How illness affects sleep

Illness, medication and sleep

You’ve been a parent for some time by now, so do trust your instincts if you are worried that your little one is ill. This is usually because she will be displaying behaviour that is not typical of her, both during the day and at night. If your toddler has been giving you some bad nights, whether her sleeping pattern has deteriorated rapidly or if it has been a slow, insidious decline, you will be wondering if she is healthy. Obviously, if your toddler is ill you will want to respond to her need for comfort while she is not feeling well. Then, of course, you will need to address her illness to ensure she recovers as quickly as possible. At this point her sleep may well return to normal.


Health issues could well be affecting your baby’s sleep if she:

  • Is crying or fussing more than normal
  • Has a temperature or rash
  • Is vomiting or has diarrhoea
  • Has lost her appetite
  • Is unusually listless or quiet
  • Is on medication
  • Has been recently hospitalised
  • Her waking repeatedly during the night, crying, is a new behaviour
  • Shows an abrupt change in behaviour and temperament
  • Has experienced any trauma (such as a bump on the head) in the last 12 hours.

You must seek medical advice if your baby is displaying any of these symptoms. ]


Acute medical issues that will affect sleep

One of the less pleasant realities of parenting is that your happy toddler will probablyfall ill at some stage of her life. These difficult times will undoubtedly wreak havoc with sleep in your household. Any acute medical issue must be treated effectively with medical intervention before you can expect your baby’s sleep to return to normal. Common acute medical conditions include:

  • Upper respiratory-tract infections such as ear and throat infections and sinusitis
  • Lower respiratory-tract infections such as bronchiolitis, croup and pneumonia
  • Urinary-tract infections
  • Encephalitis or meningitis
  • Gastroenteritis (diarrhoea and vomiting)
  • Any trauma or injury
  • Severe nappy rash.

The effects of medication on sleep

Medication your toddler is taking may have a disruptive effect on her sleep. All medication has the potential to cause side effects. These side effects range from simple symptoms like nausea, diarrhoea or vomiting, headaches, dizziness, loss of appetite, joint pain and excessive sleepiness to something more serious such as changes in heart rate. Every side effect has the possibility to cause your toddler’s sleeping patterns to change dramatically. Always read the package insert of any medication you are giving your child, and don’t be shy to quiz your doctor or pharmacist about possible side effects of the medication they are prescribing for your child.


The effect of hospitalization on sleep

If your toddler has been ill enough to have been hospitalized, and has undergone invasive or painful procedures whilst in this unfamiliar environment, this will impact greatly on her sleep. Hospitalization affects sleep for a variety of reasons not the least of which is the period of separation from you. Even if you were able to stay with your child most of the time, you may have had to leave her alone on occasion in a strange and scary environment. This could cause a state of heightened separation anxiety, particularly if the timing coincides with the known crisis periods of separation anxiety (18 mths and 3 years).


Hospitals are noisy and intrusive places, so if your toddler is used to sleeping in a quiet and calm environment, she will struggle to settle easily. She may become very dependent on you for soothing, even if she was able to effectively self soothe beforehand. Expect her to still need you to calm her for a period of time after she returns home.


The invasive and sometimes painful procedures she may have experienced in hospital frequently sensitize your baby to touch on her skin (for example intravenous lines) and around the mouth (for example nebulizing or forcing down medicine). This hypersensitivity results in heightened irritability and less use of self-soothing techniques, especially around the mouth. This is why your toddler may appear to have ‘gone off’ her dummy or bottle as an effective soother. Be patient, and in time she will return to her old self.


Managing the effect of hospitalization

  • As far as possible, within reason, stay with your toddler in hospital.
  • Keep her security object or sleep soother with her at all times.
  • Hold her and talk to her during invasive procedures so that you minimize the stress she may be feeling.
  • Try to keep her hospital routine as similar as possible to that at home. If at all possible, ask the nursing staff to perform procedures in her awake times and to leave her undisturbed if she is sleeping.
  • When you return home, expect and allow for a period of clinginess and sleep disruption.
  • From the first night home re-implement the bedtime routine (see Chapter 7).
  • As soon as she is well, encourage self-calming strategies such as a sleep soother.
  • Allow her a week or ten days to settle on her own (which she is likely to do), but if she is not settling independently, you may have to commence with some sleep training.


Ann Richardson

Sr Ann Richardson RN RM,

the Sense-Able Baby and Toddler Expert,

Private Nurse Practitioner,

Author and Parent Coach,

Lonehill, Johannesburg.

Tel: 011 465 3480/8 for appointments.




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