My toddler won’t stay asleep. It sometimes takes me an hour of tantrums before he will sleep. Then he wakes up an hour later crying. Dr says nothing is physically wrong with him. He will be 2 in May. Wakes 4-5 times a night and wakes at least 1 time during his one nap in the day time.
First of all, I'm glad you double checked with the doctor. It's always a good idea to rule out medical issues.
That said, I'm not surprised the doc gave him the all clear.
That's because what you're seeing is pretty darn common around this age.
The way I see it, there are likely three things going on here. A perfect storm of crappy toddler sleep.
First cause of crappy toddler sleep – the 18 month regression
This one's a doozy. Not only does it feature the same regressive sleep stuff we see at other regressions – difficulty falling asleep, frequent nighttime wakings, waking up crying, etc. – but it marks the starts of the "terrible twos." Defiance, a desire to flex independence, and the accompanying frustration (for both of you) starts up around 18 months, and begins to fade by 2 years.
I'm not suggesting that it's the "terrible twos" causing the crappy sleep, but if this phase is causing leftover upset (say a tantrum that didn't get resolved, from your toddler's perspective), then that can certainly affect sleep.
Second cause of crappy toddler sleep – overtiredness
Okay, this doesn't just apply to toddlers. In fact, the majority of baby and toddler sleep problems that come my way are due to plain ol' overtiredness.
When we're overtired, our bodies compensate by producing the hormone cortisol. Cortisol is highly stimulating.
Cortisol spikes in the morning (like nature's "coffee") and when we're stressed out (part of the flight-or-fight response).
A morning jolt of cortisol is a normal part of our daily rhythms. When we're well rested and not particularly stressed out, cortisol levels gradually lower throughout the day so that by bedtime, we're ready to go.
If we're NOT well-rested then, cortisol sticks around. An overtired body keeps producing cortisol because the body processes overtiredness as stress. ("I can't go to sleep, so there must be something I need to take care of. Here's some cortisol.")
Conversely, when we are well-rested, cortisol levels remain low. This is the scientific reasoning behind the old adage "sleep begets sleep."
Third cause of crappy toddler sleep – Daylight Saving Time
It's hard to say if this is affecting you since I don't know how long this has been going on for. But it takes up to a week for a body to adjust to springing ahead (see this post for more on that).
If you've been putting your child down at the usual time, by the clock, then it's not surprising he would take an hour to fall asleep – his body doesn't care what's on the clock.
The perfect storm
What's most likely is that these three things are colliding into the perfect storm of crappy toddler sleep.
The regression caused poor sleep, a build-up of sleep debt is causing higher levels of cortisol, and the time change sealed the crappy deal.
The way to better sleep
To improve this situation, you've got to manage these three elements.
If you haven't already, you can try gradually changing his bedtimes to slowly adjust him to the new time. But since we're a week past the start of DST now, this is probably not the magic bullet you're looking for.
Keep a lid on tiredness. Do your best to encourage appropriate, regular bedtimes. A good schedule for an 18-month old is something like...
7am - wake up
12pm - nap
As for the regression, you can pretty much only ride it out. And do your best to not let any bad habits pick up or stick.
But really, I think the key will be managing your not-a-baby-anymore's new needs. He needs to have opportunities to express his autonomy. He needs to have a place in his family that makes him feel big (but offers the opportunity to regress into babyhood – growing up is not a linear path).
At the same time, you'll need to ensure that the boundaries of your home and his life are crystal clear. Toddlers whose boundaries are unclear or inconsistent feel insecure and go on tantrum tirades in an attempt to figure out where the lines are.
One of my favourite go-to resources for toddler stuff is The Happiest Toddler on the Block. It's full of practical advice for connecting with and responding to toddlers in a way that makes them feel heard, so they don't have to resort to whining and tantruming.
This book, and resources like Positive Parenting Solutions can help give you ideas on how to handle his upsets so that they don't wreak havoc on his sleep.
One more thing...
It's common around this age for parents to interpret these crappy naps as a sign that their baby is ready to stop napping.
It's a ruse! He still needs a nap!
With consistency, patience, and a proactive approach to outlining and enforcing boundaries, you should start to see his sleep improve with time.
Susannah Ritchie is a family educator specializing in infant & toddler sleep. She works with tired parents to find sleep solutions for the whole family.