Solutions to sleep concerns (13) – preschoolers 3 to 5 years

Sleep concerns and your preschooler

It can be difficult to know whether your preschooler is experiencing a sleep or settling concern. If your preschooler's sleeping patterns are not affecting you or your family and you have strategies that work, then they may not have a sleep concern.

The following definition of ‘severe night waking’ provides a guide – however, you know your child the best, and if something is a concern for you, seek help and advice from your local maternal and child nurse, your doctor or the Maternal and Child Health Line on Tel. 13 22 29.

Severe night waking is when your child does one or more of the following things 5 or more times a week, for one or 2 weeks:

• Consistently wakes more than three times a night.
• Consistently takes more than 30 minutes to settle.
• Stays awake for 20 minutes after waking.
• Goes into the parents' or caregivers' bed.
• Has difficulties with sleep and settling that is causing parents or caregivers significant distress.

Strategies to help your preschooler sleep and settle

Every preschooler is different, and some may continue to wake overnight.

Parents are encouraged to be responsive to the needs of their preschooler. Responsive settling is recognising that your child needs help by responding appropriately.

You can do this by knowing their cues, tired signs  and the intensity of their cry. It is important that your preschooler knows you are emotionally and physically available if they become distressed.

Developing positive sleep environments and routines can also support your preschooler at bedtime.

Every family is different, and you need to use a strategy that you feel comfortable with and suits your preschooler and family.

Helping your preschooler sleep with bedtime fading

Bedtime fading can be used for children from 2 to 3 years. It is based on physiological theory of establishing sleep by limiting your child's time in bed. With this approach your preschooler does not go to bed until they feel naturally tired or drowsy, resulting in less night-time wakings.

• Record the time your preschooler goes to bed every night for a week.
• Identify the latest time and set this as bedtime.
• Gradually push back the bedtime by 15 minutes every 2 days.
• You can also make bedtime earlier (if needed) using this approach. Once your child gets used to falling asleep easily and quickly when put to bed, move their bedtime forward by 15 minutes every 2 days.
• Continue until your preschooler falls asleep quickly and has minimal night-time wakings, reaching a preferred bedtime.

Rewarding your pre-schooler for positive sleep behaviour

Once your child can understand and engage in conversation, you can use a reward chart or free passes to encourage positive sleep behaviour.

Reward charts

Reward charts are tools for changing your child’s behaviour and may include wall posters or apps. They demonstrate positive behaviour or goal that your child needs to achieve. Research shows that reward charts are effective in encouraging positive night-time behaviour. It is important that the reward is given after the good behaviour has been achieved, rather than before (which more resembles a bribe).

It is also important not to punish your child if they do not receive a reward. An example you could try is rewarding your child with a sticker in the morning if they do not call out overnight. Once they receive 5 stickers, they may then receive a reward (such as a family bike ride, a movie night, or special time with parents or caregivers).

Free passes

Free passes are another way to reinforce positive sleep behaviour. You will need to be consistent to use this strategy effectively. Give your preschooler a pass they can use for one acceptable request each night – for example, a drink of water or a kiss. Explain to your child that once they use the pass, they must give it to you and settle without any more requests or calling out.

If your child asks for something that is unacceptable (such as an ice cream or staying up later), or they begin protesting loudly and persistently, you must not respond as it will encourage difficult behaviour.

Helping your preschooler sleep safely

A cot is not a safe sleeping environment for your preschooler if they are attempting to or can climb out. There are strategies to help them move from a cot to a bed.

It is important to make sure your home and preschooler’s sleeping environment is safe. They shouldn’t have access to things like cords, electrical appliances, power points and access to stairs and windows as they could hurt themselves if they get up during the night.

Information in community languages

This fact sheet is available for download in the following community languages:

Maternal and child health nurse visits are important

Victorian parents have free access to the Maternal and Child Health Service. Specially trained maternal and child health will work with your family to help you care for your child until they are ready to start school.

As part of this service, you will visit a maternal and child health nurse in your local area at 10 key ages and stages in your child’s development. These visits are important because they you an opportunity to identify and address any issues and concerns early in your child’s development.

Visits take place:

• following discharge from hospital (home visit)
• 2 weeks
• 4 weeks
• 8 weeks
• 4 months
• 8 months
• 1 year
• 18 months
• 2 years
• 3 and a half years.

Families can access the service at other times by telephone or through a centre visit.

Where to get help

• Your local maternal and child health service
• Your GP (doctor)
• Maternal and Child Health Line Tel. 13 22 29 – available 24 hours a day for the cost of a local call throughout Victoria
• Mercy Health O’Connell Family Centre, Canterbury Tel. (03) 8416 7600
• Mercy Health Woi-wurrung-yagila-wulumperi Whittlesea Early Parenting Centre, South Morang Tel. (03) 9407 6820
• Queen Elizabeth Centre (QEC) Tel. (03) 9549 2777
• Tweddle Child and Family Health Service, Footscray and Werribee Tel. (03) 9689 1577
• Aboriginal Health Service (VAHS) Tel. 03 9419 3000
• Translating and Interpreting Service (TIS National) Tel. 131 450 – available (24 hours, 7 days) for callers who speak other languages
• National Relay Service (24 hours, 7 days) – Speak and listen Tel. 1300 555 727, TTY Tel. 133 677, SMS relay Tel. 0423 677 767. Captioned, internet and video relay calls are also available through this service.
• Nurse-on-Call Tel. 1300 60 60 24 – for expert health advice 24 hours a day, 7 days a week
• Kidsafe Victoria Tel. (03) 9036 2306
• Red Nose (formerly SIDS and Kids) Tel. 1300 998 698 – for safe sleeping information, education, and all other enquiries