Confused by your newborn’s sleep? The ULTIMATE guide to get you in the know

Newborn sleep is mystifying right?!  The endless nappies, the feeding and laundry are one thing, but newborn sleep is tricky to get your head around; it’s seemingly erratic, unpredictable and downright bizarre!  Yet soooo important for your baby, of course, but also for you.

Understanding newborn sleep will go a long way in putting you on the right path to healthy sleep habits for your baby.

You won’t be surprised to hear that newborn sleep patterns are very different to those of adults – understanding how will help you avoid making one VERY common mistake when it comes to your baby’s sleep!   Plus aid the development of more mature sleep patterns (which ultimately should mean better sleep for you, wins all around!)

In addition, you probably have questions such as “How long should my baby sleep?”, “Is my baby sleeping too much?” or “Should I start a sleep routine or schedule?”

These are all questions covered in this post.

As a result, this post has turned out to be quite a long and in-depth, so I’ve broken down into bite size chunks and you can easily skip around by using this handy contents table.

So let’s start on this journey to decoding & demystifying newborn sleep! 

Part 1: Newborn sleep patterns the first weeks

What to expect in the early days

Newborns sleep a lot in the first week, pretty much only waking to feed before drifting off back to sleep. Whether it’s day or night they’re going to be sleeping! But in short bouts of anything from 20 minutes to 4 hours.

Newborns have a tiny stomach – they need to feed often, so they wake often.

It doesn’t matter if it’s day or night, short stints of sleep are normal.  A newborns stomach size is tiny so they need to feed frequently and cannot go for more than a few hours before needing to feed again. So it’s perfectly normal and desirable that your baby wakes frequently to feed.

Newborns sleep in short stints as they need to fill their tiny tummies frequently
Newborns sleep in short stints as they feed frequently

If you are one of the (lucky) few whose newborn sleeps 4+ hours from the get-go, you may have to wake your baby up to feed them.  If you’re unsure how long you should let your newborn sleep without eating, it’s best to check with your pediatrician.

Newborn sleep patterns won’t reflect day and night early on

The adult body clock, or circadian rhythm, governs the times that we naturally want to sleep.  This is largely influenced by light intensity.

Light inhibits the sleep-inducing hormone, melatonin. So artificial lights such as TV and laptop screens are not recommended before bedtime; turning screens off and using low-level lights will allow the melatonin to flow, relaxing the brain in preparation for sleep.

Coming from a place of zero light, newborns are not in synch with the adult circadian rhythm

When in utero, there is research to suggest that the fetus may sync with the circadian rhythm of the mother, as melatonin crosses the placenta from mother to baby.  But this is then lost at birth, when the placenta no longer connects mother and baby.

So newborn sleep patterns are largely unrelated to day and night.  I.e. they do not know to spend more time awake in the day than at night!

For some it seems the body clock of an unborn baby works in completely the opposite way; baby sleeps during the day and is up at night.  Was your baby frantically kicking in the middle of the night and waking you late on in your pregnancy?  Yup, me too!

The theory is your normal daytime activities create a sleep-inducing rocking sensation. As a result your baby has most awake periods at night, when you’re not moving.

If this is the case, you may find your newborn sleeps all day long, only waking briefly to feed, and has several short awake periods and feeds at night.  This sleep pattern is typical of newborns.  It’s often termed day-night confusion.

Newborns often want to sleep all day
It’s common for newborns to sleep all day in the early days

Day-night confusion can be fixed in a few days

By about 3 months, with more exposure to day light, your baby will get the hang of days and nights.  Luckily there are plenty of easy ways to speed it up!

For example:

  • exposure to natural daylight during the day (rather than artificial light)
  • reducing stimulation and interaction during night feedings
  • ensuring your baby is fed frequently during the day.

This ‘day-night confusion’ can be fixed in a matter of days – for  a step-by-step guide on transitioning your baby from sleeping all day to sleeping all night (and ONLY waking to feed, not to party or play!) check out the following post:

xx

Part 2: Understanding newborn sleep cycles and stages

Firstly, a brief look at adult sleep.

The adult sleep cycle

The adult sleep cycle consists of 1 REM stage and 3 Non-REM stages

There are a total of 4 sleep stages, a REM (Rapid Eye Movement) sleep stage, and 3 NREM (Non Rapid Eye Movement) stages as follows:

STAGE 1: the first and briefest of sleep stages

  • If woken during this stage you will probably deny you’ve been asleep at all!
  • Very brief, just a few mins and makes up 5% of total sleep time

STAGE 2: first ‘true’ sleep stage

  • When you do feel like you have been asleep if woken during this stage
  • Breathing pattern and heart rate slows
  • Most time is spent in this stage at around 45%

STAGE 3: regenerative ‘deep sleep’ or ‘slow-wave’ sleep

  • The deepest stage of sleep; brain waves have slowed and become more synchronized
  • It’s hard to wake someone who is in this stage
  • Repair, regeneration and rejuvenation of the body occur; key for growth and development
  • Accounts for 25% of total sleep

REM SLEEP: ‘active sleep’, when we dream

  • When the brain is most active; small, high frequency brain waves
  • Eyes move rapidly, heart rate increases slightly, breathing rapid and shallow
  • Disturbed and woken easily
  • Thought to be when we dream, since dreams vividly recalled when woken during this stage
  • Although brain is active, arm and leg muscles are paralyzed temporarily (to stop us acting on any dreams)
  • Accounts for 25% of total sleep

The adult sleep cycle starts in Non-REM sleep, ends with REM and then repeats

The adult sleep cycle begins with stage 1 of NREM sleep.  Brain waves slow and become more synchronized, until reaching the large, low-frequency waves of stage 3.

A short period in stage 2 follows before the first REM stage is reached. One sleep cycle done!

It then repeats, with subtle changes as the night continues:

  • Early on in the night: most restorative deep sleep (stage 3) occurs with very little dreaming (REM sleep)
  • During later sleep cycles: dreaming/REM sleep episodes increase while deep sleep stages decrease and even disappear

On average, the adult sleep cycle lasts 90-100 minutes

Early on in the night sleep cycles are slightly shorter while later sleep cycles may be as long as 120mins.

Adult sleep cycle chart

The chart below shows a typical nights sleep for an adult.

Adult sleep cycle chart
Adult sleep cycle chart adapted from How Sleep Works

Sleep is complex and still not fully understood

It’s thought that each stage of sleep has important functions necessary for optimal health – interrupted sleep or missing sleep stages can have dramatic effects and ‘sleep inertia‘ can result.

Interestingly, most deep sleep occurs during the hours of 11pm and 3am, while dreaming/REM sleep is always experienced between 3am and 7am REGARDLESS of whether you fell asleep at 11pm or 2am.

Sleep is a complex mechanism!

If you want to read more about adult sleep, this article from the Division of Sleep Medicine at Harvard Medical School and this one from How Sleep Works are worth a read.

The newborn sleep cycle

The Newborn Sleep Cycle consists of an ‘Active’, ‘Transitional’ and ‘Quiet’ stage

Newborn sleep patterns may seem erratic, but they do sleep in cycles with distinct sleep stages:

STAGE 1: ‘ACTIVE’ sleep

  • This is the infant version of REM sleep
  • Brain highly active, causing arms and legs to twitch dramatically
  • Disturbed and woken easily, sudden movements/noises/lights can initiate Moro reflex
  • Thought to be when brain development occurs
  • At least 50% of total sleep time

STAGE 2: ‘TRANSITIONAL’ sleep

  • Transitional stage between active and quite sleep
  • Baby looks restless, may vocalize or even open eyes
  • Disturbed and woken easily
  • 20-30% sleep time

STAGE 3: ‘QUIET’ sleep

  • The final sleep stage
  • Slower more rhythmic breathing
  • Harder for baby to wake
  • 20-30% sleep time

The newborn sleep cycle starts in ‘Active’ sleep, ends with ‘Quiet’ sleep and repeats frequently

The newborn sleep cycle begins with active sleep – a good chunk of time is spent in this phase, as much as half an hour.  A short transitional stage follows and finally ‘quiet’ sleep, the equivalent to deep sleep in adults, which lasts up to 20 minutes.

On average, the newborn sleep cycle lasts 50-60 minutes

Newborn sleep cycle chart

Newborn sleep cycle chart
Newborn sleep cycle chart adapted from The Brain From Top To Bottom

Why babies spend such little time in ‘Quiet’ sleep?

While adults spend a lot of time in ‘Deep’ sleep, newborns spend little time in the equivalent ‘Quiet’ sleep. This is thought to be a survival mechanism, protecting against oxygen deprivation.

When oxygen levels drop it’s vital to wake up quickly.  Research has been undertaken on the impact of slightly reduced oxygen levels on newborn sleep.  Results varied according to which stage of sleep the newborn was in:

  • babies woke easily from the two light stages of Active sleep and Transitional sleep
  • babies frequently FAILED to wake during Quiet sleep; if they did it took longer than from the lighter sleep stages

The conclusion was that a lot of light sleep is beneficial, if not crucial, to newborns.

Key differences between adult and newborn sleep

#1 Difference: Newborn sleep starts in ‘active’ sleep

In contrast, adult sleep starts in Non-REM sleep.

#2 Difference: Active sleep makes up 50%+ of newborn sleep

This is double the amount of time that adults are in the equivalent stage of REM sleep.

#3 Difference: During active sleep, newborns are both mentally and physically active

In contrast, adults are physically INACTIVE in REM sleep due to the neurological barrier that temporarily paralyzes the limbs (to prevent dreams being acted out).  In newborns this barrier has not developed so they move a lot!

They twitch, wiggle, stretch, and thrash. They may frown or smile, or launch into a burst of sucking movements. They may vocalize too (Source)

#4 Difference: Newborn sleep cycles are shorter

At around 45-60 minutes per sleep cycle, versus 90-100 minutes in an adult

Why these differences are relevant – take note!

Babies may look restless a lot of the time and fool us into thinking they’re going to wake up when they’re not.  They may kick about, cry out and even open their eyes and fool us into thinking that they’re awake.  But they’re not!

Give your baby a chance to settle before rushing in. Chances are he or she may be asleep!

1 Important similarity between adult & newborn sleep

Brief wake-ups are common, both between sleep cycles & during light sleep

As adults it’s common to wake partially and briefly in the night, to semi-consciously check for potential threats. If, in this semi-conscious state, nothing is detected, back to sleep we go.

Waking up all the way is also a possibility and more likely during REM, stage 1 and when transitioning between stages.

Babies may also wake up partially and briefly, during active sleep, during transitional sleep and, most commonly, in between sleep cycles.  If still tired and not hungry or in any discomfort they should go back to sleep.

Again, give your baby a chance to settle before rushing in. Chances are he or she will go back to sleep!

The thing is, the majority of newborn sleep is in active or transitional sleep and sleep cycles are short = potentially LOTS of brief wake ups.  This is in addition to the huge potential to look awake!

Summary chart of newborn vs. adult sleep – differences & their significance

I’ve summed up this differences and noted the importance of ‘pausing’ in this handy pinnable image.  Pin away!

Newborn sleep vs. adult sleep V2

So resist the urge to rush to your baby if she stirs or cries out

PAUSE FIRST!

  1. First, check your baby is actually awake – your baby may just be in active sleep and you may inadvertently disturb her by picking her up.
  2. Second, if awake, give baby a chance to settle herself – if still tired, not hungry or in any discomfort, she may well drift off back to sleep with no disturbance (i.e. you rushing in and picking her up!)

This is key to getting your baby to sleep for longer periods and eventually through the night.  If you do inadvertently disturb baby and wake her up, you may then find yourself aiding her back to sleep…. If you presume hunger is the cause of waking, offer milk, but baby is actually still tired, you will likely end up feeding to sleep.

This is the first step towards developing a sleep association, in this case, a feeding-to-sleep association.  By pausing first, you should be able to avoid this.

For other baby sleep tips, check out this post 0n my 10-step strategy to getting your baby to sleep through the night.

Part 3: Newborn sleep patterns the coming weeks and months

Maturation of newborn sleep cycles and patterns

At 3-4 months, the sleep patterns of a newborn begins to mature.  The amount of active sleep starts to decrease and sleep cycles lengthen.

But despite your baby spending less time in light, active sleep, you may find he or she is MORE easily disturbed.  Since in this more mature sleep, light sleep becomes even lighter.  Plus, what were very brief arousals between sleep cycles are now more likely to turn into full wakefulness.

So you may find your baby wakes more often at night and takes shorter naps at this 3-4 month mark.  This is the first sleep regression!

If your baby is used to being nursed or rocked to sleep, it’s likely you will have to aid them to sleep again.

For this reason, if you can hold off on any kind of sleep aid (e.g. rocking or feeding to sleep) early on and your baby will happily go to sleep without your help and switch between sleep cycles unaided, you may not even notice this sleep regression.

This again, highlights the importance of ‘The Pause’ as noted in the last section.

At around 6 months, active sleep has dropped to just 30%.  During the toddler years, sleep cycles starts to resemble those of an adult; active sleep has developed into ‘REM’  sleep and now comes at the end of the cycle, rather than the beginning.

Newborns sleep a lot – but how much?

Newborns sleep a lot, older babies and toddlers also sleep a lot.  The question is how much?  How much sleep is necessary for healthy growth and development?  Can babies sleep too much?

Unfortunately, there isn’t an easy answer or a magic number.  You guessed it, all babies need different amounts of sleep, just like adults do.

The general consensus seems to be that the AVERAGE newborn baby needs the following amount of sleep:

  • 0-2 months: 16-20 hours a day
  • 3 months old: 15-18 hours
  • 4 months old: 14-15 hours

A word of caution on these figures

They are AVERAGES and need to be treated as a GUIDELINE ONLY  If your newborn sleeps wildly more or less than these figures it doesn’t necessarily mean there’s anything to worry about.

There have been several studies worldwide that have tried to assess how much sleep newborns need.  The overriding issue is in error in data collection/reporting, since most of these studies have relied on the memory of parents for figures.  Then there are also cultural differences and other external factors to consider.

This article from Parenting Science investigates reported newborn and baby sleep times in depth and noted a huge variation in the times that babies sleep.  In a further article, the same author reported:

“In the first few days, the average newborn sleeps between 16-18 hours a day (Iglowstein et al 2002). By four weeks, newborn sleep averages about 14 hours. But the range is considerable. Some four-week-old babies sleep as little as 9 out of 24 hours. Others sleep for 19 hours a day (Iglowstein et al 2002).” Source.

Such is this huge variability between newborns, The American Academy of Sleep Medicine does not offer any guidelines on sleep requirements for babies under 4 months.  For older babies, it recommends the following:

  • Infants 4–12 months: 12–16 hours
  • Children 1–2 years: 11–14 hours

For more information on how much sleep babies need as they grow and develop check out this post on baby sleep charts.

Reading tiredness cues to ensure your newborn is sleeping enough

The best guideline for determining whether or not your newborn is sleeping enough is to observe their behavior.

Newborn sleep yawn sign of tiredness

Yawning is one of many signs of tiredness.  Tiny babies may also:

  • Stare vacantly
  • Avoid eye contact
  • Move jerkily
  • Frown
  • Clench fists
  • Fuss and cry
  • Become very still

While older babies may also:

  • Rub eyes and ears
  • Become clingy
  • Lose interest in toys
  • Suck fingers
  • Turn head away from stimulation

Looking for these tiredness cues and allowing your baby to sleep when tired and BEFORE he or she is overtired is key.  Trying to settle an overtired baby is a challenge!

Small babies cannot stay awake for very long at all! 20-40 minutes at a time maximum in the early days and weeks.  Look for signs of tiredness and put baby to sleep before becoming overtired

Link to sleep chart post

Worried that your newborn is sleeping too much?

As long as your baby is feeding frequently and putting on weight, sleeping more than average can only be a good thing!

What may be of concern, is if you see a sudden change in your newborn’s sleeping pattern.  For example, sleeping a lot more from one day to the next could be a sign of illness or infection.  If you are following any sort of sleep and feeding routine and/or are keeping track of your baby’s sleep pattern by using a baby app of some sort, this is easy to keep track of.

Seek medical professional help if you have any concerns.

Newborn sleep schedules

A sleep routine or schedule has benefits to both baby, mother and the whole family.

It’s all too easy to lose track of previous nap times and keep baby awake too long, resulting in an overtired baby that’s difficult to settle.  With regular naps and sleep times babies should not get overtired, settle easily and quickly and sleep well.  So a newborn sleep schedule can aid the development of healthy sleep habits in your newborn.

There are benefits for a busy, tired mother too.  Having a bit more structure to the day can make running errands and the household chores a lot more manageable.  You never know, you might even manage a bit of time to yourself!

Newborn sleep schedule - time for a book perhaps?
Coffee and a book?! The dream right? But maybe a sleep schedule or routine could give you just a tinsy bit of time for yourself!

A newborn sleep schedule normally includes specified times for feeding too.  Just like anything else ‘baby’, a sleep schedule must be looked at as a ‘guideline’ to be adjusted as dictated by your babies needs.  Growth spurts and other developmental milestones are a major interrupter…

Before starting a feed and sleep schedule, it’s important that your newborn has regained birthweight and is awake and alert for short periods of the day, i.e. not just sleeping all day.

Part 4: Newborn sleep safety

What is SIDS or cot death?

SIDS, (sudden infant death syndrome) otherwise known as cot death, is the sudden and unexplained death of an otherwise healthy infant. Despite a lot of research, it’s not fully understand.  It’s thought to be related to the inability to react sufficiently to an environmental stress, such as cigarette smoke or a breathing obstruction.

Newborn sleep positions

In the 1960s to 1980s, the recommended newborn sleep position was on their front.  This was thought to reduce the chance of a baby choking.  However, research demonstrated that the chance of SIDS was actually higher for a front lying sleep position.

‘Back to sleep’ the safest newborn sleep position

In 1992 the American Association of Pediatrics issued guidelines on sleeping positions for babies.  It recommended that babies should sleep on their back or side.  In 1996 this was then amended to say that baby was safest when sleeping on the back, in the ‘Back To Sleep campaign’.

Since this recommendation, the incidence of SIDS has dropped by 50%.

Incidence of SIDs in newborns following back to sleep campaign
Incidence of SIDS decreased rapidly since the ‘Back To Sleep’ campaign. Source

Other do’s and don’ts to reduce the risk of SIDS

Certain other factors have been linked to an increased incidence of SIDS.  In addition to the ‘Back To Sleep’ recommendation, there are a whole host of guidelines that make up the ‘Safe To Sleep’ campaign.

In brief it recommends:

Avoid the chance of a breathing obstruction:

  • place baby to sleep on their back to sleep
  • position baby with their feet at the base of their cot – so they cannot wriggle down and under the blankets
  • no extra blankets, soft toys in the cot with baby
  • no bumper lining cot
  • use a firm mattress, no pillow
  • keep baby’s head uncovered, blanket coming no higher than shoulders

Keep baby close by until the age of 6 months:

  • have your baby sleep at night in the room with you
  • in the day move your baby into the same room as you for naps

Avoid your baby overheating:

  • keep room temperature 16 to 20 degrees if possible when baby is sleeping
  • don’t put a hat on baby when sleeping
  • check baby is not too hot or cold – touch the back of baby’s neck or their tummy for sweatiness or clamminess (it’s normal for hands and feed to feel cold) – and adjust clothing as necessary

Avoid exposure to cigarette smoke:

  • don’t smoke during pregnancy or let anyone smoke in the room with you when pregnant
  • don’t smoke in the same room as your baby
For Newborn sleep safety, avoid bedsharing
Safe sleep guidelines recommend to avoid bedsharing with your newborn

Do not bedshare:

  • have baby sleep in a cot next to your bed, but not in the bed with you
  • don’t sleep on the sofa with your baby

This one can be especially difficult to avoid, since it’s all to easy to fall asleep while feeding your baby in bed.  On the other hand, some parents are keen to bedshare.  If this is the case, there are steps you can take to minimize the risks when co-sleeping.

For further safe sleep advice, check out this article.

If you remember just one thing, then remember this….

So that was a tonne of info!  Too much to even recap.  But please, there is one thing you MUST remember:

Babies are very restless sleepers and spend a lot of time in ‘active’ sleep.  You may think they are waking when they are not.

Like adults, babies come into brief states of consciousness often!  You may think they are awake and ready to get up, when they’re just switching between sleep cycles.

Pause

Give baby a minute or even a few seconds to see if they will settle.

That’s it!

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