical 50-55 minute newborn sleep cycle includes only about 20 minutes of quiet sleep. The rest of the time, babies are either in REM or in "transitional sleep," a rather restless state that looks like a mash-up of active and quiet sleep, and which scientists don't yet understand (Grigg-Damberget 2016).
Put this all together, and you can see why parents feel their babies are such light (and erratic) sleepers. Like adults, newborns are more likely to awaken during REM, and during transitions between sleep stages. But unlike adults, newborns spend a lot more time in REM, and they transition between cycles more frequently.
And parents may sometimes mistake REM restlessness for waking -- and attempt to interact with or soothe a baby at the wrong time. In short, there are lots of opportunities for babies to wake up -- or get awakened unnecessarily.
This sounds like a raw deal for parents. But newborns probably benefit from being light sleepers. Having a low threshold of arousal may protect babies from SIDS, and active sleep might be crucial for a newborn's brain development (Heraghty et al 2008; Seigel 2005).
And if we understand the peculiar nature of newborn REM, we can learn to avoid jumping in too soon when we think a baby is awakening or signalling for us.
A baby who seems to be waking up may,
if left alone, go back to sleep very rapidly.
How to keep your light sleeper from waking up all the way
1. Don't rush in the moment you think your baby has awakened. As noted
above, babies experience frequent arousals, but that doesn't mean they
are doomed to wake up "all the way" every few minutes. Babies often
jerk, sigh, or vocalize during partial arousals. If you avoid
stimulating them during these moments, they may go back to sleep on
2. Tank up the baby before you go to sleep. Whether you breastfeed or bottle-fed, try to give the baby an especially large meal before your own bedtime. This will encourage your baby to sleep longer.
3. If you feed your baby formula, try to find one that includes DHA. DHA is
a fatty acid found in fish oil and other dietary sources. It’s
important for brain development, and may play a role in shaping sleep
patterns as well. In one study, children who consumed low levels of DHA
had reduced amount of slow-wave (deep) sleep (Faglioli et al 1989). In
another study, pregnant women with higher blood levels of DHA gave birth
to babies who spent more time in quiet sleep (Cheruku et al 2002). DHA
is found in breast milk, so it's plausible (though unproven) that boosting a nursing
mother's DHA intake could improve a newborn's sleep patterns. If you
use formula, it seems like a good idea to find a baby formula that contains DHA.
4. Check out my article on
baby sleep aids,
which includes more tips for improving newborn sleep.
What about you? Tips for improving your own sleep
Newborn sleep patterns take their toll on parents. In a study
tracking the sleep patterns of mothers from pregnancy through the
postpartum period, maternal sleep worsened after childbirth and
continued to deteriorate until about 12 weeks postpartum (Kang et al
2002)—-the time when newborn sleep patterns begin to show marked
circadian rhythms (Nishihara et al 2000).
Twelve weeks isn’t forever, but it can seem like it when you are
severely sleep restricted. As you struggle to cope with newborn sleep
patterns, don’t forget to look after yourself. Here are some tips to
help you cope.
• Appreciate the health benefits of a 30-minute nap. If you're only getting 2-4 hours of sleep each night, you might think a 30-minute nap will make little difference to your health. But recent research confirms that all naps are not the same. When you're coping with sleep deprivation, the brain compensates by rendering naps more restorative than usual. In one study, volunteers permitted to sleep only 2 hours at night showed the typical abnormalities in their stress hormone and immune factor chemistry. But after just two 30-minute naps, those irregularities were entirely normalized (Faraut et al 2015b). In another study, volunteers coping with a 2-hour nightly regimen experienced heightened pain sensitivity -- a common symptom of sleep deprivation. But once again, the effect was reversed after just two 30-minute naps (Faraut et al 2015a).
• Don't assume that it's pointless to lie down if you don't fall asleep. Too wired to "sleep when the baby sleeps"? If so, keep in mind
that quiet resting is better than nothing. In fact, if you are lying
down with your eyes closed, you might be asleep without realizing it. In
numerous lab studies, subjects who were awakened from the first stage
of sleep often denied that they were asleep at all (Dement and Vaughan
1999). A nap that consists only of stage 1 sleep might not help you
improve your reaction times, but it will probably make you feel less
tired. And if you manage to slip into the second stage of sleep -- even
for just 3 minutes -- your nap may have recuperative effects (Hayashi et
• Don't waste energy on self-reproach or criticism from other
people. You might be doing everything you can to get more sleep, and
still be stuck with a baby who sleeps less than average. Research
suggests that the amount of sleep we get at night is strongly influenced
by genetics (Touchette et al 2013). And newborn sleep can be extremely variable.
• Don't assume that breastfeeding will make you more sleepless than formula feeding. One study reported that the parents of breastfed
babies averaged 40-45 minutes more sleep time than did the parents of
formula-fed babies (Doan et al 2007).
• If you are breastfeeding, you are likely to get more sleep if
you keep baby nearby. The World Health Organization recommends that babies share a bedroom with their parents, and it's a recommendation
that makes breastfeeding less disruptive. A recent study found that
breastfeeding women got more sleep when they co-slept with baby (Quillin
and Glenn 2004). In fact, mothers who co-slept and breastfed got more
sleep than did mothers who bottle-fed their babies (Quillin and Glenn
• If your baby is asleep, don't worry about changing diapers. If
your baby can't sleep because she needs a diaper change, she'll let you
know. And a little urine is unlikely to awaken her anyway. In a recent
experiment, researchers injected water into the diapers of sleeping
infants to see if this would wake them up (Zotter et al 2007). It
• Get sunlight and avoid artificial lighting at night. Make sure
you expose yourself and your baby to bright light during the day. And
keep lights out--or at least dimmed--after sunset. As noted above,
natural lighting helps influence newborn sleep patterns. But it also
helps you keep your own circadian rhythms from drifting, which is
important if you are going avoid insomnia and be a source of daytime
cues for your newborn.
• Let a friend or family member watch your baby while you take a
nap, even if this means your breastfed baby will take some of his meals
from a bottle. Lactation experts often discourage breastfeeding mothers
from bottle feeding babies for the first 3-4 weeks. The worry is that
supplemental feeds will lead to a decreased milk supply and endanger
successful breastfeeding in the long-term. But you need to balance this
against the negative effects of severe sleep restriction. Lack of sleep
puts parents at increased risk of illness and postpartum depression,
which is bad for parents and babies. If you are at the end of your rope, get help.
• Trust your instincts. If something feels wrong with you or the baby, talk to your physician.
• Remember that things will get better. Newborns have special
sleep patterns and special needs. But things will start to get better
around 12 weeks postpartum.
More reading relevant to newborn sleep
For more information about babies and sleep, see these fully-referenced Parenting Science articles.
References: What scientific studies say about newborn sleep
Anders TF. 1979. Night-waking in infants during the first year of life. Pediatrics 63: 860-864.
Bennett C, Underdown A, and Barlow J. 2013. Massage for promoting
mental and physical health in typically developing infants under the
age of six months. Cochrane Database Syst Rev. 2013 Apr 30;4:CD005038.
Cheruku SR, Montgomery-Downs HE, Farkas SL, Thoman EB, and
Lammi-Keefe CJ. 2002. Higher maternal plasma docosahexaenoic acid during
pregnancy is associated with more mature neonatal sleep-state
patterning. Am J Clin Nutr 76:608-13.
Cubero J, Valero V, Sánchez J, Rivero M, Parvez H, Rodríguez AB,
Barriga C. 2005. The circadian rhythm of tryptophan in breast milk
affects the rhythms of 6-sulfatoxymelatonin and sleep in newborn. Neuro
Endocrinol Lett. 26(6):657-61.
Cubero J, Narciso D, Terrón P, Rial R, Esteban S, Rivero M,
Parvez H, Rodríguez AB, Barriga C. 2007. Chrononutrition applied to
formula milks to consolidate infants' sleep/wake cycle. Neuro Endocrinol
Custodio RJ, Junior CE, Milani SL, Simões AL, de Castro M, Moreira AC. 2007. The emergence of the cortisol circadian rhythm in monozygotic and dizygotic twin infants: the twin-pair synchrony. Clin Endocrinol (Oxf). 66(2):192-7.
Dement W and Vaughan C. 1999. The promise of sleep. New York: Random House.
Doan T, Gardiner A, Gay CL, Lee KA. 2007 Breast-feeding increases
sleep duration of new parents. J Perinat Neonatal Nurs. 21(3):200-6.
Faglioli I, Barconcini P, Ricour C, and Salzarulo P. 1998.
Decrease of slow-wave sleep in children with prolonged absence of
essential lipids intake. Sleep 12: 495-499.
Faraut B, Léger D, Medkour T, Dubois A, Bayon V, Chennaoui
M, Perrot S. 2015a. Napping reverses increased pain sensitivity due to sleep
restriction. PLoS One. 10(2):e0117425.
Faraut B, Nakib S, Drogou C, Elbaz M, Sauvet F, De Bandt JP,
Léger D. 2015b. Napping reverses the salivary interleukin-6 and urinary
norepinephrine changes induced by sleep restriction. J Clin Endocrinol Metab. 100(3):E416-26.
Ferber SG, Laudon M, Kuint J, Weller A, Zisapel N. 2002. Massage
therapy by mothers enhances the adjustment of circadian rhythms to the
nocturnal period in full-term infants. J Dev Behav Pediatr. 23(6):410-5.
Field T, Gonzalez G, Diego M, Mindell J. 2016. Mothers
massaging their newborns with lotion versus no lotion enhances mothers' and
newborns' sleep. Infant Behav Dev. 45(Pt A):31-37.
Freudigman KA and Thoman EB. 1998. Infants' earliest sleep/wake
organization differs as a function of delivery mode. Dev Psychobiol.
Grigg-Damberger MM. 2016. The Visual Scoring of Sleep in
Infants 0 to 2 Months of Age. J Clin Sleep Med. 12(3):429-45.
Iglowstein I, Jenni OG, Molinari L, Largo RH. 2003. Sleep
duration from infancy to adolescence: Reference values and generational
trends. Pediatrics 111(2): 302-307.
Harrison Y. 2004. The relationship between daytime exposure to
light and night-time sleep in 6-12-week-old infants. J Sleep Res.
Hayashi M, Motoyoshi N, Hori T. 2005. Recuperative power of a
short daytime nap with or without stage 2 sleep. Sleep. 28(7):829-36.
Heraghty JL, Hilliard TN, Henderson AJ, and Fleming PJ. 2008. The
physiology of sleep in infants. Arch Dis Child. 2008 Nov;93(11):982-5.
Horne RSC, Parslow PM, Ferens D, Watts AM, and Adamson TM. 2004.
Comparison of evoked arousability in breast and formula fed infants.
Arch Dis Child 89: 22-25.
Hugelin A. 1982. Mechanisms of respiratory control during
sleep and wakefulness: implications in newborn sleep apnoea. Electroencephalogr
Clin Neurophysiol Suppl. 36:625-30.
Jenni OG, DeBoer T, and Acherman P. 2006. Development of the 24h
rest-activity pattern in human infants. Infant behavior and development
Kang MJ, Matsumoto K, Shinkoda H, Mishima M, Yeo YJ. 2002.
Longitudinal study for sleep-wake behaviours of mothers from pre-partum
to post-partum using actigraph and sleep logs. Psychiatry Clin Neurosci.
Kato I, Franco P, Grosswasser J, Scaillet S, et al. 2003.
Incomplete arousal processes in infants who were victims of sudden
death. Am J Respir Crit Care Med 168: 1298-1303.
Kennaway DJ, Goble FC and Stamp GE. 1996. Factors influencing the
development of melatonin rhythmicity in humans. Journal of Clinical
Endocrinology & Metabolism, Vol 81, 1525-1532
Korte J, Hoehn T, Siegmund R. 2004. Actigraphic recordings of
activity-rest rhythms of neonates born by different delivery modes.
Chronobiol Int. 21(1):95-106
Lohr B, Siegmund R. 1999. Ultradian and circadian rhythms of
sleep-wake and food-intake behavior during early infancy. Chonobiology
international 16(2): 129-148.
Matsuoka M, Segawa M, and Higurashi M. 1991. The Development of
Sleep and Wakefulness Cycle in Early Infancy and Its Relationship to
Feeding Habit. The Tohoku Journal of Experimental Medicine 165
McNamara F, Lijowska AS, and Thach BT. 2002. Spontaneous arousal
activity in infants during NREM and REM sleep. J Physiol 538: 263-269.
Mirmiran M, Maas YG, Ariagno RL. 2003. Development of fetal and
neonatal sleep and circadian rhythms. Sleep Med Rev. 7(4):321-34.
Nishihara K, Horiuchi S, Eto H, Uchida S. 2000. The development
of infants' circadian rest-activity rhythm and mothers' rhythm.
Psychiatry Clin Neurosci. 54(3):305-6
Pinilla T and Birch LL. 1993. Help me make it through the night:
Behavioral entrainment of breasfed infants’ sleep patterns. Pediatrics
Poblano A, Haro R, and Arteaga C. 2007. Neurophysiologic
measurement of continuity in the sleep of fetuses during the last week
of pregnancy and in newborns. Int J Biol Sci.
Quillin SI and Glenn LL. 2004. Interaction between feeding method
and co-sleeping on maternal-newborn sleep. J Obstet gynecol Neonatal
Nurs 33(5): 580-588.
Rivkees SA, Mayes L, Jacobs H, Gross I. 2004. Rest-activity
patterns of premature infants are regulated by cycled lighting.
Sadeh A, Dark I, and Vohr BR. 1996. Newborns' sleep-wake
patterns: the role of maternal, delivery and infant factors. Early Hum
Siegel JM. 2005. Functional implications of sleep development. PLoS Biology 3(5): 756-758.
Thomas KA and Burr R. 2002. Preterm infant temperature circadian
rhythm: possible effect of parental cosleeping. Biol Res Nurs.
Torres-Farfan C, Rocco V, Monsó C, Valenzuela FJ, Campino C,
Germain A, Torrealba F, Valenzuela GJ, and Seron-Ferre M. 2006. Maternal
melatonin effects on clock gene expression in a nonhuman primate fetus.
Touchette E, Dionne G, Forget-Dubois N, Petit D, Pérusse D,
Falissard B, Tremblay RE, Boivin M, and Montplaisir JY. 2013. Genetic
and environmental influences on daytime and nighttime sleep duration in
early childhood. Pediatrics 131(6):e1874-80.
Tsai SY, Thomas KA, Lentz MJ, Barnard KE.2012. Light is
beneficial for infant circadian entrainment: an actigraphic study. J Adv
Van Sleuwen BE, Englelberts AC, Boere-Boonekamp MM, Kuis W,
Schulpen TWJ, and L’Hoir MP. 2007. Swaddling: A systematic review.
Pediatrics 120: e1097-1106.
Wahnschaffe A, Haedel S, Rodenbeck A, Stoll C, Rudolph H, Kozakov
R, Schoepp H, and Kunz D. 2013. Out of the lab and into the bathroom:
evening short-term exposure to conventional light suppresses melatonin
and increases alertness perception. Int J Mol Sci. 14(2):2573-89.
Wulff K, Siegmund R. 2002.[Emergence of circadian rhythms in
infants before and after birth: evidence for variations by parental
influence]. Z Geburtshilfe Neonatol. 206(5):166-71. Review. German.
Zotter H, Urlesberger B, Pichler G, Mueller W, Kerbl R. 2007. Do
wet diapers induce arousals in sleeping infants? Acta Paediatr.
Content of "Newborn sleep patterns" last modified 9/17
Image credits for "Newborn sleep patterns"
top image of mother kissing newborn ©iStockphoto.com/Shawn Gearhart
image of father and newborn by Patrik-Hagglund / wikimedia commons
image of newborn with pacifier by
image of tired mother with sleeping newborn by istock