Wake to sleep: does it work for night waking and early starts?

Wake to sleep is a technique where you gently rouse your baby a little before the time they usually wake, then help them back to sleep. The idea is to interrupt a habit of waking at the same time each night, or each morning or nap, so your baby links into the next sleep cycle instead. The version studied in research is called scheduled awakenings, and it has reasonable evidence for predictable night waking. The popular uses for early morning waking and short naps haven't been studied, so it's worth knowing which is which before you set an alarm.

What is the wake-to-sleep method?

There are two versions, and they're often mixed up:

• Scheduled awakenings (studied). The American Academy of Sleep Medicine (AASM) describes it as parents waking their child before a typical spontaneous waking and giving the "usual" response, such as feeding, rocking or soothing, as if the child had woken on their own. The wakings are then gradually phased out.
• Wake to sleep (popular). In much parenting advice, the term means only partly rousing a baby, enough that they stir, shift or suck, but not enough to wake fully, shortly before an early morning wake or the end of a short nap. The hope is that they slip into a fresh sleep cycle.

The two share the same logic of getting in before the habitual waking, but only the first has been tested.

Where does wake to sleep come from?

The research version comes from behavioural sleep medicine. A 1988 Pediatrics trial by Rickert and Johnson compared scheduled awakenings with systematic ignoring ("cry it out") in infants and toddlers who woke and cried at night. The AASM's 2006 practice parameters later listed scheduled awakenings among recommended treatments for night waking. The softer "wake to sleep" name and its use for early mornings and naps are common in popular sleep advice, but we couldn't find a research source for that version.

What age is wake to sleep used from?

There's no official starting age. The review by Kang and Kim lists scheduled awakenings as a treatment for infants, and the 1988 trial included infants and toddlers.

It only makes sense once wakings happen at fairly predictable times. HealthyChildren.org says babies don't have regular sleep cycles until about 4 months. The NHS notes that newborns wake in the night to be fed, that between 3 and 6 months some babies may sleep for 5 to 8 hours at night, but not all, and that night feeds may no longer be needed from 6 to 12 months. A review by Douglas and Hill found behavioural sleep interventions in the first 6 months hadn't been shown to improve outcomes for babies or mothers, so most families keep this for older babies.

How do you do wake to sleep, step by step?

This follows the scheduled awakenings approach described in research, for a predictable night waking.

1. Keep a sleep diary for a week or two. Note the times your baby wakes. Kang and Kim describe scheduled awakenings for children who wake at relatively fixed hours. If the times jump around, this method isn't a good fit.
2. Rule out other causes. Hunger, illness, teething pain, a room that's too hot or cold, or a big change can all cause waking. See night wakings.
3. Pick your time. Kang and Kim describe waking the child about 15–30 minutes before the typical waking; the 1988 trial used 15 to 60 minutes before.
4. Rouse and give the usual response. Gently wake your baby and do whatever you'd normally do when they wake, such as a feed, a cuddle or rocking, keeping lights low and the room quiet. In the research version, the child is genuinely woken; in the popular version, parents aim for just a stir.
5. Settle them back on their back in the cot.
6. Repeat each night at the same time while the spontaneous wakings continue.
7. Phase it out. Once the spontaneous wakings stop, Kang and Kim describe gradually increasing the gap between scheduled wakings until they're no longer needed.

Using it for early waking or short naps

If you want to try the popular version for an early start or a short nap, keep it gentle: a light touch, a slight jiggle of the mattress or a hand on the tummy, using the same 15–30 minute window as the research version, just enough for a stir. This is untested, so try it for a short period, watch whether it helps, and stop if it causes full wakings. For more reliable starting points, see early morning waking and short naps.

What does a typical first week look like?

Expect it to be slower than some other approaches. In Rickert and Johnson's trial, ignoring crying worked better than scheduled awakenings during the first week of treatment, though the two were similar after that. There's no reliable night-by-night pattern, so judge progress from your diary over a couple of weeks rather than night to night.

The practical cost falls on you: someone has to be awake before your baby's usual waking every night for a while. Some families share this between parents or tie it to their own bedtime.

Does wake to sleep work? What the evidence says

• For predictable night waking: yes, with reasonable evidence. In the 1988 trial of 33 infants and toddlers, both scheduled awakenings and systematic ignoring reduced night waking and crying compared with no treatment, over 8 weeks of treatment and at follow-ups 3 and 6 weeks later.
• Expert reviews. The AASM rated scheduled awakenings an effective treatment at "guideline" level, and a 2006 AASM review found support for scheduled awakenings alongside other behavioural methods.
• Speed. It worked more slowly than ignoring in the first week of the 1988 trial.
• For early morning waking and naps: unknown. We found no studies testing wake to sleep for early starts or short naps.

The night-waking evidence is old and from small studies, and none of it can tell you whether it will work for your baby.

Who does wake to sleep suit, and who doesn't it suit?

It may suit:

• babies over about 4 months who wake at roughly the same time most nights
• families who'd rather avoid crying-based methods
• parents who are awake at that time anyway, or can share the job

It's less likely to suit:

• babies whose wakings are random or frequent through the night
• young babies who still need night feeds; for a planned top-up feed, see dream feed
• babies who wake fully when touched and then won't resettle
• babies who are unwell or teething; comfort them as needed and try later

What safety rules apply, and when should I stop?

When you rouse or resettle your baby, keep the sleep set-up safe. NICHD Safe to Sleep advises placing babies on their back for every sleep until 1 year old, on a firm, flat surface with only a fitted sheet and nothing soft in the sleep area. Red Nose recommends keeping your baby's head and face uncovered and their own safe sleep space in your room for at least the first 6 months. If you feed or cuddle your baby during a scheduled waking, don't do it on a sofa or armchair, which NICHD says are never safe places for babies to sleep.

Stop and get help if anything seems wrong. The NHS urgent help guide says to call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) if your baby is difficult to wake or can't be woken, is floppy, is struggling to breathe, has blue, grey or blotchy skin or lips, is having a seizure, or has a weak, high-pitched or continuous cry. A baby who is unusually hard to rouse needs urgent help, not resettling.

Stop the technique, too, if your baby starts waking more, wakes fully each time and can't resettle, or you're too exhausted to keep it going. See your GP or child-health nurse if night waking continues despite consistent changes.

How does wake to sleep compare with other methods?

For all the options side by side, see the sleep training overview.