# napping ep 2 audio only

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**Craig Canapari MD:** Okay, welcome back to the latest episode of Sleep Edit, a podcast where we help tired parents and kids sleep better. I'm Dr. Craig Canapari

**Arielle Greenleaf:** And I'm Arielle Greenleaf.

**Craig Canapari MD:** And

this is part two of our napping spectacular.

**Arielle Greenleaf:** naps really are spectacular

**Craig Canapari MD:** you don't appreciate a nap as a child, but when you get one, it's a grownup. It's pretty great.

Um, uh, unless you have problems sleeping at night, then don't do that.

this is a podcast about kids, so let's talk about

kidnaps instead. And kids, at least nominally, a lot of them are supposed to be napping.

so last week we talked about, napping in general, what the science says about napping, which is limited. Trying to answer a lot of questions about napping. we have yet more questions to cover, but I thought it'd be very interesting 'cause Arielle has brought some great cases talking about [00:02:00] nap transitions, the ages they happen and how parents can manage them. I thought it'd be good to go through them because this is something that many parents struggle with.

**Arielle Greenleaf:** Yeah, absolutely.

**Craig Canapari MD:** let's start with going from three naps to two naps. if I recall correctly at the last episode, you said that generally you see this around eight or nine months though obviously it can vary.

**Arielle Greenleaf:** I would say it can happen anywhere from five to seven or eight months. It's rare for me to see. An eight or nine month old on three naps. they need longer time awake to get that sleep drive to sleep well. And so, you know, essentially what happens is that third nap starts to get edged out because it's starting way too late.

You know, it's starting at five o'clock or something like that, and then we're encroaching on bedtime. and that is one of the signs to look for when you're thinking about how do I [00:03:00] know if I'm supposed to drop the third nap? one of those telltale signs is that, your child needs more awake time before their first nap and their second nap, and you're getting to the third nap and it's uhoh, it's five o'clock, it's five 30, and your child is taking a nap until six, and then you're trying to put them to bed at seven 30 or eight.

And they're like, I'm not tired.

**Craig Canapari MD:** so this is related to the biology, right? Like a

slower accumulation of sleep drive.

**Arielle Greenleaf:** Yes.

**Craig Canapari MD:** what

parents are gonna notice specifically is that that third nap is moving later,

and how do they know if that's interfering with bedtime?

**Arielle Greenleaf:** that's a great question. I've been poking around on Reddit and some other places. I just like to see what's going on out there sleep stuff and sleep training. I actually put a poll up today in my, Instagram stories because I so many of these parents are putting their kids to bed [00:04:00] between,

Nine and 10:00 PM which to me is I'm talking about babies, infants, young toddlers, I just can't fathom having a baby or a young toddler awake that late. and the evidence does show that bedtimes before 9:00 PM are more beneficial to young children, up until a certain age.

I don't know which age that is, but I think it's for quite some time, into Young school age.

**Craig Canapari MD:** I feel like this is in really young kids. And we've all seen the families, their kids are taking four or five naps a day. And

like I'm talking about infants, like two or three month olds and they're going to sleep at 10 o'clock at night. if it works for you, I guess it's okay for a short period of time, but it's probably not working that great.

'cause it's gonna be shortchanging your baby's sleep at night, in your sleep at night.

**Arielle Greenleaf:** Yes.

**Craig Canapari MD:** Let's talk a little bit about the two to three NAP transition.

we've talked about this, you said this is almost always done by eight or nine months of

age, but typically you see it between five to seven [00:05:00] months. How is a parent gonna know that it's maybe worth thinking about getting rid of a nap and which nap should go first?

**Arielle Greenleaf:** Well, it's interesting because I think it all comes back down to how much sleep does your child need in a 24 hour period. Because if your five month old, is lower on sleep needs, then they're going to need more time awake during the day. if your baby only needs 12 hours of sleep in a 24 hour period, that means they need 12 hours of awake time, those quote unquote wake windows are gonna be much longer than a baby that needs 16 hours of sleep in a 24 hour period, which leaves eight hours of awake time. It's very rare for me to see a child that only needs 12 hours of sleep at five months. what I will say is that there are children where you know that they need more awake, they need more stimulation, they need to be awake, they need to be active, for two or three hours before they can take their first nap.

If they're sleeping till seven, that puts you at 10:00 AM [00:06:00] And let's say we determine, you know, they, we need to cap sleep at maybe two and a half hours during the day. what's happening is 10 to 11:00 AM they're sleeping that first nap and then they need until 2:00 PM to get. To the second nap, and the second nap is two to three, if they need, another two or two and a half hours of awake time, that's putting you at five or 5:30 PM which then encroaches on bedtime.

In my opinion, I recommend ending naps for young infants. by 5:00 PM as they get closer to age one, I sometimes back that up to 4:00 PM because otherwise an 11 month old who's lower in sleep needs and needs more awake time, that can sometimes mean that everything is pushed out like bedtime in general I end naps by 5:00 PM for infants, and then older infants can sometimes be like, four o'clock. It just depends on how much their total sleep is. So once we [00:07:00] determine that total sleep that they need, that helps us sort of create that schedule for them, right?

I have two five month olds right now, and they both get 13 and a half hours of sleep in a 24 hour period. Sure. There's some nights or days where it's 14 hours, there are some days where it's 12 and a half hours. it's going to vary, but when we average it out over seven, 14 days, we see that 13 and a half hours is what they're giving us.

So how do we look at that? Well, we see, are they sleeping? Some children will sleep only 10 hours overnight, or they'll sleep only 11 hours overnight. So then you know how to break up the daytime sleep.

**Craig Canapari MD:** let's make this very concrete. So you have two patients Let's

say they're five months old,

they sleep 14 hours, in a 24 hour period. if you are trying to figure out the ideal placement of these naps, and when they might be going from three naps to two naps,

**Arielle Greenleaf:** So what happens is when those naps start to consolidate, the first two naps, when those first two [00:08:00] naps start to consolidate, they're being woken up from the first nap or the second nap, or both to get in that third nap.

**Craig Canapari MD:** Can we just define, consolidate?

**Arielle Greenleaf:** Sure, I'm sorry. Consolidate. Meaning that they're getting more than one sleep cycle, for their nap.

So pushing it beyond that 30 to 45 minute nap and they're sleeping, an hour, an hour and a half, in conjunction with needing longer awake time. I think it all comes back to that third nap, starting too late and then having difficulty putting the child to bed at, say, seven 30 or 8:00 PM They don't, they're not tired enough because that third nap is pushing beyond 5:00 PM or 5:30 PM and then bedtime is pushing later.

And parents are like, I would really like them to go to sleep earlier because we have to be up for the day at 6:00 AM to get ready for daycare. we have to be looking at when is this child waking in the morning and then how much are they getting overnight if that makes sense.

**Craig Canapari MD:** [00:09:00] with a 14 hour sleep requirement, we had talked previously how you felt like for a lot of kids, even young kids, 10 hours at night is pretty good, and then you apportion the rest of the sleep during the day.

**Arielle Greenleaf:** Yeah.

**Craig Canapari MD:** so if this child was sleeping from 8:00 PM to 6:00 AM

that would work well for a lot of families who have either a single parent or two parents who work outside the home

because it gives them time to get ready in the morning.

they're on a three nap schedule that might look like, one hour and 15 minute, one hour and 20 minute naps three times a day, which seems almost too good to be true, right?

**Arielle Greenleaf:** in general, the third nap is dropped very early on in their lives, right? the third nap is usually just there to get you through to bedtime, and it's generally one sleep cycle. usually only 30 to 45 minutes. So I plan on. The first two naps being longer. Now those are the naps that are gonna be there for a while until they drop to one nap.

focusing on those naps and making sure they're [00:10:00] really getting more than a sleep cycle for those two naps is my main focus. a 30 45 minute cat nap is fine. I have two five month olds right now, and that third nap is very difficult to get because they're sleeping well for their first two naps it's a little too early for bedtime, so sometimes we have to give 'em a little extra support to get that third nap in.

Right now, they're too young to go from waking up from that second nap at say, two o'clock until 7:00 PM bedtime. So the third nap acts as a sort of bridge to get us through to bedtime.

**Craig Canapari MD:** extra support means maybe rocking them to sleep, nursing them to sleep,

**Arielle Greenleaf:** Stroller, you know, anything like that. I would try to avoid, nursing to sleep especially if a child has a nurse to sleep association and that's what we're working on, I try to avoid that. But any sort of a little extra, you know, do they fall asleep in the car? Do they fall asleep in the stroller?

do they sleep in the carrier? You know, put them in the carrier and walk around your house and do some chores or something. [00:11:00] just to give them a little more help, because that one is a little trickier to achieve. So, with this scenario that you're giving me, what I would do is say, if we're looking at, so the two that I have right now, it's 13 and a half hours is what they're getting.

So since it's fresh in my mind, I'm gonna tell you what that looks like. I'm capping both of the naps at an hour and 15 minutes. The first two naps that puts us at two and a half hours. the last nap is, 30, 40 minutes, whatever.

it's roughly around three hours of daytime sleep. And 10 and a half hours of overnight sleep. I focus a lot less on, you know, you're talking about that sounds too good to be true. Sometimes it is. So say the baby takes a 50 minute nap. The first nap we can allow for more sleep.

And that second nap, because they haven't slept an hour and 15 minutes, we're looking at their sleep bank. They have say, three [00:12:00] hours of sleep during the day, three hours of nap time. if they're only sleeping 50 minutes for their

first nap, we can allow a little more sleep. To pull from that sleep bank for that second nap, let it go a little bit longer, if they will, and then, move on to that third nap.

**Craig Canapari MD:** So you mean 50,

**Arielle Greenleaf:** Yes.

**Craig Canapari MD:** So just to summarize, in this example with the 13 and a half hours of sleep, children are sleeping 10 and a half hours a night, three hours of sleep during the day. You look at the first nap, judging that, ideally you're gonna wake that kid up after an hour and 15 minutes. If they wake up earlier, you allow them to nap longer for the second nap

**Arielle Greenleaf:** Mm-hmm.

**Craig Canapari MD:** The third nap is the one where you're like, I have a fussy. six month old, it's dinner time. I can't have this kid go to bed now 'cause they'll be up at four in the morning.

**Arielle Greenleaf:** Hmm.

**Craig Canapari MD:** So, you know, it's not dinner time, it's three or four in the afternoon. gonna rock them until they fall asleep, put them down, try to get in 20 or 30 minutes as a bridge to bedtime

**Arielle Greenleaf:** [00:13:00] Correct.

**Craig Canapari MD:** and eventually that becomes just impossible. Or if it happens, bedtime gets a lot harder. So that's the time for that three to two nap transition.

**Arielle Greenleaf:** Yes,

**Craig Canapari MD:** So what that is gonna look like then is that the kids may, hopefully they're gonna start having longer naps earlier in the day. and we might have to move bedtime earlier, right?

**Arielle Greenleaf:** We also have to pay attention to how long that child can stay awake for. Because sometimes when you're moving to that second, you know, three to two naps, you have to shift that schedule. you can't suddenly make a child sleep 12 hours overnight. If they're only sleeping 10 and a half.

Some babies will make up lost sleep overnight. Others are just gonna sleep 10 and a half hours overnight, no matter when you put them down. for those babies that can make up lost sleep during the day, you can get them down early for, you know, 5:30 PM bedtime and they're up at seven.

but for others you put 'em down at five 30 and their night is horrible. They think it's a nap and then they wake up at seven or they're awake at nine and they want to be awake [00:14:00] for an hour and it just screws things up. So you wanna make sure that the baby is also able to handle longer awake times, the three to two nap transition, they still need the same amount of sleep. So now you're putting that 30 minute, 45 minute nap into dispersing that into those other naps, appropriately. some babies will say, I only want an hour nap in the morning, but I wanna take a two hour nap in the afternoon, Capping it at three hours. Planning for that 10 and a half hours is important, but also making sure that you're dispersing that 10 and a half hours of awake time between three wake windows

So those are gonna have to get longer. They're gonna have to stay awake longer and not freak out or start falling asleep before their next sleep time, if that makes sense.

**Craig Canapari MD:** So what I'm hearing is that three to two nap transition is tricky. There's a lot of moving pieces, because often those kids, if they're finishing their second nap at like two in the afternoon, they can't go for five hours.

**Arielle Greenleaf:** Correct.

**Craig Canapari MD:** the thing I've always noticed with nap [00:15:00] transitions in general is there's always a kind of rocky transition period. It's not where kids just raise their hand and be like, okay, I'm just gonna stop napping now. It's gonna be great. it's usually entails some period of time where you're gonna be dealing with irritability if you're trying to get to bedtime. and that's okay.

**Arielle Greenleaf:** Yeah. the longer I do this, the longer my tooth gets. I will say when they're ready, it's a lot easier than when they're not ready. So, for instance, if daycare is trying to force a transition, And they're not ready. That can be a lot more difficult than if, naturally they're able to stay awake longer and their naps are getting longer.

that is much easier than if it's , being forced a little bit. And sometimes we get into situations where it's just a nap strike situation, but that's usually with a two to one transition. We're not there yet.

**Craig Canapari MD:** parents are gonna need to be attentive

and see, well, my baby can be awake [00:16:00] longer and I can't just put them down I'm gonna need to move things a little bit later and stretch that out to preserve the quality of that nap. this is really hard for people

**Arielle Greenleaf:** it's very hard. It's very, very hard I've been doing this for so long that I can see the signs, but I absolutely understand why people don't know what to do. why is my baby not falling asleep when they used to? Why is my baby taking a 30 minute nap when they used to sleep two hours?

it's confusing. And then you go online and see these arbitrary wake windows, and that's even more confusing.

**Craig Canapari MD:** Yeah, it's, very confusing for people. so let's go to a nap two to one NAP transition, which, at least according to our show notes, it's easier. So tell me about this. And we actually have a,

**Arielle Greenleaf:** Did I say it's easier?

**Craig Canapari MD:** you said it's easier to spot,

**Arielle Greenleaf:** Oh yeah. Okay. I was gonna say the actual transition is not always easier. Um. Yeah, I would say it's easier to spot.

**Craig Canapari MD:** So, the two to [00:17:00] one NAP transition easier to spot, can be difficult to deal with. What age do you usually see this?

**Arielle Greenleaf:** Great question. when they're ready is usually 13 months to 16 months. There are outliers always, but that's usually where I'm seeing it. And I would say 16 or 17 months is on the late end. when babies or young toddlers are going through anything developmental, their sleep can be disrupted. there's something that goes on in the 11th month. Not for all children, but enough that I can say there is an up strike in the 11th month for many, almost toddlers.

And I think it probably coincides with, cognitive developments. There's a lot going on. They're, pre-verbal, but they're getting ready for language. if they're not already walking, they're getting ready to walk. They're, running, climbing, all this stuff is going on, and they tend to [00:18:00] have nap strikes, and it's usually only one nap.

a lot of times it's the afternoon nap, which is awful because they're taking their morning nap and then they're. A mess in the afternoon. they've woken up from their morning nap at, 10 30 or 11 and then it's 7:30 PM bedtime and they're just melting down. So then parents think, oh gosh, well I should transition to one nap.

But then it may go well for a little bit, but then it doesn't. I've actually seen people go back and bring back the second nap because they're just not ready to be awake for that long. I think it's important from the two to one transition, we were talking about this with three to two, it's important to think about the fact that your child only has two windows of wake time.

if they're not able to stay awake for four or five hours at a time, they're not ready to transition to one nap

**Craig Canapari MD:** that's a really good rule of thumb.

**Arielle Greenleaf:** If your child is not able to stay awake for four to five hours between sleeps, [00:19:00] they are not ready to transition to one nap.

**Craig Canapari MD:** Yeah. perfect. I think that's very insightful. I can tell you for a lot of time it's walking. My brother was complaining to me that his baby a little bit of a late walker, was 14 or 15 months, was making strides towards walking. He's like, naps are really chaotic. I'm like, What should I do? I was like, send me some sleep diaries, but you can also just wait a week and.

**Arielle Greenleaf:** Yeah. I see a lot. other milestones that affect naps are crawling. Crawling is a massive one, one of my current clients, when we first started, I didn't know if the child had something like if they were ill because they just woke up every 20 minutes, 15 minutes, they'd sleep for half an hour, then they'd wake up for five minutes and I was just perplexed and I sent her to the doctor.

I had the ears checked, everything was fine. And then lo and behold, the next morning, after the third night of mayhem she said, [00:20:00] guess what he did this morning? He rolled over. And from that point forward, we got longer stretches of sleep.

it's wild how much those milestones can affect certain kids.

**Craig Canapari MD:** Sure. did you wanna talk about this case of Drew We have a 13 month old.

**Arielle Greenleaf:** so mom had reached out to me and she was a client that I worked with Drew, I think originally at like nine months or something. And we got him sleeping well and worked on Big Brother. after we got Drew sleeping, we got big brother sleeping mom came to me at around like barely 13 months and was like, I don't know what's going on.

He's waking up super early, he's taking super short naps. is it time for the transition? I told her to wait a little bit. For that reason, I felt he was a little bit young. Let's see. You know, let's try to adjust the schedule a little bit. Let's cap that first nap to see if it helps get a longer second nap.

we tried that. It worked for like [00:21:00] a day or two, and then he was back to a super short second nap or skipping the nap. he was awake from waking up at 10 30 or 11 and trying to get him to 7, 7 30. Bedtime was a nightmare.

She came back to me about two weeks later and it had gotten worse. ultimately we made the determination, let's try this. He had skipped his nap enough and it was affecting overnights enough that I felt comfortable trying it.

**Craig Canapari MD:** and what was happening was he was skipping naps and the

**Arielle Greenleaf:** It was unpredictable. and so I said, all right, let's give this a shot. So when I start the transition to one nap, I generally like to start.

I don't wanna push their first wake window too far because a lot of times if we push six hours on the first day, they are not ha, they can barely make it. They're falling asleep eating lunch. then they take a short nap because they're not used to being awake for that long.

So I try to make that a shorter wake time [00:22:00] before the first nap. So I can start the first nap as early as 10 30 or 11:00 AM for the first few days. And what I do is I give that a shot and as they adjust and start taking ideally an hour and a half or more. I slowly push them forward. Usually if you're at daycare or preschool, naps start between 12 and one. So my goal for all children that I work with is to get them starting a nap between 12 and one, but it might take us.

**Craig Canapari MD:** after lunch.

**Arielle Greenleaf:** after lunch, it can take us a few weeks to get there. I might start at 10 30, then go to 10 45, then to 11. it can be a two week process moving forward incrementally by 15 minutes. in some cases I'll push them 15 minutes or even 10 minutes, and suddenly the nap falls apart.

So we pull them back again to that earlier time. The nap is longer, and then in a few more days, we push it forward again and things improve. During this time though, it's important to remember that they're getting used to [00:23:00] longer times awake.

normal bedtime may need to be brought earlier by 30 to 60 minutes, depending on your child. some children do well with early bedtimes and they'll make up for sleep that they, may have missed during the day overnight. Others, you have to put them down close enough to their bedtime, otherwise it just leads to a bad night.

So I do recommend backing up bedtime at least initially as they adjust, because they can get tired in the afternoon. Not having that second nap.

**Craig Canapari MD:** so in a nutshell, you have a kid who's taking two naps. The naps get kind of crappy. the nighttime sleep gets pushed later, and then your process is. Going to one nap offering it a little bit later than you would when there's someone's taking two naps, but

not that much later.

**Arielle Greenleaf:** Correct. And I think also paying attention to when they wake in the morning. So if you're working with a baby that wakes up at five 30. you're probably gonna start with that 10 [00:24:00] 30 nap. If I'm working with a baby or a toddler that's waking at seven, I might push it to 11 or 1130 because they're waking up later in the day.

I'm getting to like, four or five hours there before offering the nap. But that will vary based on each child's wake up time.

**Craig Canapari MD:** Yeah, just listening to this and thinking about the struggles that we had. the challenge is there's a lot of moving pieces, right? the children are, becoming able to stay awake longer. there's the overlay of developmental milestones, which tends to mess everything up. They may be getting colds, there may be other things going on in the house. it seems like the key to success is tracking sleep. I see, some people use the Huckleberry app. I don't know if there's other apps that you like for this. People can do this on paper as well.

**Arielle Greenleaf:** Yeah, I do like Huckleberry, for their data. there are some other apps, they're kind of cumbersome and clunky. I actually prefer the spreadsheet that shows me [00:25:00] tons of things, a lot of times I always have a parent tell me. I don't get this information from the Huckleberry app, but I'll tell parents, tell me when you put the child down to sleep, but then tell me when they fell asleep.

Like how long is it taking them to fall asleep? Because if it's taking, 30 minutes, we might have our timing off We might need to push them forward a bit to avoid either crying or fussing. So that is kind of critical information

**Craig Canapari MD:** How,

**Arielle Greenleaf:** But yeah, the huckleberry is a great place to start because it does give you averages.

if you log for seven days, you can look at the graphs and it will give you the average amount of time your baby is sleeping for naps, the average amount of time they're sleeping overnight, and their average 24 hour sleep. it's helpful, useful information in trying to decide what might work well for your baby's or toddler's schedule.

**Craig Canapari MD:** how do you find the data produced by Smart Monitors for

work like this?

**Arielle Greenleaf:** I don't [00:26:00] like them.

**Craig Canapari MD:** I don't,

**Arielle Greenleaf:** the problem, the

**Craig Canapari MD:** wanna edit, make this a big editorial.

**Arielle Greenleaf:** The reason why I don't care for that. Information is because a lot of times it will mark a baby or toddler as awake when they're simply moving in their sleep. so it will say, oh, your baby has been awake for, two minutes and they're really just turning around.

But then they count that as a wake up. So it'll be like, your baby woke up 13 times last night when really your baby is just shifting overnight. so that's why I don't find it very helpful. it gives a lot of parents anxiety. It makes them think that their sleep quality isn't good when it's actually just normal sleep.

**Craig Canapari MD:** I suspect the issue is that, you know, , like we're talking about Nanit, the audio video somnography is pretty well validated compared with. Gold standard technology like an EEG. But the fact is that short awakenings where your child is not crying are totally [00:27:00] fine.

in some ways, I prefer the parent data because it's actually the important data, if your child wakes for 15 minutes of the night and they don't cry, that's fine.

**Arielle Greenleaf:** There you go.

**Craig Canapari MD:** the parent data of when the parents perceive difficulty and when they perceive their child to sleep, is actually good enough.

Because who are our, I don't like the word customers or clients. Or patients. it's the children. It's their parents too. if we can make everybody sleep better and the parents are happy with where they're at, that's what matters to me. And not how many random arousals a piece of technology said they had at night.

random arousals happen every.

**Arielle Greenleaf:** Those parental observations are so important to my work because they help me determine. of course I'm looking at it as a math problem. 13 and a half hours of sleep, 10 and a half hours of a wake. Let's try two and a half hour, whatever. but you know, saying, yeah, [00:28:00] I put them down after two and a half hours, but then it took them 30 minutes of screaming or I had to go in there several times.

I'm like, okay, well this should make sense mathematically, but your baby's not a robot, so let's try a little bit later next time and see if it helps eliminate that crying actually happened with one of these five and a half month olds. He was not falling asleep well, at bedtime. He was doing fine for his naps, but bedtime was still a struggle.

It was 30 minutes here, 45 minutes there, and then he would fall asleep. I just said, I think we need to. Put him to bed a little bit later and she was, reporting that.

**Craig Canapari MD:** Yeah,

**Arielle Greenleaf:** pure data.

**Craig Canapari MD:** I mean when we use actigraphy, which is a research technology for measuring sleep, we still need sleep diaries, right? Like, 'cause we need to know if a child falls asleep at midnight, if you put them to sleep at 1159 versus 6:00 PM those mean very different things

and the machine data does not tell us that.

so let's talk about the dreaded NAP transition. [00:29:00] End of napping. let me just say, with my kids, we had a month where our kids at the same time, they're three years apart. it was one the best months of my life was amazing

I could chill, I could nap, I could play video games, whatever during time. And then that was end of it. And then I remember the youngest one gave up his nap when we, decided it was time to be done with this pacifier.

**Arielle Greenleaf:** Mm-hmm.

**Craig Canapari MD:** your permanent teeth start to come in, that's really when you gotta get rid of it.

So we did the whole pacifier, binky fairy thing

where the fairy comes, you get a gift and it goes to the other kids. the trade off was, he's like, well, this is great. But he just stopped

afterwards.

**Arielle Greenleaf:** He is like, cool, but I'm done.

**Craig Canapari MD:** the Binkie Ferry also took his nap away too.

**Arielle Greenleaf:** Oh, that's that. she got her signals crossed.

**Craig Canapari MD:** Yeah, I guess it's part of the, you know, when you're dealing with these supernatural entities, there's a

cost to be paid.

**Arielle Greenleaf:** There really is. I always say, don't talk about if your sleep is going well, 'cause you're gonna have to sacrifice something to the [00:30:00] sleep gods for a first rule of sleep club. Don't talk about sleep club.

**Craig Canapari MD:** exactly. let's talk about this transition,

I have more of a brute force approach. when I see kids coming in terrible insomnia. They're staying up super late. I see this in teenagers, in four year olds.

Sometimes in two and a half year olds. The parents will say, they don't fall asleep till 10 o'clock no matter what we do. even when the sleep hygiene's on point, I'm like, what's happening with the napping? they're taking a four hour nap during the day. I would say that, the typical age range for this transition around three. Sometimes it can be a little bit earlier for other kids, it can be closer to kindergarten.

the biggest sign that this transition is ready is either if there's a big fighting at nap or all of a sudden your kid is staying up a lot later than you expect.

the classic way is this, they're napping at daycare. They

can't fall asleep till 10 o'clock. They don't nap on the weekends for mom and dad and they fall asleep easily at seven or eight. those are the classic presentations of a child that's ready to give up a nap.

**Arielle Greenleaf:** I see that last [00:31:00] situation so much, and it just breaks my heart to see these children who fall asleep at school and then it's like a disaster at night. And then of course, they're tired for a nap the next day because they can't fall asleep because they've taken a nap. So it's like this crazy cycle.

in that scenario, if you have a child that's at daycare or preschool, and this is happening, sometimes it really causes some serious issues with behavior. and sometimes health. if the nap is out of your control and they're in the care of someone else and the other person is saying, well, I'm not gonna keep them awake.

Get your pediatrician involved. they will write a note on behalf of your family saying, you know, when this child naps, it's disrupting their important nighttime sleep. sometimes people push back but

I would say the majority of times that has happened, they will work with the parent to create a nap bag or something where you bring it [00:32:00] in and it's quiet activities that the child can play and do, while others are napping. your child isn't the only one in this situation.

that's a complicated situation, but that is one workaround that I have used in more serious cases.

**Craig Canapari MD:** Yeah, I've had my notes disregarded by daycares.

**Arielle Greenleaf:** sure,

**Craig Canapari MD:** I had one patient in New York City who was, fired from his daycare 'cause he didn't need to nap anymore. what can parents control and what can't they control generally if a child is in

**Arielle Greenleaf:** Is in daycare. I think this is probably the harder one, honestly, When it comes to naps and daycare, the two bigger issues that I see are pushing a child to one nap before they're ready and pushing a child to nap when they need to give up the nap. the first one is a little more controllable because

if the child is on one nap and the nap is short, they [00:33:00] can at least get home and put the child to bed earlier

Make sure they're fed, but don't prolong the bedtime routine and try to get them down sooner. that can often help on the days that they're home, continue to offer the two naps. You can always try talking to the daycare the teacher, the director, in that situation.

But in many cases, they just don't have the room to keep your child in an infant room, which is, generally a two nap situation. in the other scenario, it's really tricky. I think that, one possible, negotiation with the daycare could be,

Can we limit the nap to 30 minutes or an hour? if that doesn't happen, I think you just have to change your expectations, unfortunately. Not expect your child to fall asleep at the time. They, they used to because it's not that they're, they, and they might tantrum when you're trying to put them to bed.

It's not their fault. They cannot biologically fall asleep because the sleep pressure has been relieved during the [00:34:00] day and they just can't fall asleep until whatever time, 10 o'clock, for instance. they're kind of not great options either way, but that's sort of what we can control in those situations.

**Craig Canapari MD:** Yeah, it can be real. Challenging. 'cause it's hard to find good childcare.

**Arielle Greenleaf:** Can we just go back to the one to zero transition? I don't feel like I really gave clear advice on what to be looking for. let's say the child is like almost two and a half, or just barely two and a half.

I don't like to rush to drop a nap, but a lot of times I will look at the sleep diaries and the 24 hour sleep. I always start with capping a nap. If they say the nap is two hours I'll say, let's start by backing it up. let's see if capping it at an hour and a half or one hour makes any difference at bedtime.

Usually there's a bedtime fight because the child is not tired enough to fall asleep at night. It can also cause overnight wakings, prolonged overnight wakings, and early rising [00:35:00] because their sleep is shifting and any daytime sleep can disrupt their nighttime sleep.

so when that's happening and the child is two and a half or older, I'm looking at how long is the nap? Let's see if we can cap the nap even sometimes 30 minutes. if the child, there are children who cannot sleep during the day or nighttime is a mess, bedtime's a battle, it's taking hours.

or the night is shortened 'cause they wake up early in the morning, those are really the things that I'm looking for. if they're three and a half or younger, I won't rush to drop the nap. after that. It's almost always appropriate to drop the nap.

**Craig Canapari MD:** I think you are a nice formulation here. Maybe we could close with this is, well, do you wanna talk about nap strikes versus, which again, is not that precise a term versus a nap transition.

I feel like in my world, nap strikes aren't well defined, but I would say it's like, yeah, if your kids clearly not in the range where they should be dropping a nap, but [00:36:00] they're skipping a nap for some reason. it's usually not every day. some days it's not

other days. you know, I think that sometimes this often has to do with, it could have to do with changes in sleep schedule or something else going on with your kid.

**Arielle Greenleaf:** Yeah. And I would say too, a nap is suddenly 30 minutes, I wouldn't rush to change the timing just yet. But if it's been going on for a little bit, you might try putting them down 30 minutes later and seeing if that makes a difference and lengthens whichever nap that is.

but if those things don't change anything, then you're probably looking at, your child is probably ready to drop

**Craig Canapari MD:** So you have a great list here

the signs that a kid is ready to transition for a nap,

**Arielle Greenleaf:** sure.

**Craig Canapari MD:** yeah. I mean, it's taken them a long time to fall asleep at

night

**Arielle Greenleaf:** at least one nap is consistently shorter, under an hour, consistently, defined as, one to two weeks, another one to look out for is sudden middle of the night wakings. that's a tricky [00:37:00] one because sometimes that can be illness.

so you wanna make sure to exhaust all the other areas there before rushing to make. Just because your child's waking overnight doesn't mean it's time to drop the nap. It's one of the things that can happen and be looking for if things are getting funky with naps.

**Craig Canapari MD:** Brett Kuhn, who's a sleep psychologist calls this too much time in bed syndrome.

**Arielle Greenleaf:** Yeah,

**Craig Canapari MD:** and for older kids, they may not even cry or be irritable during this time. They might just be awake

in their room. Now, younger kids certainly may cry. developmentally, they just may not be wanna be alone, but like, especially if you hear your baby quietly playing in their crib for an extended period of night, it's not worrisome,

But it is a sign that maybe they're getting too much sleep during the day.

**Arielle Greenleaf:** Yeah, something might be off scheduling wise. that being said, during milestones, sometimes babies will practice crawling in their crib or toddlers will practice standing in their crib. And so you wanna make sure that it's not [00:38:00] like just they're learning something new. And I know that's really hard, like they can't talk to us and tell us, but that's why I say give it a week or two and just see if things improve versus just a couple nights in a row, which is annoying, but it might pass,

**Craig Canapari MD:** Yeah. And I would say don't panic with one or two days of anything.

but more consistent things than make one change at a time.

Move one thing later, earlier,

**Arielle Greenleaf:** Yeah,

**Craig Canapari MD:** don't try to fix it all,

**Arielle Greenleaf:** yeah,

**Craig Canapari MD:** because then you don't, if it gets worse or it gets better, you don't even know what worked.

**Arielle Greenleaf:** yeah. And I would also say that a lot of times just one change will make a difference. So, you know, pushing a nap later or capping a nap or something like that can make all the difference. ensuring that it's really time to do something is one thing. And then, you know, trying some things but don't try too many things.

**Craig Canapari MD:** in a nutshell, parents are having trouble with a kid falling asleep for a nap, [00:39:00] or the naps are short. moving that nap a little bit later is a good thing to do.

if bedtime is difficult, capping that last nap of the day is probably all you wanna do.

**Arielle Greenleaf:** Or capping total daytime sleep.

**Craig Canapari MD:** and yeah, just to underline, tracking your baby's sleep over time.

I know one other thing you had on your list was early morning awakenings and you're like,

you won't necessarily draw a line from too much napping during the day to early morning awakenings unless you're actually tracking it and be like, wow, my kid who sleeps 14 hours is sleeping seven hours during the day

**Arielle Greenleaf:** Yeah,

**Craig Canapari MD:** the math is that you're getting seven hours a night and your kid's up at three or four in the

I think this is good.

That's all I got

**Arielle Greenleaf:** I want to give very clear steps on 24 hour sleep. Because honestly, aside from learning to fall asleep independently, the schedule is such a big part of it that I want.

Parents to understand that you don't even have to worry about the wake [00:40:00] windows you find out there. Just log your own child's sleep.

**Craig Canapari MD:** That's how you generate the Greenleaf windows,

**Arielle Greenleaf:** Yeah, I like that. The Greenleaf windows. Oh, I should, you know, trademark that.

**Craig Canapari MD:** Yeah, why not? I mean, everybody else is doing it.

**Arielle Greenleaf:** right?

**Craig Canapari MD:** Love it. this is good.

Thanks so much for listening to the Sleep edit. You can find transcripts at the web address Sleeped show. You can also find video of the episodes at that address as well as in my YouTube channel. You can find me at Dr. Craig canna perry.com and on all social media at D-R-C-A-N-A-P-A-R-I. You can find Ariel at Instagram at Ariel Greenleaf.

That's A-R-I-E-L-L-E-G-R-E-E-N-L. If you like the flavor of the advice here. Please check out my book. [00:41:00] It's Never Too Late to Sleep. Train the Low Stress Way to high Quality Sleep for babies, kids, and parents. It's available wherever fine books are sold. If you found this useful, please subscribe at Spotify or Apple Podcast and share it with your friends.

It really helps as we're trying to get the show off the ground. Thanks.