Sleep Associations

Associations are talked about a lot in the sleep world. You may have heard them identified as sleep props, habits, cues or maybe somebody has said to you or somebody else that you are “spoiling your baby.” All of these words make associations sound scary and can make families really nervous about making changes around sleep.

Throughout my years as a Sleep Consultant I have been able to identify that sleep associations are one of the main causes of sleep disruptions for a family. Understanding what a sleep association is and how it is formed can help everything make sense in relation to your little one’s sleeping patterns.

What is a Sleep Association

Sleep associations are simply when your brain creates a link between an action or an object and the process of falling asleep. Some common sleep associations for babies include:

- Bottle/breast feeding/soother – all the same thing with the sucking reflex

- Rocking

- Walking

- Bouncing

- Co-sleeping

- Crib

- Singing

- White noise

Adults have sleep associations as well. Our brain needs to create a link between actions/objects in order to know when it is going to be falling asleep. Some common sleep associations for adults include:

- Pillow

- Blankets

- Our bed – often times not being in our bed can make it more difficult to fall asleep

- Spouse or partner

- White noise – we all have white noise!! It is the sounds around us that make us feel at home

Sleep associations are NORMAL and everyone has them. One of the most important things I want you to consider about associations is that there are no “right” or “wrong” associations but instead each association can be either “positive” or “negative”. It seems like this is the same thing but let me explain. Associations can be either positive or negative depending on how it impacts sleep. For example, baby A who is 6 months old may feed to sleep and then sleep 12 hours with 1 night feed while baby B who is the exact same age may feed to sleep and then wake up every couple of hours all night long. They both have the same association which is the feeding to sleep but for one baby it is a positive association because they sleep just fine but for baby B it is more of a negative association because it is impacting the body’s ability to get restorative sleep.

I always look at sleep from this point of view because I am all about not fixing what isn’t broken! We think of associations as bad or wrong and this can make us doubt our parenting choices which isn’t fair. If it is causing a problem for you, your baby and your family then at that point you can work on making some changes but if it is working for your family then it is fine! This is why I say there are no “right” or “wrong” ways to put your baby to sleep.

How are sleep associations formed

Now that we know what sleep associations are it is important to understand how they are formed. I think more importantly it is good to know why they are formed!

During sleep cycles our body enters a partial awakening which is a point in our sleep cycle where we come out of sleep just enough to assess our surroundings. We do this to make sure that we are safe and not in danger. If all of our sleep cues/associations are in place and everything is the same as how it was when we fell asleep at bedtime then our body knows that it is safe to enter into the next sleep cycle. Our body is so good at going through these partial awakenings that you never remember them in the morning but they include times when you realized you had to use the washroom so got up to go, when you felt cold so you pulled up the blankets, when you felt hot and so you flipped your pillow to the cool side, ect.

After the 4 month sleep regression your baby begins to experience these partial awakenings and they can occur anywhere from every hour to every couple of hours because their sleep cycles are shorter. So, if your baby wakes up every hour or every couple of hours it could be because of this! A baby doesn’t understand the larger cues like we do such as our room, our house noises, sounds from the streets outside, the furnace, ect and so their body has associations that are usually set up by us through our daily routines before sleep periods. The strongest associations are the ones that put them to sleep and this is what the body will compare their environment to during those partial awakenings. If a baby falls asleep with a specific association and then they come into a partial awakening and that association is not there this will then signal to their body that something is not right. This triggers a full awakening to assess the situation and because they are little they call out for their safe person which is you to help bring that consistent sleep cue back! As mentioned above, this could happen every couple hours if the association is strong enough!

Here is an example:

Baby Johnny gets rocked to sleep from his dad. Once asleep dad walks as quietly as he can to the crib, gently lays him down being extra careful not to wake up Johnny, tip toes out of the room and slowly closes the door. If the door creaks his heart literally stops beating for a second because he thinks it is going to wake up Johnny (laugh… we have all been there). When Johnny comes into a partial awakening his body is going to detect a change…. There is no more motion. He was being rocked while being held when he fell asleep and now he is lying in his motionless space and not being held. This will make him wake up and call out for you and often times whatever helped him fall asleep at the beginning of the night will help throughout the night as well because this is bringing back that association.

Again, if you are helping your baby fall asleep and their association is rocking, feeding, bouncing, ect but they are sleeping good then that means you have a positive association and so it is fine! If they are waking up a lot at night though then this could be a sign that the association in place is having a negative effect.

To sum up this section, sleep associations are normal and are formed when we have a repetitive way of falling asleep and are formed as a way to keep our body safe. Consistency at each wake-up means we are where we are supposed to be. Just like you crawl into a bed and use a pillow every night as your association your baby builds one from cues that we implement such as rocking, feeding, bouncing or maybe falling asleep on their own. The longer something is in place the stronger an association can become. How would you feel if tonight I told you that you had to sleep on the kitchen floor and you could have 1 blanket but not your pillow? You would say “no way” because that is not associated with sleep. Don't worry, it is not too late to make changes if you feel ready to do so!

Now, keep in mind that you are not spoiling your baby or doing anything wrong if they are waking up all-night-long, but instead their body is communicating to you that they just need that cue back to fall asleep. This is why sometimes it is healthy to change from an association that you, the parent, need to do for your baby to fall asleep to one that can be consistent without you having to be there (them falling asleep on their own). This way when your baby comes into a partial awakening they can feel safe and put themselves back to sleep unless it is something they need like a feed, diaper change, ect.

How do I know if my baby has a negative association

This is always the big question. Some ways that you can identify a negative sleep association include:

- Your baby will only fall asleep with that specific thing or action

- It is getting harder and harder to get your baby to fall asleep for naps and bedtime. Maybe rocking used to take 5 minutes but now it takes 30-60 minutes or more!

- You dread nap and bedtime because of how much work it takes

- Your baby wakes up frequently at night. This could be every 1 to 3 hours all night long for a baby who is 4+ months old.

- Your baby only naps for 30-45 minutes or under 1 hour on a regular basis. Partial awakenings happen during nap sleep cycles as well.

- Your baby wakes up in the night and even after feeding/rocking/ect they still need more help falling back asleep

How to make changes to sleep associations

Anytime you are using strategies such as sleep coaching to help improve sleep you are not necessarily eliminating associations but instead replacing negative associations with positive ones. This can be a big process which is why I never recommend jumping into everything all at once. Give your baby a couple of days with each of the following steps to see if it helps and if not and you are still ready to work at it then you can move forward with a more direct plan of action.

Tips to help make changes to sleep associations:

1. Make sure you have strong sleep routines!! I can’t stress this one enough. Each step of your nap and bedtime routine act as a cue that tells your baby they will be sleeping soon. A routine is like your baby’s clock. Every step is a cue or an association to sleep but usually the last one that they fall asleep with is the strongest. Setting up a strong routine with the same association you have now at the end will put other things in place so that when you are moving the association that is negative there will be other positive ones in place.

2. Identify the association that your baby has and figure out if it is a positive one or a negative one! Is your baby sleeping well or not?

3. Just start with working on the association at bedtime. Don’t stress yourself out with breaking associations at bedtime, middle of the nights and naps all at the same time. We all have the strongest sleep drive at night (our body is made to sleep at bedtime) and so I find this the easiest place to start! Once asleep when your baby wakes in the night you can do what you normally do. Once you are at a step where falling asleep at bedtime is more independent and overall sleep has improved you can then move onto naps and middle of the night.

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4. Feeding to sleep is the strongest association and this is because it is the sucking reflex in combination with being held and often being rocked at the same time. If you want to take a very gentle approach then try breaking this association with another such as rocking or holding to sleep. This is still a tough transition but you can take it 1 step at a time by first eliminating that sucking reflex. Move the feed earlier into the routine a few steps and finish the routine with rocking to sleep. Every night try moving the feed earlier and earlier until it is in the living room before you go into their room and finish with the rocking. Then move onto the steps below.

5. Once you identify the association you can try and reduce it until it is gone. For example, if you are rocking to sleep then first start with working towards holding to sleep. This might mean every night you rock less and less to soothe and work on having your baby fall asleep at a point where they are being held versus a point where they are being rocked. Once you get to the point where you sit down, rock as you hum a song a couple of times and then hold to sleep you can move into a step of putting them in their crib awake.

6. Putting your baby down awake is way easier said than done! I have 3 little ones (4, 2, 8 months) and so I know this! It can be a work in progress but when you are ready then you can use a method that suits your family and work on making your baby feel safe with independent cues. This may be using an approach where you sit beside them and offer 100% constant hands on soothing until they are asleep and then every couple of days reducing that intervention or it may be an approach where you take 2 minute breaks before soothing them to give them a little space.

7. Always choose a method that YOU feel comfortable with. You are the one who is making the changes for your baby and so if it doesn’t feel right to you then it won’t feel right to your baby either! If you feel confident though then you will be able to implement a strategy in a healthy way to reach your goals.

If you suspect your little one may have a negative association to feeding, soother, bouncing, rocking or something else then check out one of my local OR online sleep courses! In these sessions we talk about everything you need to know to help start working on sleep in your home. You can check them out HERE.

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