Dr. Sarah Mitchell
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18 Month Sleep Regression: Causes and 6 Tips on How to Survive it

I had been back to work for about six months, managing home and the work front and proud of my “good sleeper”.   I had life by the balls!  And then the 18 month sleep regression hit… and humbled me.

Why the 18 month sleep regression is the WORST!

By 18 months, we’ve all dealt with the 4-month and 12-month sleep regressions and survived.

Wiser, calmer, more experienced, one plans on dealing with this sleep hiccup of increased night waking in a similar manner.

But this one is different.  The night wakings seem longer and the regression itself seems to last longer.

It is confusing too since it can appear as early as 16 months and last on and off for many months to follow.

Why this sleep regression freaks us out.

Where we were previously able to handle a sleep regression with some verbal reassurance or some physical touch, this sleep regression may look completely different.

Your toddler may seem inconsolable and the techniques you previously used to reassure just don’t work!

The tears seem so much more intense and the night waking so much longer.  Our confidence is shaken!

tarts to set in which often leads us to vary our responses and we falter in our ability to respond consistently, which becomes a slippery slope of bad habit building.

What is going on in the sleep regression?

As you know, night waking usually occurs when a child surfaces in between nighttime sleep cycles.

A nighttime sleep cycle is 3 hours. Kids who know how to self-soothe will be able to relax themselves into the next sleep cycle without much fuss.

If something is distracting the child, the child will have difficulty relaxing into the next sleep cycle and the result is a “night waking”.

The Cause of the 18 Month Sleep Regression

Can I trust the world?

According to Erikson’s famous stages of psychosocial development, 0-2 years is where the child tests the theory of “Can I trust the world”? Around 18 months toddlers are becoming more independent from Mom physically and emotionally.

Parents provide a strong base of security from which the child can venture out to assert their will.  Children simultaneously crave independence but are also scared of that increased independence from Mom.

Sometimes at night they surface between sleep cycles and think back to their day and their blooming autonomy and want reassurance that Mom is still there. This can also happen at bedtime too.

Where your toddler previously fell asleep quietly there is more crying at bedtime, or where you toddler previously slept through the night, there are frequent night wakings or night wakings that last a long time, such as an hour or more.

I have a voice!

Your toddler is blossoming in vocabulary and gaining many more words. Her opinions are also blooming. Perhaps she surfaced between sleep cycles and remembered that awesome Dora episode she watched that day. And she has decided that what is what she wants to do right now.. .watch Dora.

I’m not gonna lie, there has been a 3 am viewing of Dora at our house in the past before we knew what was going on, and recently there has been some pointing to the living room yelling “play, play” at 2 am.

I’m in motion!

As with any sleep regression, any new motor skill can cause a sleep regression. Just thinking about a new motor skill, let alone practicing it, can throw a baby’s sleep off. Most kids start running around the 18-month mark and before 2 years of age.

Your toddler will gain 2 sets of teeth between 16 and 24 months:

Baby teeth eruption chart for 18 month sleep regression


1st molars

2nd Molars – on their way after 25 months

I’m not sure what mother nature was thinking when she programmed all these puppies to come in within this short time span.

The entry of these teeth is much more painful than the previous teeth.

You might want to speak to your pharmacist about provide both Advil and Tylenol at night to help manage the pain.

How to survive 18 month sleep regression

  1. Offer Comfort
    Offer comfort without nursing or milk, and do so in the confines of baby’s bedroom. Once you start takingg your toddler out of her normal sleeping environment you are opening up a can of worms that will be harder to recover from.
  2. Be generous with the painkillers
    Those canines can be particularly painful. Consult your pharmacist for advice on the use of double dosing – Advil and Tylenol in staggered administration. Obviously consult with your doc or pharmacist about medicine.  
  3. Set your own personal limits
    Are you okay with rocking babe for 20 minutes to help distract from the whirlwind going on in language or motor development? But is 1 hour of rocking too much. Have a general plan before you go in.
  4. Trade off with your partner
    At this age many Moms are back to work and a 1 hour crib party is really killer on a gal’s day job. Trade off with Dad to help ease the pain.
  5. Communicate.
    When the teething and motor development leaps have passed, and your toddler is past 20 months, you can talk to your toddler about what is going to happen in the night.  They are so afraid of missing out, they may not want to go to bed.  Tell her that “daddy is sleeping and mommy is sleeping,” and list off all the people in her world.  It may also help to set boundaries – “I am not coming into your room anymore tonight”… but then you have to be prepared to stick with that.    
  6. Stay sane.
    Remember that this too shall pass and that you are not the only one that this happens to. This is not because of some new food that you fed your toddler or because of any personal fault. This is parenting.

The hardest part of this sleep regression is knowing if you should be firm and implementing sleep training strategies or if you should be coasting and offering reassurance.

Only you will know when your baby is legitimately uncomfortable or anxious, and when she is taking that mile instead of the inch.

Don’t forget that a sleep regression is different than a baby who was never able to fall asleep independently without having a bottle, pacifier or being rocked as part of the bedtime routine.  If you are stuck in sleep funk, I can teach you everything you need to know about how to gently teach your toddler to sleep.

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