When your baby can’t fall asleep: causes and tips

The wrong sleeping positions may mean that your baby can’t relax. These positions can trigger the startle reflex more quickly – a reflex that protects babies from the sensation of falling. The wrong sleeping position can also hinder breathing, promote overheating of the body and disrupt deep sleep.​ You should therefore avoid the following positions:

• On the tummy: This position partially covers the nose and mouth, hinders free breathing and thus triggers the startle reflex. This position should therefore be avoided until around the age of six months – or until your baby is able to turn on its own.
• Side position: This position is unstable and risky. From here, babies can easily roll onto their tummies, which restricts breathing and causes restlessness. They feel unsafe, fidget and struggle to settle down.
• Swaddling too tightly: Wrapping your baby too tightly puts pressure on its chest and airways. So make sure you don’t swaddle it too tightly.
• Open arms: In this position, the baby’s freely swinging arms trigger the startle reflex even with minimal stimuli, such as noises or changes in light. This prevents the baby moving from a drowsy state into a deep sleep. Gentle swaddling can help the baby feel safe and lessen the triggers that can disturb their sleep.

Certain habits can also lead to incorrect sleep associations. For example, if you often rock your baby to sleep in your arms, they may associate this position with falling asleep, which makes it harder for them to adjust to sleeping in a bed.  

A lack of bedtime routine can also make it harder for your baby to fall asleep, because they miss the predictability and security that this entails and they are unable to self-soothe. Find out which bedtime routines help in the tips below.  

Being awake too long can cause a baby to be overtired. This condition overwhelms their still-developing nervous system.

As a result, the body comes under stress, causing it to release cortisol and adrenaline. These stress hormones put the immature nervous system on alert, increase the heart rate and cause hyperactivity. 

As a result, your baby may fidget, cry intensively or react hypersensitively to stimuli. 

These spurts and leaps create many new neuronal connections in the baby’s brain so that it retains what it’s learned (e.g. rolling, gripping). These phases are taxing for the brain, making babies more irritable at these times.

During these phases, babies may be more tearful, clingy or overactive as new neural connections generate millions of stimuli. As a result, cortisol levels rise in the body – the baby becomes stressed and cries more frequently, refuses to be soothed and exhibits signs of overstimulation during the day, such as yawning, rubbing their eyes, or staring.

This has an effect on sleep behaviour: the sleep cycles become fragmented – the baby may take longer to fall asleep, wake more frequently during the night and need more naps during the day.

Cramps and colic cause severe abdominal pain, bloating and discomfort. This prevents the baby from falling asleep and causes it to wake more often during the night.

This is partly due to the still immature digestive system. ​Babies often swallow air while breastfeeding or bottle-feeding, which often causes bloating. 

​Furthermore, the body doesn’t produce enough melatonin during the first three months. This sleep hormone typically induces tiredness and relaxes the intestinal muscles for the night.  A melatonin deficiency can lead to tension in the digestive system – which also promotes colic. 

When the first teeth begin to emerge, they irritate the nerve endings in the gum tissue, causing inflammation and the production of extra saliva. This leads to babies rubbing their gums, sucking more intensively and being more irritable – especially at night when there is no distraction. 

Teething disrupts the light sleep phases (REM sleep) in particular. In this phase, babies aren’t able to soothe themselves. In general, teething causes more restlessness, more frequent waking and shorter sleep phases. 

Sleep regression is a temporary phase in which babies who previously slept well suddenly start to sleep poorly. This isn’t a step backwards, but the result of rapid development.

During growth spurts, a baby’s brain processes newly learned skills at night.

This increases brain activity and leads to overstimulation. This, in turn, makes it harder for the baby to fall asleep, causes them to wake up more often, and results in more restless and shorter sleep, as well as a greater need for sleep during the day. 

The right environment can help your baby sleep better. Bear the following points in mind:

• Temperature: The ideal room temperature is 16 to 18 degrees. If it’s too hot or too cold, babies may become restless, wake more frequently and experience less deep sleep, as they are less able to regulate their body temperature.
• Light: Make sure the room is dark, because darkness boosts the production of the sleep hormone melatonin. Bright light, by contrast, inhibits the production of melatonin, delays falling asleep and shortens sleep phases.
• Sleeping position: Use a sleep sack and lay your baby on its back to sleep.
• Noises: Loud or sudden noises can wake babies, especially during the light sleep phase. To dampen the background noise, you can play white noise from a device.
• Humidity: Avoid dry air in the room. This irritates the mucous membranes and increases discomfort.

Bedtime rituals give your baby a sense of security and encourage it to self-soothe: 

• Fixed bedtime routine: This is especially important between the age of 3 and 6 months. It could be a bath, massage, feeding, dimming the light, singing a lullaby or making soft “shhh” noises. Importantly, the routine should last 20 to 30 minutes and follow the same sequence.
• Physical contact: This includes cuddling, swaddling or rocking – and then placing the baby in the cot while it is sleepy but still awake. During physical contact, breastfeeding, a dummy or sucking a thumb/finger can help.

Try the 5S method developed by U.S. paediatrician Harvey Karp. This method soothes babies by mimicking conditions in the womb: 

• Swaddling: Swaddling is when you wrap your baby in a light cloth or swaddle. The arms are close to the body and the legs slightly bent. Swaddling creates the sense of security they enjoyed before birth and helps prevent the startle reflex, which might otherwise wake the baby. Important: When swaddled, babies should only be placed on their back. Don’t make the swaddle too tight. 
• Side or stomach position: Hold your baby on their side or stomach on your arm. This reduces the feeling of pressure and calms your baby. 
• Shushing: Make a constant shushing noise or play white noise (50-60 dB). This masks other noises and simulates the sounds in the womb. 
• Swinging: Gentle, rhythmic movements, such as rocking in your arms, mimic the mother’s steps when the baby was still in the womb. 
• Sucking: Give your baby something to suck on. The sucking reflex is innate and activates the part of the nervous system responsible for relaxation. You can breastfeed or bottlefeed or give the baby a dummy or their thumb or finger. 

Noises such as white noise help to calm babies as they try to sleep by imitating the sounds of the womb and masking disturbing noises.

In the womb, babies hear constant sounds such as a heartbeat or blood flow (approx. 60-70 dB). White noise imitates the familiar sound environment, desensitises the baby’s hearing to disturbances and promotes relaxation. It also inhibits the startle reflex and helps the brain to slip into deep sleep.

How it works: Play the noise at a moderate volume (50-60 dB), roughly the level of a normal conversation, using apps, a music system or YouTube.

Leave the sound playing all night, not just when falling asleep. Start from birth, but see a doctor in case of any hearing problems. 

Closeness to parents helps babies to fall asleep and conveys a sense of safety and comfort. Skin-on-skin contact or being carried in a baby carrier helps babies perceive the familiar heartbeat and smell of their parents. 

This activates the cuddle hormone oxytocin, calms the startle reflex and makes night-time breastfeeding easier. As a result, the sleep cycle stabilises.

The co-sleeping method also ensures greater closeness to the parents: parents and baby sleep in the same room. This way, parents can react more quickly to the baby’s signals, the baby cries less and has longer sleep phases. In addition, the baby’s rhythm adapts to that of the parents, which strengthens the bond.

Numerous methods help the baby to fall asleep by promoting relaxation and reducing stimulation:

• Osteopathy: It helps babies who have problems falling asleep by using gentle manual techniques to release tension in the body caused by birth or everyday strain and calm the nervous system. This method is painless. Studies and reports show a significant improvement in sleep disorders, colic or restlessness.
• Aromatherapy: Lavender oil (diluted in a base oil) as a foot massage or in the bath (1–2 drops) has a calming effect on the nervous system. A scented lamp or hot bowl of oil in the room relaxes the baby before sleep. Chamomile also helps as a mild bath additive to reduce restlessness.
• Herbal teas/baths: Melissa or lavender tea (from 6 months) or hop baths (diluted) also promote relaxation.
• Bach flowers: Mixtures such as “Sandman” drops help with problems falling asleep or nightmares. Dab the drops on the inside of the lips or cheeks (the mucous membrane in the mouth) or on a sensitive area of skin such as the elbows and bends of the knees, behind the ears, on the soles of the feet or on the forehead. 
• Homoeopathy: Here, too, certain substances can help. For example, coffea cruda for overstimulation, phosphorus for anxious babies or passiflora for nervous restlessness and palpitations.
• Acupressure points: Massage the point right between the eyebrows on the root of the nose with gentle, circular movements. This reduces agitation, promotes calm and helps them fall asleep. You can also massage gently on the crown of the head, in the midline. This reduces restlessness, irritability and anxiety. Massage using the thumb or index finger.