By 3 months of age most babies are waking only once or already have started sleeping through the night; they should definitely be doing so by 4 or 5 months old. So, for example, if an otherwise healthy child has reached 5 or 6 months of age and is still having problems going to sleep, or is waking up for extended or repeated brief periods during the night, then a problem seems likely.

To diagnose sleep problems, physicians must take a good, careful history from the parents. Diagnosis requires an in-depth understanding of normal and abnormal sleep patterns and behavior, but (with proper training and sufficient time) it often can be made in a general pediatrician's office. Parents are often able to diagnose these problems themselves after reading proper educational materials.

Ask parents where they prefer their child to sleep, with them or in their own room alone. But whatever way they choose should be the way the child goes to sleep and wakes up. He shouldn't fall asleep being rocked in the living room with the TV on if he's going to wake alone normally during the night in his dark and quiet bedroom.

Avoiding improper habits from becoming associated with falling asleep and being sure that night time feedings are not excessive are two key factors after the first few months. But a third factors that's very important (and often least recognized) is the schedule. All of our body's systems (including those that control sleep) function best when on a regular and appropriate schedule. So, if we're on an irregular sleep schedule, sleep can suffer. If a child's bedtime, wake time, and nap times differ day to day, one cannot know on any given night or day when that child is even capable of sleep. Or, a schedule may be regular but inappropriate. Thus, children may be unable to sleep well at night because they sleep too much during the day, or they can't nap well during the day because they sleep too much at night.

Muchos padres intentan que su hijo duerma más de lo debido. They put the child to bed at 7 p.m., want them to sleep until 8 the next morning, and take two, two-hour naps each day. Los niños no pueden dormir tanto y lo demuestran de distintas maneras. They'll get only the total amount of sleep they need, and if parents try to force them to sleep more (or at the wrong times), there will only be frustration.

Young infants may sleep 12 to 13 hours total. But by 6 months, most children sleep only 11 to 12 hours total, and this number changes only slowly as children grow. Even by mid-childhood the number usually has not dropped below 10.

How those hours are distributed may vary. In the first few months, a third or more may still occur in the day. But after three months, most should occur at night. Aún así, un niño que necesita 12 horas de sueño puede distribuirlas entre la noche y el día en una proporción de siete y cinco, ocho y cuatro, o nueve y tres. As the child gets to 5 months or so, he probably should be getting at least nine hours of sleep at night.

Most children stop between the ages of 3 and 4. Some stop at age 2, and some continue until kindergarten.

There are some children who are naturally good and long sleepers, but basically all healthy, normal babies have the ability to sleep well. If they're not, then a thorough understanding of the cause of the problem and implementation of corrective behavioral and schedule-related measures should normalize their sleep within a few days. Sleep medication is rarely ever necessary.

El impulso del sueño es muy poderoso en los niños y si se comprende y se controla de manera adecuada, casi todos los niños podrán dormir sin problemas.

Yes, especially if the snoring is present most nights, is present much of the night, and is loud enough to be heard outside of the bedroom. There should also be concern if the child usually sleeps with his or her mouth open or clearly has trouble breathing (chest gets sucked while breathing and there are gasps, snorts, or squeaky sounds).

Children should be able to breathe quietly with mouth closed most of the time, except, perhaps, when ill. The snoring indicates an obstruction somewhere, usually at the back of the throat. Just how much trouble there is may be difficult to tell just from watching: breathing okay with a little snoring, or suffering from obstructive sleep apnea (with inadequate breathing and sleep disruption). You would be best to discuss this with your doctor who should examine your child and possibly refer him or her to an ENT specialist for further assessment, or to the sleep center for evaluation and possible overnight sleep study (Polysomnography).

The most common cause of significant breathing difficulties in a snoring child is enlargement of tonsils or adenoids (spongy tissues at the back of the throat). If indicated, this tissue can be removed surgically. Other common causes include abnormal facial structure, low muscle tone, and obesity. In these cases, other treatments may be called for. The most common non-surgical treatment is nighttime CPAP usage, which is highly effective.

The usual cause is a late or delayed sleep phase caused by late wakings on the weekend. The late weekend wakings become internalized, setting the biological clock on a late schedule, and leaving the child unready to fall asleep at an appropriate hour and unready to wake at the time necessary to go to school. The solution requires consistent wake-up times every day (weekday and weekend) as the bedtime gets adjusted to a regular time early enough to allow for sufficient sleep. This should be easy to accomplish until adolescence; then it may become more difficult partly for biological reasons and partly because of children's desires to be more independent and to stay up very late on weekends as well as to sleep in whenever they can.

If your young child insists on having more than a night light on at night, you can stay with him a little after the main light is turned off to show him how much he can actually see once his eyes get used to the dark. Or you can gradually move to less light with lower wattage light bulbs or through the use of a dimmer control.

Sleep talking is normal and common and certainly is not a sign of anything worrisome. Most sleep talking takes place between sleep states, during a partial waking as your child is moving about and getting ready to fall back into deeper sleep again. It typically does not occur during a dream. After the waking is more complete, the child settles back to sleep.

Sleepwalking occurs in the same setting, but now instead of just talking, a child gets up and moves about. Occasional events are common in the young child, and the main job of the parents is to assure a safe environment. Little should be necessary except to lead the child back to bed. Frequent events or events where the child could hurt himself (such as running about wildly) may have different triggers related to habits and schedules and personality. Various therapies are possible. Such symptoms should be discussed with your doctor. If questions remain, referral to the sleep center should be considered.

Yes, at least after the first 6 months and if certain precautions are followed. When bed sharing is chosen, ideally this choice should be the parents', not the child's. If co-sleeping fits into the parents' philosophy and desires, there should be no problem as long as conditions are safe. This is especially a concern for young infants who might be safer sleeping adjacent to the parents' bed until they are bigger. In fact, a task force of the American Academy of Pediatrics recently concluded bed sharing was potentially risky for young infants, saying "that bed sharing, as practiced in the United States and other Western countries, is more hazardous than the infant sleeping on a separate sleep surface and, therefore, recommends that infants not bed share during sleep" (for the full statement of the Academy, click aquí).

Some of the conditions known to increase risk of problems include improper bedding and parental alcohol intake and smoking.

When there is bed sharing, parents may have to adapt to a schedule that fits their child more than themselves, and they may have to accept both the loss of privacy and their child's (possibly considerable) nighttime restless body movements. Finally, parents should decide how long (until what age) they want their child sleeping with them, and have plans for how to move their child to his or her own bed when that point is reached.