Four-Month Regression!

As a sleep consultant, I often hear the term 'regression' used in relation to almost every imaginable circumstance. Essentially, if a baby doesn't sleep well for a few nights, parents start mentioning the 'R' word. Some people subscribe to the idea of an 8-month regression, a 9-month regression, a 1-year regression, as well as teething regressions, growth spurts, and so on. Others see them as simple setbacks caused by mitigating circumstances. But regarding the four-month regression, everyone agrees, and for a good reason. It's real and permanent!

To understand what's happening to your baby during this phase, you first need to know a few things about sleep in general. So, here's the scientific reason, explained in layman's terms.

Many of us just think of sleep as a situation of 'on' or 'off.' Either you're asleep, or you're not. But sleep actually has several different phases, and these make up the 'sleep cycle,' which we go through several times a night.

Phase 1 (Drowsiness) is that initial stage we all know, where we feel a bit adrift but don't really feel like we're asleep. It lasts about 5 minutes, eyes move slowly, breathing slows down, and muscle activity decreases. It's a stage where we wake up easily.

Phase 2 (Light Sleep) is considered the first phase of 'true sleep.' This is the phase where eye movements stop, heart rate slows down, and body temperature decreases. It's a phase where the body is relaxed, but the mind is still alert, making it easy to wake up with some noise or movement.

Phase 3 is deep and regenerative (Deep Sleep). This is the phase where muscles completely relax, and the body becomes less sensitive to external stimuli like movements and noises, making it difficult to wake up. In this phase, the mind is shut off, and there are no dreams. This phase is crucial for the repair of the immune system, muscle tissues, energy reserves, and, in the case of children, for growth and development stages.

Phase 4 is REM sleep (Rapid Eye Movement). This is the last phase of the sleep cycle and lasts about 10 minutes. It typically begins 90 minutes after falling asleep. In this phase, eyes move very rapidly, heart rate increases, and dreams occur. This is where the brain starts consolidating information and memories from the previous day. It's also in this phase that sleepwalking can occur, where a person may get up and walk around the house without fully waking up. The REM phase becomes longer with each sleep cycle, potentially reaching 20 to 30 minutes in duration.

After going through all the phases, we either wake up or are almost awake, and then the cycle starts again until the alarm goes off.

So, what does this have to do with the dreaded regression we were originally talking about?

Well, newborns have only 2 sleep phases: Phase 3 and REM, and they spend about half of their sleep in each phase. But around the third or fourth month, there's a sleep reorganization as they transition to a 4-phase sleep cycle, which they will have for the rest of their lives.

When this change happens, the baby goes from 50% to 25% REM sleep to make room for the two new initial phases. So, while REM sleep is light, it's not as light as these 2 new phases they are getting used to. Spending more time in lighter sleep naturally increases the chances of the baby waking up. This doesn't mean we want to prevent or avoid the baby from waking up. Waking up is entirely natural, and even as adults, we continue to wake up three, four, five times a night.

As adults, however, when we wake up at night, we can recognize that it's still night, that 'there are no monsters in our bed,' and we go back to sleep.

"Usually, we do it so quickly that the next morning, we don't even remember waking up. For a four-month-old baby, of course, these critical thinking skills are lacking. For a baby of this age who fell asleep in their mother's arms, the reasoning would be much more like: 'OK, the last thing I remember is a familiar face, I was nursing, and someone was singing me a soothing song. Now I'm alone in this dark room, there's no food, and there are probably at least three, possibly four, scary monsters nearby.'

This is probably an exaggeration, but who knows what's going on in the mind of a four-month-old? Anyway, now that the baby has suddenly realized that mom is not around, and isn't absolutely sure where they are, the most natural reaction is to get scared.

Like an adult, when the baby gets scared, they instinctively go into a kind of 'fight or flight' state and won't go back to sleep without a significant assurance that everything is okay.

The other big cause of this regression is that up to this point, parents could put their baby to sleep with a pacifier, rocking them, nursing, or some other similar technique where the baby was assisted in falling asleep.

Now that the baby is spending more time in light sleep and is, therefore, more likely to wake up, this suddenly becomes a much bigger problem. These 'crutches' or sleep associations can become real traps because although they might be helpful to assist your little one in the initial falling asleep phase, the lack of them when they wake up will only make them unable to go back to sleep without some external help. Sleep struggles, crying, increased adrenaline... When this starts happening every half an hour, it becomes a real nightmare for parents.

The good news for anyone going through the dreaded Four-Month Sleep Regression is that this is not actually a regression. A regression is defined as a 'reversion to a previous mental or behavioral level,' and that is indeed the opposite of what your baby is experiencing. It would be much more appropriate to call it the 'Four-Month Sleep Progression.'

So, let's tackle the big question. What can you do to help your baby adapt?

Firstly, make sure the room is completely dark. You might eventually think that the baby's room is already dark enough or that they may not like complete darkness, finding some light from the windows or the hallway comforting. Definitely not! The baby's room should be pitch black. I'm talking about a coal mine on a moonless night! If necessary, put towels or sheets on the windows to block the slightest hint of light. Newborns and babies are not afraid of the dark. They are, however, sensitive to light. Light signals their brains that it's time for activity and alertness, and the brain secretes the stress hormone (cortisol), so we want to keep the bedroom absolutely dark during the night and naps.

The other nemesis of daytime (and nighttime, although not as often) sleep is noise, whether it's the doorbell, the dog barking, or something falling in the next room. With the baby spending more time in lighter sleep, noises easily startle them and wake them up, so a white noise machine might be a good option to 'drown out' all those noises.

"But isn't that a sleep crutch?" you ask. Well, in a way, it is, but it doesn't require any resetting, reinsertion, or parental presence. It's just there and can be on while the baby is sleeping, so it's not a 'crutch' we need to avoid.

Another crucial component for your baby to sleep well is the implementation of routines that are entirely predictable, relatively short (no more than 4 or 5 steps), and ideally unchanged. This step provides security for the baby and ends up working as a 'trigger,' as if sending a signal to the baby that it's time to go to sleep. The last step of the routine should never be the meal (breast milk or infant formula). Otherwise, you risk the baby falling asleep at the breast or bottle, creating a new sleep association - the association of feeding with sleep!

On the other hand, these routines will only work if the baby doesn't fall asleep during them. Remember that the goal of the routine is not to put the baby to sleep but to give them signals that bedtime is approaching.

Finally, but not least, don't wait for your baby to reach the peak of tiredness to put them to bed. This is a very common mistake! When the baby is in a good mood, parents tend to wait for them to show some signs of tiredness, and only then do they start thinking about putting them to bed. The problem is that the baby often goes to bed extremely tired. When babies exceed their 'window of opportunity,' they enter extreme tiredness, which increases stress levels and cortisol production, making the entire falling asleep process more challenging.

So, how to break this vicious cycle? Establish a daytime and nighttime schedule that works for your child (variable depending on age). Even if they don't show signs of tiredness, it's essential to maintain the schedule so as not to surpass their awake time window.

In short, the best way to overcome this or any other sleep regression is to stay consistent in developing independent sleep strategies!