Capturing typical toddler sleep in context: A videosomnography study

Sleep is a common concern raised at well-child visits, which may stem in part from parental uncertainty around what is expected for toddler sleep. Despite recent attempts to classify normative sleep using large samples, there are notable gaps in existing studies and how they inform parental sleep expectations. Most studies use parent reports and community samples that likely include children with developmental concerns. Thus, we aimed to characterize variations that parents can expect for sleep within typical development.

Nighttime sleep patterns of typical development toddlers were explored using videosomnography, a video-based measure of sleep behaviors. Participants included 71 toddlers (female n=31, 44%; White n=60, 85%) drawn from 2 larger prospective studies. In this cross-sectional sample, sleep was recorded in the home at 18 (n=15), 24 (n=36), or 36 (n=20) months, and toddlers were classified as typical development at 30 or 36 months based on detailed developmental monitoring.

Children woke .65 times per night on average, ranging from 0-2.75. For children with wakings, the average duration per waking was 17.09 minutes (range = 2.0-128.50 minutes). Children required parental intervention to fall back to sleep for 49% of wakings. Most children fell asleep and woke in their own bed (95%) and did not have a parent present at sleep onset (88%).

Behaviors such as night waking can be a normative part of early development for toddlers without developmental concerns. Findings from our study may be useful for helping families set realistic expectations about their child's sleep during toddlerhood.