Early morning awakenings: What to do about them

Expert Opinion
By: 
Craig Canapari, MD.
Director of Yale Pediatric Sleep Center

"When I meet other parents socially, there is one question I get asked more than any other. 'Why does my child get up so early in the morning?' and, more pressingly, 'What can I do about it?' I’m going to talk about toddlers and preschoolers here (1-5 years of age). [Most parents of teens have the opposite problem, as school start times and excessive homework has resulted in less than 10% of teens getting enough sleep at night.]

When assessing this concern, I always see if the parents have realistic expectations. Most little children are morning people, which is a real challenge if you are a night owl like me. To expect your toddler to sleep past 6:30 AM is usually unrealistic. Some children naturally wake up between 5:30-6:30 AM. Other children may have developed a habit of waking up early because of sleep onset associations but are not actually ready to get up, and tend to be quite cranky. I have a couple of suggestions to try if you want to try to get your little one to sleep later:

  • Minimize ambient light. Those black out shades are expensive but they may be worth it. Most kids are really light sensitive. This spring, my kids were getting up earlier and earlier with the longer days. This was getting a bit painful until daylight savings time bailed us out and magically made 5:30 into 6:30 AM.
  • White noise via a sound machine may be useful if a parent needs to get ready for work before the appointed hour, or if one child tends to wake another. We use this one, which appears to be indestructible. Some concerns have been raised about the possibility of these machines affecting children’s hearing. Based on my own very unscientific research, I suspect that this is pretty safe for most children.
  • Adjust the sleep schedule. Children 1-3 years old will sleep between 11-13 hours a day, with 9.5-10.5 hours at night. If your child is going to bed before 7-7:30 PM I would move the bedtime 30-60 minutes later, although it may take a week or two for this strategy to bear fruit.
  • Avoid switching your child from a crib to a bed until they are three or four, unless they are jumping out of the crib. Changing from a crib to a bed is often a “Hail Mary” move for desperate parents, but in my experience it often backfires.
  • Check sleep associations. In other posts, I’ve talked about sleep onset associations and this means that if your child requires a certain set of conditions to fall asleep, they will need them again whenever they wake in the night. Early morning awakenings can be a version of this. When a child is brought into the parents’ bed when he/she wakes very early ( before 5 AM), they will soon start to wake up anticipating this comfort. We went through a month with my son at six months of age where I was lying on the floor with him with a pillow and blanket every day at 4:30 AM (pathetic, I know). I was essentially trying to have my cake and eat it too – get to sleep some more but avoid a sleep association. It didn’t work. The next step was ignoring him until a later and later time until he got to 6 AM. So we got up with him at 4:40 AM, then 4:50 AM, then 5 AM and so on, until he slept until a more reasonable time. I felt comfortable with this strategy as he clearly was not ready to be up at 4:30 AM. Was this painful? Yes. But it was worth it.
  • Wake up clock: This may work with older toddlers or preschoolers. Set up a timer with a light or just try out one of these OK to Wake Clocks . Our older son tends to rush out of bed if he hears his brother stirring or me getting ready for work. He likes his new clock and will wait for it to turn green. The key in being successful with this is going slowly and being realistic. That is to say, buying one of these clocks will not make your two year old sleep until 9 AM on the weekends. I would recommend picking a time about ten minutes later than your child’s current wake time, then moving it later by ten minutes every day or two until you reach your target wake time. This maximizes your chance of success and your child’s sense of mastery.
  • Other positive reinforcement: A sticker chart can be helpful in this context, or even (!) an M&M or jelly bean every time your child gets up when you wish them to.
  • Negotiate. When I first wrote this post my boys were four and one; now they are seven and four. This has made mornings much better. My older son understands time very well and will actually take his brother downstairs or read him stories if we ask him to. This is simply lovely. On the weekends we ask them not to get us before 7:30 AM and, unbelievably, they have complied. Once your children are old enough that they do not require direct supervision, I don’t have a problem with parents turning on a show for their kids for 30 extra minutes of sleep on the weekend.

The keys to success are being consistent every time, having realistic expectations, and keeping your child’s room dark. If you have persistent early AM awakenings (e.g. 4-5 AM or earlier) it is worth discussing with your pediatrician, especially if your child seems really cranky and tired during the day.

As part of my “30 More Minutes of Sleep in 2015” series, I have updated this post, one of my first from when I started this blog in 2012. In fact, this was originally a guest post over at Seattle Mama Doc which you should go check out. As I describe above, this was a really touch issue for us when our old son was less than a year old. In terms of parental quality of life, teaching your kids to get up a bit later is pretty high yield."

Dr. Craig Canapari directs the Yale Pediatric Sleep Center and is dedicated to helping children, teens, and parents get a better night's rest. For more helpful evidence-based information on sleep, head over to Dr. Canapari's website.