Baby sleep deprivation:

How to tell if your baby is overtired or underslept

© 2008 Gwen Dewar, Ph.D., all rights reserved

Baby sleep deprivation? As a chronic condition, it's probably very rare. Babies are pretty good at regulating their own sleep if they are given plenty of opportunities for quiet time.

Often, parents are worried because they are uncertain about their baby's sleep requirements. Healthy babies may vary significantly in the amount of sleep that they need. To help you put your concerns about baby sleep deprivation in perspective, see this article about baby sleep needs.

But it’s possible for things to go wrong. Some parents may inadvertently over-stimulate their babies, making it harder for them to fall asleep. In other cases, babies may suffer from medical conditions or behavioral problems that interfere with their sleep. Parents may also overestimate how much sleep their babies need, causing babies to resist bedtime.

How can you tell if your baby isn’t getting enough sleep? There isn’t much scientific information available about identifying baby sleep deprivation. Nevertheless, a number of pediatricians, “baby gurus,” and experienced moms have noted these signs of baby sleep deprivation or overtiredness. Here is a sample.

Signs of overtiredness or sleep deprivation

For very young babies, signs include:

• Looking “glazed over” and other facial expressions. Baby may close eyes, look away from stimulating things, flutter eyelids, and have trouble focusing their vision

• Rubbing eyes, pulling at ears; yawning

• Losing interest in people and toys

For older babies who can walk and pick up objects, signs also include:

• Becoming more accident prone

• Becoming more “clingy” (may occur when the baby becomes “overtired,” i.e., so tired that he has trouble winding down)

• Becoming ever more active as the night wears on (a sign of “over-tiredness”)

• Having a hard time waking up in the morning

I’ve also culled two possible signs of baby sleep deprivation from the scientific literature...

More signs of baby sleep deprivation:

Baby is hard to awaken

Individual babies can vary widely in their sleep habits and still be healthy. But it’s generally not a good sign if your baby is always hard to awaken. To understand why, you need to understand baby sleep patterns.

When babies first fall asleep, their sleep takes the form of “active sleep,” a state characterized by fluttering eyelids, relatively rapid and irregular breathing, irregular heart beats, occasional body movements and vocalizations (grunts or brief cries). Active sleep is the baby equivalent of REM (rapid eye movement) sleep, and babies engaged in active sleep are easily awakened. This is why it can be hard to put down a baby who has just nodded off.

Unfortunately for sleepless parents, much of baby sleep time is spent in the active phase. Whereas REM makes up only 20% of an adult’s sleep, active sleep represents 50% of a newborn’s sleep (Seigel 2005). As they mature, babies spend progressively less time in active sleep, but the change is gradual. At three years of age, children spend about 30% their sleep time in active sleep (Anders 2003).

After active sleep—which may last 20-25 minutes—a baby drifts into quiet sleep. Quiet sleep is characterized by slower, more regular breathing, more regular heart beats, little movement and no eyelid fluttering. While in quiet sleep, babies are less likely to be awakened by noise or other discomforts. Quiet sleep represents the end of the baby’s sleep cycle. When it’s over, babies either begin the cycle again (re-entering active sleep) or wake up. The whole cycle is relatively short—about 50-60 minutes for the first 9 months of life (Jenni et al 2004).

Deep sleep might sound like the better deal. After all, it's not just more peaceful for parents. As noted above, it's also associated with more regular breathing and heart rates. Irregular heart rates and breathing irregularities--like severe episodes of sleep apnea--can put babies at greater risk for SIDS if babies fail to arouse from sleep.

So active sleep may pose special risks to babies who have trouble arousing. And one study has reported that SIDS babies experience fewer arousals from active sleep than do healthy babies (Kato et al 2003).

But active sleep is a natural part of baby sleep patterns, and it appears to serve a function. Research suggests that active sleep is important for a baby’s brain development (Siegel 2005).

It’s also possible that active sleep is “safer” sleep, at least for infants who aren't predisposed to SIDS. One experiment found that babies experiencing breathing problems were more likely to wake up during active sleep than during quiet sleep (Parslow et al 2003).

In any case, research suggests that tired babies spend more time in quiet (deep) sleep. They also experience more irregular breathing episodes—-including apnea-—(Canet et al 1989). And they are harder to awaken, even when they are in active sleep.

One study subjected 8-week-old infants to brief episodes of sleep deprivation and then attempted to awaken them with blasts of “white noise” (Franco et al 2004). Compared to well-slept babies, sleep-deprived infants required louder noises before awakening (Franco et al 2004). A earlier study of three-month old infants yielded similar results (Thomas et al 1996).

The bottom line? If your baby routinely sleeps like a log, it makes sense to ask yourself if she’s suffering from baby sleep deprivation. It’s also makes sense to bring this up to your doctor, in case she shows signs of irregular breathing or sleep apnea.

Baby sleep deprivation and negative emotions

Studies of older children reveal an association between poor emotional regulation and sleep restriction (see my article on signs of sleep deprivation in children and adults). This association might also apply to babies.

A recent study 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).

It's unclear if poor emotional regulation is the effect or cause of baby sleep deprivation. More emotional babies might have had a harder time adapting to—-and sleeping in—-the lab environment.

But whether poor emotional regulation is a cause or effect, it’s nonetheless predictive of sleep problems. If your baby has trouble recovering from negative emotions, it may be a good idea to review his sleep schedule.

References: Baby sleep deprivation

Anders TF. 2003. Sleep-wake states and problems and child psychosocial development. In: RE Tremblay, RG Barr, and RDeV Peters (eds). Encylopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood Development 2003: 1-6. Available at http//www.child encyclopedia.com/documents/AndersANGxp.pdf. Accessed 1.6.08.

Canet E, Gaultier C, D'Allest AM, and Dehan M. 1989. Effects of sleep deprivation on respiratory events during sleep in healthy infants. J Appl Physiol. 66(3):1158-63.

Franco P, Seret N, Van Hees JN, Scaillet S, Vermeulen F, Grosswasser J, and Kahn A. 2004. Decreased arousals among healthy infants after short-term sleep deprivation. Pediatrics 114: 192-197.

Jenni OG, Borbely AA, and Achermann P. 2004. Development of the Nocturnal Sleep Electroencephalogram In Human Infants. Journal of Physiology - Regulatory, Integrative and Comparative Physiology 286: R528-R538.

Kuhn BR, Mayfield JW, and Kuhn RI. 1999. Clinical assessment of child and adolescent sleep disturbance. Journal of Counseling and Development 77: 359-368.

Montgomery-Downs HE and Gozal D. 2006. Toddler behavior following polysomnography: effects of unintended sleep disturbance. Sleep 29: 1282-1287.

Thomas DA, Poole K, McArdle EK, Goodenough PC, Thompson J, Beardsmore CS, and Simpson H. 1996. The effect of sleep deprivation on sleep states, breathing events, peripheral chemoresponsiveness and arousal propensity in healthy 2 month old infants. European Respiratory Journal 9: 932-938.

Last modified 7/08