Learn more about the health implications of a child moving a lot in their sleep, what stages this tends to happen, and when to be concerned.
Is Sleep Movement Normal in Children?
Understandably, parents may become concerned if they notice their child flipping and flopping, sitting up, or twisting and turning in their sleep. Common worries may include wondering if your child is getting enough sleep, if their sleep is restorative, if their fitful sleep could be a sign of an underlying medical condition, or if they’re at risk of injuring themselves. However, moving during sleep is totally normal in many cases, and seen across many ages from infants, toddlers, preschoolers, and even teens, says Shelby Harris, PsyD, a clinical psychologist and board-certified sleep medicine expert practicing in New York. “Some kids move around a great deal in their sleep, but the behavior tends to level off once elementary school-age happens,” she says. However, very restless sleep—or anything that seems off to a parent—may indicate a potential health issue, says Shalini Paruthi, MD, a specialist in sleep medicine and internal medicine and co-director of the Sleep Medicine and Research Center at St. Luke’s Hospital in St. Louis, Missouri. The type and frequency of movement depend on the child, says Dr. Harris. “Sometimes, a child may sit up, yawn, move limbs, rub eyes, move around and then go back down to sleep again,” she explains.
Understanding Sleep Cycles
All humans need sufficient sleep for proper functioning. But children, in particular, need to sleep for a large percentage of each day, with babies and children under three spending more time asleep than they do awake. And whether or not a child is moving while they sleep, lots of activity is happening in both the brain and body. Sleep is a complex process about which much remains unknown. However, it is clear that vital growth, development, healing, rest, memory consolidation, brain activity, and revitalization occur during slumber for people of all ages—and that not getting quality sleep can have detrimental health effects. “All children (and adults) awaken multiple times per night, usually after each sleep cycle is completed,” says Dr. Harris.
Typical Timing of Sleep Movement
“Many caregivers/parents observe [that] their child is a restless sleeper some nights or some parts of every night,” says Dr. Paruthi. “Some movement in sleep is normal, such as a few times an hour to reposition.” It is normal for brief movements, light sleep, and awakenings to occur, particularly between states of sleep. The frequency and intensity of nighttime restlessness vary among children but occurs most often in babies, toddlers, and teens. In fact, these periods of activity are helpful and needed. “Position changes are important throughout the night,” says Paruthi, “so our nerves do not get compressed, i.e., ‘fall asleep.’” Most often, sleep movement will decrease over time. “Usually they outgrow it,” says Dr. Harris. “But if there’s an underlying sleep disorder such as restless leg syndrome, periodic limb movement disorder, or sleep apnea, you won’t typically outgrow it until the underlying issue is treated.” So, if a caregiver or parent notices more restlessness than they expect or if their child doesn’t seem to wake up well-rested, Paruthi recommends discussing this with their pediatrician or sleep doctor.
Potential Signs of Sleep Issues
While varying degrees of nightly sleep movement are healthy and normal, sometimes moving about during sleep indicates a health concern. So, it is important to keep an eye on your child’s sleep movements. It’s worth noting, too, that sleep problems are common in childhood. In fact, research tells us that sleep-wake disorders impact close to a third of all children. Plus, around 25% of children under five years of age experience some type of sleep issue. Signs of disrupted sleep that may be related to excessive movement during sleep include the following, says Dr. Harris:
Difficulty wakingDisrupted breathing, snoring, or gasping during sleepFatigueIrritabilityMouthbreathingMoving around excessivelyNot feeling refreshed from sleepNot having a regular sleep-wake schedulePain or discomfort in the limbs (and/or moving them while sleeping), which may also be related to “growing pains"Trouble falling or staying asleepWaking up frequently during sleep
Possible Causes
There are a variety of possible health conditions that may cause more fitful sleep that may need attention from a healthcare provider. So, if anything concerns you about your child’s sleep movement and/or if you sense that an underlying condition may be contributing to their fitful slumber, contact their healthcare provider to evaluate their specific sleep issues and provide a treatment plan, if needed.
Obstructive Sleep Apnea
Restlessness can be seen in some sleep disorders, such as obstructive sleep apnea, a common disorder in children and adults that causes breathing to stop and start during sleep. “When a child has a partial or total blockage in breathing and then may snort or gasp as they resume normal breathing,” says Dr. Paruthi. “This is often accompanied by a change in position.”
Stress and Other Mental Health Concerns
Stress, anxiety, and traumatic events have all been shown to negatively impact sleep, which may also result in more sleep movement and disordered sleep. “Insomnia is a growing issue [for older kids] as well with increased stress and pressure, anxiety, and depression,” says Dr. Harris. Difficulty falling asleep may contribute to more tossing and turning.
Restless Leg Syndrome
Another common sleep disorder associated with moving during sleep is restless legs syndrome (RLS). RLS is an uncomfortable sensation that usually occurs in the legs, in the evening hours, and is usually worse with resting and during sleep, explains Dr. Paruthi. Periodic limb movement disorder (PLMD) is a related condition in which symptoms of repetitive limb movement occur during sleep.
Sleepwalking
A more extreme example of moving during sleep is sleepwalking. “They can accidentally walk out of the house, so door alarms are recommended for safety,” suggests Dr. Paruthi.
Night Terrors
Fitful sleep may also occur with sleep or night terrors, a condition that occurs in up to 6.5% of children under age 12. In these episodes, children may thrash around, sit up, and/or awaken abruptly in an alarmed, chaotic, distressed, and confused state. While often frightening, night terrors are not harmful and children typically grow out of them.
How to Help Kids Sleep Better
Firstly, determine if your child’s sleep movement is normal. If not, or you’re not sure, get an evaluation (and treatment, if needed) from their healthcare provider. You can also see a pediatrician or sleep doctor. “If a sleep disorder is recognized and treated, sleep is likely to become more restful,” explains Dr. Paruthi. Additionally, following sleep hygiene recommendations can help kids who move in their sleep to improve slumber quality—and safety. These guidelines include sticking to a regular sleep schedule, sleeping in a cool, dark, distraction-free room, and using a calming pre-sleep routine like taking a bath and reading before bed. Children may also move around if they need to wake up to use the bathroom. So, limiting beverages a few hours before bed and making sure your child uses the toilet just before bedtime may help them hold it all night more comfortably. Also, be mindful of the danger of falling off the bed or onto something sharp, such as hitting into the corner of a side table. “Sleep safety is really important!” says Dr. Paruthi, who recommends all babies and toddlers sleep in their own crib, playpens, or other safe sleeping space for overnight sleep and naps. “For toddlers who are ready to move out of the crib, I recommend either a mattress on the floor, a size-appropriate toddler bed, or bed with bed rails—all for safety, so they do not fall out of bed,” says Dr. Paruthi.
A Word From Verywell
While the amount and vigor of movement during sleep will vary among babies and children, it is normal and healthy for them to shift their body position occasionally during slumber. However, since excessive or erratic movements can be a sign of an underlying condition, it’s recommended to consult with your child’s healthcare provider if you notice any nighttime fitfulness that concerns you.
