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Most children will not have a significant underlying pathology to explain their sleep patterns. However, occasionally there is a reason why some babies wake up and these are actually due to underlying issues that may require the help of a medical professional.
This guide aims to provide you with some insight on what these underlying issues could be. Trust your instinct, research shows that parent instinct is very often right. If you think something more is going on, it’s quite possible you’re right!
If your little one is over the age of one (or possibly younger) and they are experiencing hourly wake ups which have been going on for several months, it could mean that your child has an undiagnosed tongue tie, is experiencing discomfort from food sensitivities or digestion concerns, they may need to be seen by an ENT (ear, nose and throat specialist) to have their airway assessed.
Mouth breathing, snoring or pauses in breathing
Babies and toddlers should be sleeping with their mouth closed. This enables them to breathe through their nose while sleeping which allows for optimal oxygen distribution throughout their body. If you find that your little one is sleeping with their mouth opened rather than with their lips sealed with their tongue resting on the roof of their mouth, this could be suggestive of sleep-disordered breathing.
Mouth breathing during sleep is normal if your child is congested from allergies or illness. However, if mouth breathing persists even while your little one is well, it is worth getting it investigated. This is because it could be due to an undiagnosed tongue tie (there is some anecdotal evidence that this can happen but the evidence is sparse), enlarged tonsils or another pathology.
Suitable referrals: Doctor, ENT specialist
Tongue Tie
A tongue tie is an abnormal attachment of the lingual frenum which is the tissue that connects your tongue to the bottom floor of your mouth. Tongue ties can make it difficult for a baby to sleep with their mouth closed with the tongue on the roof of their mouth. Little ones with a tongue tie may find it difficult to lay flat, may wake often due to hunger and they often fall asleep feeding. You may notice clicking sounds while feeding or milk spilling out of the sides of their mouth while feeding. It is possible that there is increased gassiness or fussiness which can be misdiagnosed as reflux.
Suitable referrals: Tongue Tie Specialist
Food Intolerance
Both food sensitivities and food allergies can be a sleep disruptor. Your little one may be sensitive to particular food groups such as dairy products, nuts, fish, wheat, soy and sesame which can cause discomfort and disturbed sleep.
Certain foods can trigger atopic eczema but they don’t cause it @allergy_uk and @eczemasociety have more information about eczema if you would like to read more. Other eczema triggers beside food, are irritants, such as soaps, chemicals such as chlorine in a swimming pool, fabrics such as wool, contact allergens such as dust mite, pollen. Eczema flare ups can cause disturbances in sleep.
Suitable referrals: Doctor, they may refer you to an allergy clinic
Unusual Fatigue in the Day
If you have noticed that your child is particularly tired during the day despite getting plenty of sleep, it may be that they are not achieving deep sleep at night or their sleep is disrupted by discomfort . This could be due to an underlying sleep pathology, such as obstructive sleep apnoea (where breathing is interrupted repeatedly during sleep by snoring and episodes of a stop in breathing) or periodic limb movement disorder.
Suitable referrals: Doctor, ENT, Health visitor
Night Sweats
Some children are just sweaty but if this is new for your child, it is worth getting them checked over. Low blood sugar and some other serious health conditions can also cause night sweats, so it is better to get this checked by a doctor just in case.
Suitable referrals: Doctor
Eating Challenges
If your child excludes entire food groups, seems scared to eat, or eats a very limited range of foods (less than 20–30 individual foods) then it is possible that they are deficient in nutrients. If they become deficient in iron it can cause anemia which can reduce the quality and quantity of sleep. There may be underlying sensory issues that are causing the food or eating aversion.
Suitable referrals: Speech/language therapist, Dietician, Doctor, Occupational Therapist
Restlessness
It is normal for little ones to move around at night and some children are naturally more active, wrigglier sleepers . However, if you notice that your child constantly moves the entire night, they have restless limbs or perhaps you notice a one-sided jerking, a new movement, or a movement that appears to be uncomfortable, it is worth getting it checked out. Try to get a video of it so that you can show your doctor. It may be a sign of low iron so you might want to ask your doctor if they think a blood test is worth organising.
Suitable referrals: Doctor
Illness
It’s normal for kids to get ill, their immune systems aren’t fully developed and they are often exposed to many bugs from an early age. However, if your child has been generally unwell for some time, it’s worth getting them looked at by a doctor. Sometimes an acute ear or urine infections (which don’t always have obvious symptoms) will also disrupt sleep.
Suitable referrals: Doctor
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