Why does my child wake in the night, and what should I do?

The short answer

Brief waking can occur between sleep periods, but repeated, prolonged or distressing waking needs a closer look. Record when the child wakes, how alert or distressed they are, what they do, the support required and when sleep returns. Check pain, reflux, constipation, itching, temperature, hunger, toileting, anxiety, nightmares, medication, sound, light, restless movement and breathing. Keep the overnight response quiet, predictable and sufficient for safety and comfort: use few words, meet the identified need and return to the same settling cue. Do not withhold necessary care to avoid creating a habit, and do not add several new rules at 2am. Speak to the GP when waking is persistent, has changed suddenly or significantly affects the child or family. Loud habitual snoring, choking, breathing pauses, significant pain, unusual episodes or marked daytime sleepiness need prompt clinical attention.

• Record what happens before, during and after waking rather than guessing motive.
• Check discomfort, breathing, medication, anxiety and environment.
• Make the overnight response calm, brief and predictable, but still meet genuine needs.
• Change one safe factor at a time and judge the whole night and following day.
• Persistent or concerning waking deserves medical assessment.