Sleep Consultant Course of Study

IMS739 Solving Toddler and Preschooler Sleep Problems

Syllabus

Course name: Solving Toddler and Preschooler Sleep Problems

Course code: IMS739

Course description

This course introduces students to the unique sleep needs of toddlers and preschoolers. It covers how a lack of sleep can affect toddlers and how to create a healthy sleep schedule for them. Students will learn how to tell if a child’s bedtime is too late, how to figure out the best time for naps and bedtime, and how to create a suitable bedtime routine. The course also includes steps for transitioning from two naps to one, handling night waking, teaching a child to sleep in their own bed, and what to do when a child resists bedtime or refuses to nap.

Course objectives

By the end of this course, students should be able to:

  • Explain the basics of sleep for toddlers and preschoolers.
  • Describe how lack of sleep can affect a toddler’s mood and behavior.
  • Help parents establish a healthy sleep schedule for their children.
  • Identify when a toddler’s bedtime is too late and how to set an appropriate bedtime.
  • Determine the best time for naps.
  • Guide parents on creating a bedtime routine for toddlers and preschoolers.
  • Recognize signs that a toddler is ready to move from two naps to one and explain the steps to make this change.
  • Offer advice on reducing night waking and helping toddlers stay in their own bed.
  • Give practical advice on managing co-sleeping and breastfeeding while maintaining healthy sleep habits.
  • Determine how long naps should be and suggest ways to handle nap refusal.
  • Understand common reasons behind bedtime resistance and offer solutions to parents.

Course content

Unit 1

  • Introduction to Toddler and Preschooler Sleep
  • How Lack of Sleep Can Affect Toddlers
  • Creating Healthy Sleep-Wake Rhythms for Toddlers
  • How Do You Know if the Toddler’s Bedtime Is Too Late?
  • How to Determine the Ideal Bedtime?
  • How to Find the Best Time for a Child to Take a Nap?
  • Is a Sleep Schedule Really Necessary?
  • How to Create a Good Bedtime Routine for Toddlers and Preschoolers?
  • How Can a Child Smoothly Transition From Two Naps to One?
  • Signs the Child Is Ready for the Transition From Two Naps to One
  • Step-By-Step Guide for the Transition From Two Naps to One

Unit 2: 

  • How to End the Toddler’s Night Waking?
  • How to Teach a Child to Sleep in Her Bed?
  • Sleeping Through the Night When Breastfeeding and Co-sleeping
  • How Long Is the Optimal Length for a Nap?
  • What Should Parents Do if Their Child Needs a Nap but Will Not Sleep?
  • Bedtime Resistance

Assessment

  • 5 practice quizzes (not graded)
  • 3 practical exercises (not graded)
  • 1 final test
  • 3 case study exams

Grading System

Pass/Fail based on performance in the final test and the case study exams.

Prerequisites:

Students must have completed the following courses before enrolling in this course:

References:

Mindell, J.A., Leichman, E.S., Composto, J., Lee, C., Bhullar, B. and Walters, R.M. (2016), Development of infant and toddler sleep patterns: real-world data from a mobile application. J Sleep Res, 25: 508-516. [Wiley]

Teng, A., Bartle, A., Sadeh, A. and Mindell, J. (2012), Infant and toddler sleep in Australia and New Zealand. Journal of Paediatrics and Child Health, 48: 268-273. [Wiley]

Pantley, E., 2009. The No-Cry Nap Solution: Guaranteed Gentle Ways to Solve All Your Naptime Problems: Guaranteed, Gentle Ways to Solve All Your Naptime Problems. McGraw Hill Professional.

Mindell, J. and Owens, J., 2009. A clinical guide to pediatric sleep. Lippincott Williams & Wilkins.

Juulia Paavonen, Outi Saarenpää-Heikkilä, Isabel Morales-Munoz, Minna Virta, Niina Häkälä, Pirjo Pölkki, Anneli Kylliäinen, Hasse Karlsson, Tiina Paunio, Linnea Karlsson. Normal sleep development in infants: findings from two large birth cohorts. Sleep Medicine, 2020; [ScienceDirect]

Barry ES. What Is “Normal” Infant Sleep? Why We Still Do Not Know. Psychological Reports. 2021;124(2):651-692. [Sage]

Liu J, Feng R, Ji X, Cui N, Raine A, Mednick SC. Midday napping in children: associations between nap frequency and duration across cognitive, positive psychological well-being, behavioral, and metabolic health outcomes. Sleep. 2019 Sep 6;42(9):zsz126. [PubMed]

Chaput JP, Gray CE, Poitras VJ, Carson V, Gruber R, Birken CS, MacLean JE, Aubert S, Sampson M, Tremblay MS. Systematic review of the relationships between sleep duration and health indicators in the early years (0-4 years). BMC Public Health. 2017 Nov 20;17(Suppl 5):855. doi: 10.1186/s12889-017-4850-2. PMID: 29219078; PMCID: PMC5773910.[PubMed]

McLaughlin Crabtree V, Beal Korhonen J, Montgomery-Downs HE, Faye Jones V, O'Brien LM, Gozal D. Cultural influences on the bedtime behaviors of young children. Sleep Med. 2005 Jul;6(4):319-24. doi: 10.1016/j.sleep.2005.02.001. Epub 2005 Apr 1. PMID: 15978515. [PubMed]

Kataria S, Swanson MS, Trevathan GE. Persistence of sleep disturbances in preschool children. J Pediatr. 1987 Apr;110(4):642-6. doi: 10.1016/s0022-3476(87)80571-1. PMID: 3559818. [PubMed]

Zuckerman B, Stevenson J, Bailey V. Sleep problems in early childhood: continuities, predictive factors, and behavioral correlates. Pediatrics. 1987 Nov;80(5):664-71. PMID: 3670967.[PubMed]

Hale L, Berger LM, LeBourgeois MK, Brooks-Gunn J. Social and demographic predictors of preschoolers' bedtime routines. J Dev Behav Pediatr. 2009 Oct;30(5):394-402. [PubMed]

Ockwell-Smith, S. (2015). The Gentle Sleep Book: a guide for calm babies, toddlers and pre-schoolers. Piatkus; UK ed. Edition

Williams KE, Nicholson JM, Walker S, Berthelsen D. Early childhood profiles of sleep problems and self-regulation predict later school adjustment. Br J Educ Psychol. 2016 Jun;86(2):331-50.  [PubMed]

Mindell JA, Telofski LS, Wiegand B, Kurtz ES. A nightly bedtime routine: impact on sleep in young children and maternal mood. Sleep. 2009 May;32(5):599-606.  [PubMed]

Sexton, S., & Natale, R. (2009). Risks and benefits of pacifiers. PubMed, 79(8), 681–685. [AFP]

Butler R, Moore M, Mindell JA. Pacifier Use, Finger Sucking, and Infant Sleep. Behav Sleep Med. 2016 Nov-Dec;14(6):615-23. doi: 10.1080/15402002.2015.1048451. Epub 2015 Nov 7. PMID: 26548755. [PubMed]

Degan VV, Puppin-Rontani RM. Prevalence of pacifier-sucking habits and successful methods to eliminate them--a preliminary study. J Dent Child (Chic). 2004 May-Aug;71(2):148-51. [PubMed]

North Stone K, Fleming P, Golding J. Socio-demographic associations with digit and pacifier sucking at 15 months of age and possible associations with infant infection. The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Early Hum Dev. 2000 Dec;60(2):137-48. [PubMed]

Wennergren G, Nordstrand K, Alm B, Möllborg P, Öhman A, Berlin A, et al. Updated Swedish advice on reducing the risk of sudden infant death syndrome. Acta Paediatr. (2015) 104(5):444–8. [PubMed]

Jenik A, Vain N. The pacifier debate. Early Hum Dev. (2009) 85(10):S89–91. [PubMed]

Muzulan, C. F., & Gonçalves, M. I. R. (2011). Recreational strategies for the elimination of pacifier and finger sucking habits. Jornal da Sociedade Brasileira de Fonoaudiologia, 23, 66-70. [PubMed]

For the dental patient. Thumb sucking and pacifier use. J Am Dent Assoc. 2007 Aug;138(8):1176. doi: 10.14219/jada.archive.2007.0331. [JADA]

Scudine KGO, de Freitas CN, Nascimento de Moraes KSG, Bommarito S, Possobon RF, Boni RC, Castelo PM. Multidisciplinary Evaluation of Pacifier Removal on Oro-Dentofacial Structures: A Controlled Clinical Trial. Front Pediatr. 2021 Sep 13;9:703695. [PubMed]

Weaning from the breast. Paediatr Child Health. 2004 Apr;9(4):249-63. doi: 10.1093/pch/9.4.249. [PubMed]

Lawrence R. Breastfeeding: A Guide for the Medical Profession. 5th edn. Vol. 335. St Louis: Mosby; 1999. pp. 338pp. 343–344.

Krause, J., & IBCLC Rosenthal, C. (2019). Lactivate!: A User’s Guide to Breastfeeding. Sourcebooks, Inc.

Wiessinger, D., West, D., & Pitman, T. (2010). The womanly art of breastfeeding: Completely revised and updated 8th edition. Pinter & Martin Publishers.

Huggins K, Ziedrich L. The Nursing Mother’s Guide to Weaning. Boston: Harvard Common Press; 1994.

Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breastfeed Med. 2015 Jun;10(5):246-52. doi: 10.1089/bfm.2014.0153. Epub 2015 May 14. [PubMed]

Elias MF, Nicolson NA, Bora C, Johnston J. Sleep/wake patterns of breast-fed infants in the first 2 years of life. Pediatrics. 1986 Mar;77(3):322-9. [PubMed]

Thulier D, Mercer J. Variables associated with breastfeeding duration. J Obstet Gynecol Neonatal Nurs. 2009 May-Jun;38(3):259-68. doi: 10.1111/j.1552-6909.2009.01021.x. [PubMed]

Williamson, A. A., Leichman, E. S., Walters, R. M., & Mindell, J. A. (2019). Caregiver-perceived sleep outcomes in toddlers sleeping in cribs versus beds. Sleep Medicine, 54, 16–21. [ScienceDirect]

Ganga, A., Kim, E. J., Tang, O. Y., Shao, B., Svokos, K., Klinge, P. M., Cielo, D. J., Fridley, J. S., Gokaslan, Z. L., Toms, S. A., & Sullivan, P. Z. (2023). The epidemiology of crib-related head injuries: A ten-year nationwide analysis. The American Journal of Emergency Medicine, 74, 78–83.  [ScienceDirect]

Honaker, S. M., Meltzer, L. J. (2014). Bedtime Problems and Night Wakings in Young Children: An Update of the Evidence. Paediatric Respiratory Reviews, 15, 4. [ScienceDirect]

Turgeon, H., & Wright, J. (2014). The Happy Sleeper: The Science-Backed Guide to Helping Your Baby Get a Good Night's Sleep-Newborn to School Age

Legg, C., Sherick, I. & Wadland, W. Reaction of preschool children to the birth of a sibling. Child Psych Hum Dev 5, 3–39 (1974). [Springer]

Mayr, J., Seebacher, U., Lawrenz, K. et al. Bunk beds – a still underestimated risk for accidents in childhood?. Eur J Pediatr 159, 440–443 (2000). [Springer]

Belechri M, Petridou E, Trichopoulos D., Bunk versus conventional beds: a comparative assessment of fall injury risk. Journal of Epidemiology & Community Health. 2002; 56:413-417. [BMJ]

Rothbart MK, Ahadi SA, Hershey KL, Fisher P. Investigations of temperament at three to seven years: the Children's Behavior Questionnaire. Child Dev. 2001 Sep-Oct;72(5):1394-408. [PubMed]

Staton S, Rankin PS, Harding M, Smith SS, Westwood E, LeBourgeois MK, Thorpe KJ. Many naps, one nap, none: A systematic review and meta-analysis of napping patterns in children 0-12 years. Sleep Med Rev. 2020 Apr;50:101247. [PubMed]

Hall, W. A., Zubrick, S. R., Silburn, S. R., Parsons, D. E., & Kurinczuk, J. J. (2007). A model for predicting behavioural sleep problems in a random sample of Australian pre‐schoolers. Infant and Child Development: An International Journal of Research and Practice, 16(5), 509-523. [Wiley

Atkinson E, Vetere A, Grayson K. Sleep disruption in young children. The influence of temperament on the sleep patterns of pre-school children. Child Care Health Dev. 1995 Jul;21(4):233-46. doi: 10.1111/j.1365-2214.1995.tb00754.x. PMID: 7554104. [PubMed]

Pham C, Desmarais E, Jones V, French BF, Wang Z, Putnam S, Casalin S, Linhares MBM, Lecannelier F, Tuovinen S, Heinonen K, Raikkonen K, Montirosso R, Giusti L, Park SY, Han SY, Lee EG, Huitron B, de Weerth C, Beijers R, Majdandžić M, Gonzalez-Salinas C, Acar I, Slobodskaya H, Kozlova E, Ahmetoglu E, Benga O, Gartstein MA. Relations between bedtime parenting behaviors and temperament across 14 cultures. Front Psychol. 2022 Nov 24;13:1004082. doi: 10.3389/fpsyg.2022.1004082. PMID: 36507001; PMCID: PMC9731114. [PubMed]

Breitenstein RS, Doane LD, Clifford S, Lemery-Chalfant K. Children's sleep and daytime functioning: Increasing heritability and environmental associations with sibling conflict. Soc Dev. 2018 Nov;27(4):967-983. doi: 10.1111/sode.12302. Epub 2018 Apr 26. PMID: 30686863; PMCID: PMC6345410. [PubMed]

Wilson KE, Lumeng JC, Kaciroti N, Chen SY, LeBourgeois MK, Chervin RD, Miller AL. Sleep Hygiene Practices and Bedtime Resistance in Low-Income Preschoolers: Does Temperament Matter? Behav Sleep Med. 2015;13(5):412-23. [PubMed]

Yokomaku A, Misao K, Omoto F, Yamagishi R, Tanaka K, Takada K, Kohyama J. A study of the association between sleep habits and problematic behaviors in preschool children. Chronobiol Int. 2008 Jul;25(4):549-64. [PubMed]

Sadeh A, Gruber R, Raviv A. Sleep, neurobehavioral functioning, and behavior problems in school-age children. Child Dev. 2002 Mar-Apr;73(2):405-17. doi: 10.1111/1467-8624.00414. PMID: 11949899. [PubMed]

Stein MA, Mendelsohn J, Obermeyer WH, Amromin J, Benca R. Sleep and behavior problems in school-aged children. Pediatrics. 2001 Apr;107(4):E60. doi: 10.1542/peds.107.4.e60. PMID: 11335781. [PubMed]

Mindell JA, Li AM, Sadeh A, Kwon R, Goh DY. Bedtime routines for young children: a dose-dependent association with sleep outcomes. Sleep. 2015 May 1;38(5):717-22. doi: 10.5665/sleep.4662.  [PubMed]

Iemura, A., Iwasaki, M., Yamakawa, N., Tomiwa, K., Anji, Y., Sakakihara, Y., Kakuma, T., Nagamitsu, S., & Matsuishi, T. (2016). Influence of sleep-onset time on the development of 18-month-old infants: Japan Children’s cohort study. Brain & Development, 38(4), 364–372. [Brain&Development]

Hale L, Berger LM, LeBourgeois MK, Brooks-Gunn J. A longitudinal study of preschoolers' language-based bedtime routines, sleep duration, and well-being. J Fam Psychol. 2011 Jun;25(3):423-33. doi: 10.1037/a0023564. PMID: 21517173; PMCID: PMC3134391. [PubMed]

Owens J, Maxim R, McGuinn M, Nobile C, Msall M, Alario A. Television-viewing habits and sleep disturbance in school children. Pediatrics. 1999 Sep;104(3):e27. doi: 10.1542/peds.104.3.e27.  [PubMed]

Hayes MJ, Parker KG, Sallinen B, Davare AA. Bedsharing, temperament, and sleep disturbance in early childhood. Sleep. 2001 Sep 15;24(6):657-62. doi: 10.1093/sleep/24.6.657.  [PubMed]

Bruni O, Lo Reto F, Miano S, Ottaviano S. Daytime behavioral correlates of awakenings and bedtime resistance in preschool children. Suppl Clin Neurophysiol. 2000;53:358-61. [PubMed]

Minde K, Faucon A, Falkner S. Sleep problems in toddlers: effects of treatment on their daytime behavior. J Am Acad Child Adolesc Psychiatry. 1994 Oct;33(8):1114-21.  [PubMed]

Hysing, M., Sivertsen, B., Garthus-Niegel, S., & Eberhard-Gran, M. (2016). Pediatric sleep problems and social-emotional problems. A population-based study. Infant Behavior & Development, 42, 111–118. [ScienceDirect]

Mindell, J. A., Goh, D., Collins, M., Bartle, A., Kohyama, J., Sekartini, R., Veeravigrom, M., & Leichman, E. S. (2020). 0947 Parent-Perceived sleep problems and sleep goals in infants and toddlers: a global sample. SLEEP [OxfordAcademic]

Beltramini AU, Hertzig ME. Sleep and bedtime behavior in preschool-aged children. Pediatrics. 1983 Feb;71(2):153-8. [PubMed]

Bernier A, Carlson SM, Bordeleau S, Carrier J. Relations between physiological and cognitive regulatory systems: infant sleep regulation and subsequent executive functioning. Child Dev. 2010 Nov-Dec;81(6):1739-52. [Wiley]

Blair PS, Humphreys JS, Gringras P, Taheri S, Scott N, Emond A, Henderson J, Fleming PJ. Childhood sleep duration and associated demographic characteristics in an English cohort. Sleep. 2012 Mar 1;35(3):353-60. [OxfordAcademic]

Horváth K, Liu S, Plunkett K. A Daytime Nap Facilitates Generalization of Word Meanings in Young Toddlers. Sleep. 2016 Jan 1;39(1):203-7. doi: 10.5665/sleep.5348. PMID: 26237777; PMCID: PMC4678333.[PubMed]

Horváth K, Myers K, Foster R, Plunkett K. Napping facilitates word learning in early lexical development. J Sleep Res. 2015 Oct;24(5):503-9. [PubMed]

Nakagawa, M., Ohta, H., Nagaoki, Y. et al. Daytime nap controls toddlers’ nighttime sleep. Sci Rep 6, 27246 (2016). [Nature]

Sivertsen B, Harvey AG, Reichborn-Kjennerud T, Torgersen L, Ystrom E, Hysing M. Later emotional and behavioral problems associated with sleep problems in toddlers: a longitudinal study. JAMA Pediatr. 2015 Jun;169(6):575-82. [PubMed]

Akacem LD, Simpkin CT, Carskadon MA, Wright KP Jr, Jenni OG, Achermann P, LeBourgeois MK. The Timing of the Circadian Clock and Sleep Differ between Napping and Non-Napping Toddlers. PLoS One. 2015 Apr 27;10(4):e0125181. doi: 10.1371/journal.pone.0125181. PMID: 25915066; PMCID: PMC4411103.  [PubMed

Acebo C, Sadeh A, Seifer R, Tzischinsky O, Hafer A, Carskadon MA. Sleep/wake patterns derived from activity monitoring and maternal report for healthy 1- to 5-year-old children. Sleep. 2005 Dec;28(12):1568-77. doi: 10.1093/sleep/28.12.1568. PMID: 16408417. [PubMed]