Why Down Syndrome Babies Struggle to Sleep and How to Help Them

Babies with Down Syndrome: Sleeping Difficulties and Solutions for Better Sleep

Every new parent faces challenges when raising a newborn. The most love a person can ever know is also accompanied with around the clock care for the newest addition to the world. The first few months leave most parents exhausted and also wondering if they'll ever sleep again. What parents sometimes take for granted, however, is that this is all par for the course. Though these difficulties are absolutely valid, parents of babies born with Down Syndrome have a greater set of challenges. And sleep problems are more common in these special needs babies.

As the most common genetic disorder, occurring in about 1 in 700 births in the U.S., it's important to understand why babies born with Down syndrome have more difficulty when it comes to sleeping. Even more important is knowing how to help these little ones get the quality sleep they need to be healthy and thrive. And helping them, in turn, helps their parents get the sleep they need to give the best care possible.

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Why Babies with Down Syndrome Have a Harder Time Sleeping

The cause for sleep difficulties in babies born with Down syndrome can be attributed to various factors. Parents experiencing these issues should always first consult their child's pediatrician. But the most common causes are either breathing-related or behavioral.

Breathing-related: The physical abnormalities associated with Down syndrome are a large part of why babies born with Down syndrome are likely to have more difficulty getting to sleep and staying asleep. Obstructive sleep apnea (describe in-depth below) can be caused by the following physical features.

  • narrow upper airways,
  • larger tongues, and
  • low muscle tone.

This makes frequent wakings more common and deep sleep harder for them to come by. If this sleep disorder is suspected, parents should contact their child's doctor. 

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Behavioral: The behavioral issues that can accompany babies born with Down syndrome are another factor. Often they are the same types of behaviors you'd see in any infant. But due to developmental delays, these behaviors may last longer in babies born with Down syndrome. As is recommended with all babies, establishing a relaxing, consistent bedtime routine is key in helping your little one fall asleep. Though it can be more challenging to get this established with a baby born with Down syndrome, it absolutely can be done!

Common Sleep Difficulties in Babies Born with Down Syndrome

The difficulties laid out here don't look that different from common sleep problems in typically developing children. However, these challenges are often resolved in the first few months with non-disordered children, whereas lingering sleep difficulties are much more prevalent in babies born with Down syndrome.

Some of the most common sleep difficulties include: 

  • Obstructive Sleep Apnea - This is one of the challenges faced by babies born with Down syndrome that's mostly unique to their genetic disorder. Large tongues and narrow airways make it difficult to breathe normally during sleep. According to the National Institue of Health, about 31% of infants experience this. Parents who believe this is why their baby is having trouble sleeping need to consult their pediatrician to manage the condition.
  • Frequent Night Wakings - All young infants are likely to wake often due to hunger, the Moro Reflex and a lack of established sleep patterns that come after around 4 months of age. But sleep apnea, found in many babies born with Down syndrome, make frequent night wakings even more common.
  • More Light Sleep, Less REM sleep - When babies haven't learned to fall asleep on their own and have frequent night wakings, they will ultimately have less deep sleep which is important for both physical and cognitive growth.
  • Difficulty settling to sleep - Many parents report having a hard time getting their little ones to fall asleep and settle, not just parents of babies born with Down syndrome. It's important to remember that routine and consistency is key for helping a baby to learn to fall asleep on their own as well as put themselves back to sleep in the middle of the night.

Quality sleep is necessary for all babies...and for parents, too! Whether a baby born with Down syndrome is having difficulty sleeping due to a physical or behavioral issue, it's important to determine the underlying cause. That way, it can be corrected so that everyone starts getting a lot more sleep!

Babies born with Down syndrome can learn to overcome their sleep struggles just as any baby can. It just may take a little extra time and patience.

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Tips for Helping Babies Born with Down Syndrome Sleep Better

The recommendations for helping a baby born with Down syndrome sleep better aren't really much different from helping any baby learn to sleep. The first step will be determining with a pediatrician whether sleep disturbances are being caused by sleep apnea. From there, if lack of sleep is still of concern, it's time to teach your little one how to fall asleep and stay asleep.

This is what parents of babies born with Down syndrome can do to help their baby sleep:

  • Prep your baby for bed the same way every night. This can include a bath, storytime, singing, and snuggling. When it's time for your baby to sleep, swaddle your baby or put them in a weighted sleep sack. Dim the lights and rock them until they are drowsy.
  • Create a calming sleep environment. Utilizing blackout curtains and white noise are practices that will let your baby know that it's time to sleep. If your baby wakes, these elements will signal to your baby that it is still sleeping time.
  • Put your baby down awake. This ensures that your baby will learn to fall asleep on their own. This is a difficult stage for many babies, with or without Down syndrome. As a parent this can be a tiring process, but it's the number one thing you can do to help your baby start getting the sleep they need. Once they can do this, they'll also be able to put themselves back to sleep if they wake in the middle of the night.
  • Avoid co-sleeping with your child. As tempting as it is to take your baby into your bed with you, it will only prolong their sleep issues.
  • Make sure your baby is getting plenty of activity in their waking hours. This will ensure they are ready for sleep when it is time.
  • Stay consistent! The more established the bedtime routine is, the quicker your baby with Down syndrome will learn that the expected outcome is sleep.

We also offer some extra great tips that work well for all babies in our article "Getting Your Baby to Sleep in a Crib."

Helping babies learn to sleep, including little ones with Down syndrome, is imperative for their cognitive and physical growth. Additionally, when babies sleep better, so do their parents. This makes for happier wake times where everyone is enjoying life and thriving. 

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Does it take longer for babies with Down Syndrome to fall asleep?

It's a little-known fact that babies with Down Syndrome may have trouble establishing healthy sleep patterns. Down Syndrome babies often struggle with various sleep issues, including difficulty falling asleep. In fact, according to the NIH, 76% of children with Down Syndrome experience difficulty with sleep onset, quality, and duration.

This is partially due to the physical features of children with Down Syndrome, such as narrow upper airways and large tongues. These features can cause breathing-related sleep problems like Obstructive Sleep Apnea which more than 30% of babies with Down Syndrome have.

However, these sleep issues can also be behavioral as well as physical. For some children with Down Syndrome, learning to develop healthy sleeping habits can take a bit of extra time, just like reaching any other developmental milestone.

Does sleeping get easier for babies with Down Syndrome growing up?

Overcoming sleep problems and establishing quality sleep patterns can be an ongoing issue for children with Down Syndrome. Therefore, it's essential to understand the steps you can take as parents and caregivers to help your child experience better sleep.

Studies show that even older children with Down Syndrome experience less total sleep time and spend less time in REM sleep than typically developing children. While some children may grow out of it, these sleep struggles can persist into adulthood for many.

However, taking steps to establish healthy sleep patterns and teach your baby to make positive sleep associations from an early age can help set your child up for success.

This includes things such as following a consistent bedtime routine, creating a comfortable sleep environment, and using a weighted sleep sack or swaddle to help your baby learn to self-soothe and fall asleep on their own. In addition, kids with Down Syndrome can benefit from undergoing a sleep study to evaluate the need for sleeping appliances like a CPAP machine to treat any underlying health issues.

 

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Can you sleep train babies with Down Syndrome?

Children can quickly become dependent on their caregivers for sleep onset and maintenance if they are not taught how to fall asleep independently. This is why many parents turn to sleep training programs to help their child learn how to manage their sleep regulation on their own.

While it can be tempting to rely on external methods such as nursing, bottle-feeding, or rocking to help your child fall asleep – these methods can quickly become crutches that prevent both parent and child from getting a good night's sleep.

It's vital for babies with Down Syndrome to learn how to self-soothe, fall asleep on their own, and resettle when they wake up in the middle of the night. One of the ways this can be accomplished is to make sure you are placing your child to bed while they are still awake.

Sleep training can also be carried out in babies with Down Syndrome within reason. However, you may consider modifying one of the many traditional sleep training programs, which can be pretty strict, to suit your child's unique individual needs and your family's preferences.

Can babies with Down Syndrome use a swaddle?

Swaddles, especially weighted swaddles, can help your baby fall asleep faster and stay asleep longer. In addition to aiding with quality sleep, swaddles can offer other benefits for babies with Down Syndrome. For example, babies with Down Syndrome have a greater presence of Hypotonia (or decreased muscle tone). Swaddling your baby can help with muscle tone, thus keeping your baby safe while sleeping sound.

According to the AAP, proper swaddling can help your baby sleep longer, fall asleep quicker, and get better sleep quality. With Down Syndrome infants, swaddling has the added bonus of helping keep your baby's arms and legs in the midline, which is important for their development. Swaddling your baby during the daytime hours, such as during feedings, can be beneficial as well.

Swaddling must be done correctly to promise the safety of your baby. Some swaddles are more user-friendly than others. As a tired and sleep-deprived parent, find a swaddle that's easy to use - it's a game changer. The Dreamland Baby Swaddle has a built-in swaddle band that makes swaddling a breeze for you and your baby.

 

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Can a baby with Down Syndrome use a weighted sleep sack?

A weighted sleep sack can be an even better alternative to swaddling in some instances. Some babies and toddlers don't like the extra restriction of a swaddle and actually sleep better with the freedom and range of motion afforded by a sleep sack. Sleep sacks are especially convenient for older babies and toddlers who have discovered how to break out of a swaddle.

Sleep sacks are proven to be safe and effective for children between the ages of 0-2 and are often recommended by pediatricians. Babies with Down Syndrome can safely use a sleep sack and can especially benefit from the extra touch of a weighted sleep sack to reduce anxiety.

Using a weighted sleep sack can naturally calm and soothe your baby, helping them fall asleep faster and stay asleep longer. In addition, weighted sleep sacks provide deep pressure stimulation and help regulate your baby's body temperature, improving their quality of sleep.

Do Down Syndrome babies cry more when they are tired?

As with any child, Down Syndrome babies are going to cry when they are hungry, upset, or tired. You may experience that your child with Down Syndrome is fussier than a child that does not have Down Syndrome. The fussiness could be attributed to a number of reasons, including physical discomfort, developmental delays, and behavioral issues. In addition to sleep issues, Down Syndrome babies may also experience issues with feeding, hearing or vision, and other impairments.

All of these challenges can certainly result in a fussier baby, especially when they are tired. If your baby is tired, you probably are too. As a result, they may feed on your agitation, causing them to cry even more. Raising a child with Down Syndrome requires extra patience and a lot of love. You're doing great, so hang in there. To reduce fussiness, try using a weighted sleep sack or swaddle. If you can help your baby sleep longer and better, you too can get more sleep - a win for the both of you. Another way to reduce fussiness is to help your child learn to communicate. Since development may be delayed, utilizing alternative communication methods such as sign language can help you understand what your baby needs. While parents are superheroes, they are not mind readers. They may have a sixth sense when it comes to knowing what their child needs but with babies it can be especially challenging to know what they need and want.

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