© 2020, Gwen Dewar, Ph.D., all rights reserved
Is there such a thing as "baby sleep deprivation" ?
It's clear 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 difficulty settling, too-frequent night wakings, sleep-disordered breathing, and medical conditions that can interfere with sleep, like GERD. You can read more about it in this Parenting Science guide.
Researchers also recognize the existence of something called "behavioral insomnia" in young children. Behavioral insomnia" refers to problems caused by a child's refusal to go to bed, or by a child's dependence on lengthy or elaborate caregiving in order to fall asleep at night (Mindell et al 2006).
But -- to date -- I haven't found any scientific descriptions of chronic sleep restriction in babies.
Maybe that's a good thing, evidence that sleeplessness 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 needs 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? And does chronic sleep loss during infancy have any long-term effects?
Here I review what the available evidence tells us.
How much sleep does a baby really need?
Babies vary substantially in the amount of sleep that they need, especially during the first year postpartum.
For example, more than half of all 6-month-olds get at least 12 hours of sleep each day. Yet a sizeable percentage of babies -- who appear to be otherwise healthy -- sleep substantially less. So merely sleeping less-than-average doesn't mean your baby has a problem (Paavonen et al 2020).
This Parenting Science article about the normal range of sleep times in infants may help put your concerns about baby sleep deprivation in perspective.
Still, it's possible for things to go wrong, even if your baby's total sleep time falls within this broad range of normal variation.
For instance, your baby may take a long time to fall asleep at night, or wake up more frequently than most other babies do. Is this evidence of a problem? Is it something you can improve?
As I explain elsewhere, there are many environmental factors that can contribute to bedtime resistance and frequent night wakings. Read more about these factors -- and how to fix them -- in this trouble-shooting guide.
And whether your baby resists bedtime, or wakes up very frequently, you may wonder about our baby's personal sleep requirements.
Some babies log as little as 9-10 hours of total sleep time each day, and don't appear to suffer from any health problems. But should we assume that all babies sleeping this little are receiving the optimal amount of sleep? No, we shouldn't.
So how can you tell if a baby isn't getting enough sleep?
Pediatricians and experienced parents have noted these signs of "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 markers of sleep deprivation from the scientific literature:
- Poor recovery from negative emotions
- Feeding troubles
- Being hard to awaken
- Having a lower threshold for pain
Let's take these up in detail.
Poor recovery from negative emotions as a sign of baby sleep deprivation
I'm sure you've experienced it yourself: Running short on sleep makes it harder to bounce back from negative emotions.
We become moodier and more impulsive when we're sleep-deprived. We have more trouble interpreting the emotions of others, and we're more likely to perceive neutral stimuli as threatening (Ben Simon et al 2020).
These difficulties have been documented in preschoolers as well as adults (Lassonde et al 2016; Berger et al 2012). But what about babies? They, too seem to be affected.
In an 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).
Sleep problems are linked with feeding problems
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 "behavioral insomnia" (Tauman et al 2011).
Does a lack of sleep cause feeding problems? Do feeding problems cause sleep loss? Or do these troubles go together for some other reason?
We can't know the answer from this study. It reports correlations only. But in a follow-up study, researchers found that both types of trouble tend to make parents feel more distressed (Golik et al 2013), and parental distress can fuel sleep problems.
Sleep-deprived babies have more difficulty awakening
Research suggests that sleep-deprived adults spend more time in deep sleep, a state characterized by fewer arousals and greater difficultly awakening.
Babies appear to fit this pattern as well.
For example, 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.
Compared to their responses during a (non-sleep-deprived) control condition, the babies required louder noises before awakening (Franco et al 2004).
An earlier study of three-month old infants yielded similar results (Thomas et al 1996).
Is this reason for concern? I think so.
Another experiment found that babies subjected to short-term sleep deprivation experienced more sleep-disordered breathing, including obstructive sleep apnea (Canet et al 1985).
Obstructive sleep apnea has been linked with a variety of health problems (Jennum et al 2013), and an increased risk of SIDS.
Sleep restriction may make babies more sensitive to pain
Controlled experiments confirm that chronic sleep restriction can lower our thresholds for pain.
For example, an experiment on young adults found that people became more sensitive to painful stimuli after spending three weeks on a sleep-restricted schedule. These study volunteers -- who were permitted to sleep only 4 hours on weekdays -- also reported more frequent, spontaneous aches and pains, including headaches, back pain, and muscle aches (Simpson et al 2019).
Do sleep-deprived babies experience similar effects? I don't believe anybody has ever tested this on human infants (and perhaps they never will, given the obvious ethical considerations).
However, a recent experiment on infant mice is concerning.
When the mice were newborns, researchers restricted their total sleep by two hours each day. The treatment lasted for 10 days, after which the mice were free to sleep normally. Later -- when the mice where adolescents -- researchers tested their responses to pain by placing them on a hot plate.
Compared to peers in a control group, the mice who'd experienced infant sleep restriction exhibited a lower tolerance for pain. Their threshold for heat pain was almost 25% lower (Araujo et al 2018).
What does this mean? Mice aren't humans, and it's good to know that the increased sensitivity to pain wore off by the time the mice were adults.
But, in combination with the research on human adults, this study lends weight to the idea that infant sleep loss could shape the course of development.
What about other long-term outcomes? Does chronic sleep loss during infancy cause problems later on?
There is some evidence for the idea. We've already noted that short-term sleep loss affects a baby's emotional responses. And a recent study hints that chronic short sleep might be a risk factor for developing self-regulation problems. Children who slept less than their peers at the age of 3 months were more likely to experience self-regulation deficits at the age of 24 months (Morales-Munoz et al 2020).
Where might this trend lead? A young child who is irritable or overreactive will tend to provoke negative responses from other people. And this could make it harder for the child to develop positive social relationships, and learn social skills.
In support of this idea, a study of preschoolers found that kids who slept less were less likely to be accepted by their peers. They tended to have poorer social skills and smaller receptive vocabularies. They also showed a weaker understanding of the causes of emotions (Vaughn et al 2015).
So we shouldn't rule out the possibility that chronic sleep loss, starting in infancy, could contribute to the development of behavior problems.
And today's researchers speculate that early life sleep loss may affect the growth of myelin, the white matter in the brain that insulates our neurons (LeBourgeois et al 2019; Kurth et al 2016).
What's the takeaway?
If you suspect your baby is routinely overtired and seems unusually hard to awaken, it's worth discussing your concerns with your medical provider. 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:
More Parenting Science articles about baby sleep
References: Baby sleep deprivation
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"Baby sleep deprivation" last modified 7/2020
This is an update of a Parenting Science previously published under the same title; portions of text derive from a version last modified in 2014.
Image credits for "Baby sleep deprivation: How to tell if your baby isn't getting enough sleep"
Title image by Kahana/wikimedia commons
Image of tired child in stroller by Kyryl Gorlov / istock
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