Optimizing infant and toddler sleep: a review on evidence-based approaches to promote sleep consolidation

Paediatr Respir Rev. 2025 Nov 25:S1526-0542(25)00108-3. doi: 10.1016/j.prrv.2025.11.009. Online ahead of print.

Abstract

Consolidated nighttime sleep is a critical milestone in infant development, underpinning physical, cognitive, and socioemotional growth. Despite being a normative maturational process, fragmented sleep and difficulties initiating/maintaining sleep are common parental concerns. This review synthesizes developmental and behavioral science to elucidate mechanisms and evidence-based strategies that foster healthy sleep consolidation in infants and toddlers. First, we describe the evolution of sleep architecture and the interaction between circadian and homeostatic processes that regulate sleep-wake cycles. Then, we highlight how environmental and caregiving factors support these biological systems. Lastly, we describe behavioral strategies and the influence of environmental elements on circadian entrainment and independent sleep initiation. Across approaches, we emphasize the importance of family-centered implementation, where caregivers can both promote and benefit from optimal infant sleep. This review provides clinicians, researchers, and caregivers with a comprehensive framework to promote sleep consolidation and well-being during early childhood.

Keywords: Behavioral interventions; Caregiver practices; Circadian development; Infant sleep; Sleep consolidation.

Publication types

  • Review