Does Sleep Training Cause Stress?
We’ve all heard it: sleep training causes stress to a baby, flooding their brain with cortisol (the stress hormone), killing neurons, and altering development. Sounds terrifying, right? As parents, it’s completely understandable that we’d want to avoid anything that could harm our baby’s well-being. Add to this the emotional struggle parents face when choosing self-settling methods—when our babies cry, it’s hard not to feel the weight of their discomfort. After all, seeing your baby upset is never easy!
However, before we let these fears take over, let’s take a moment to dig deeper and understand what’s really going on. We need to interpret the science and signals correctly if we want to do what’s best for our baby and families.
The Difference Between: Chronic vs. Positive Stress
Chronic, toxic stress—like what a child may experience in cases of severe neglect or abuse—can cause significant harm to a baby’s development and brain. This has led some to claim that “self-settling is damaging.” But here’s the important part: these claims don’t accurately reflect the effects of sleep training in a nurturing, supportive environment. Sleep training in the context of a loving, responsive relationship is vastly different from the extreme stress that comes from neglect. In fact, teaching a baby to sleep independently is a healthy step towards development!
Now, let’s think about how we respond to stress ourselves. Picture this: You’re getting ready for a big presentation at work. At first, you feel a little nervous, your palms get sweaty, and maybe your heart beats a little faster as the clock ticks down. But as you get into the flow, you find yourself focused, energized, and pushing yourself to do your best. That’s a perfect example of positive stress—a short-term, manageable level of pressure that drives you to perform at your best. It might feel uncomfortable at first, but it motivates you to rise to the challenge and succeed.
What Does the Research Say?
The American Academy of Pediatrics (AAP) defines three types of stress responses in children in their study "The Lifelong Effects of Early Childhood Adversity and Toxic Stress" (2012):
Positive Stress Response – Brief and mild to moderate in magnitude, like dealing with frustration, getting an immunization, or feeling nervous about the first day of school.
Tolerable Stress Response – Caused by a major, non-everyday event (like a death or divorce) but with the support of an adult can be buffered.
Toxic Stress Response – Intense, frequent, or prolonged activation of the stress response in the absence of supportive, nurturing relationships, as seen in neglect or abuse.
https://www.health.state.mn.us/communities/ace/trauma.html
Let’s focus on positive stress and toxic stress and see where sleep training fits in.
Positive Stress in Sleep Training
Sleep training—whether it’s a gentle method or something with a bit more crying—never fits into the category of toxic stress. Most sleep training routines last a few nights, or if done gradually, a couple of weeks at most. If a baby is crying for weeks on end, something isn’t quite right, and parents should reassess their approach and plan.
Positive stress, like feeling frustrated or anxious, isn’t inherently bad. In fact, it can promote healthy growth and development when it’s buffered by a stable, supportive relationship. This is true for sleep training as well. The baby may experience a bit of frustration or discomfort as they learn to self-soothe, but with a parent who is there to guide them lovingly, it becomes a healthy opportunity for learning and adaptation.
Research has shown that positive stress is a normal part of development. It’s how children learn to handle frustration, deal with new challenges, and build resilience. When supported by caring, responsive parents, this type of stress can actually be growth-promoting and help babies learn how to adapt to new situations, like falling asleep on their own.
Toxic Stress vs. Sleep Training
On the flip side, toxic stress occurs when a child is exposed to prolonged, harmful stress without support. Chronic stressors like child abuse, neglect, or parental substance abuse can have severe long-term effects on a child’s brain development, immune system, and overall health.
But let’s take a step back and ask: Is sleep training really like those extreme situations?
Of course not. Sleep training is about teaching a baby to settle themselves, and while crying may be part of the process, it is not the same as the severe, ongoing stress caused by neglect or abuse. In fact, sleep training is often a temporary challenge—a few nights or a couple of weeks—compared to chronic, ongoing stress that can last for months or years.
The Role of Parental Support in Sleep Training
A key aspect of sleep training is that it involves parental presence and support. Parents aren’t abandoning their babies to cry it out endlessly; they are there, guiding, soothing, and comforting them as they learn a new skill. This support makes all the difference between positive stress and toxic stress.
The research highlights that children need stable, supportive relationships during times of stress. And that’s what sleep training—when done properly—is about: helping your baby through a challenging process with love and support.
Parents should also be setting their little ones up for success with a proper sleep plan that addresses external and internal factors that can make sleep harder.
Bottom Line: Sleep Training & Stress
So, does sleep training cause stress? Yes, but it’s positive stress—the kind that helps babies grow and learn. When done in a loving, responsive environment, sleep training is a healthy, normal part of a baby’s development. It's not the same as the severe, harmful stress caused by neglect or abuse.
Often to parent’s surprise Sleep training isn’t a traumatic, long-term experience for your baby. With the right approach, it can take just a few nights for your baby to learn to sleep independently. And as parents, we’re there to guide them through it, providing the comfort and support they need.
So, if you’re considering sleep training, remember this: Positive stress can be a healthy, growth-promoting experience. With the right approach, sleep training can help your baby (and your whole family) get the rest you all need. And with support from someone who understands the science and the methods, you can be confident in your approach—whether it involves a little crying or a lot of cuddling.
While we often think about crying with sleep training we often don’t consider the crying and longterm stress that sleep deprivation can cause.
While there’s no evidence to suggest that sleep training is harmful, there is substantial research showing the negative effects that lack of sleep can have on a child’s physical, cognitive, and emotional development. Chronic sleep deprivation can strain the parent-child relationship and lead to long-term health issues. Health professionals consistently emphasize the importance of a full night’s sleep for both children and parents. While it’s easy to overlook this because it’s common knowledge, it’s far more crucial to prioritize consistent, restorative sleep than to stress over a few days of sleep training.
Understanding the role that stress plays in our bodies is just the beginning to making significant changes that will benefit your family in the long run. If you need help getting started, getting a proper age appropriate sleep plan and finding a sleep training technique that works for your family (that you feel 100% comfortable with), book a discovery call now.
It will change your life.
Evidence:
Journal of Abnormal and Social Psychology (1959) : "No unfortunate side - or after affects of this treatment we’re observed. At three and three-quarters year of age, the child appears to be a friendly, expressive, outgoing child."
Journal of Developmental and Behavioural Pediatrics (1991) : "Extinction is an effective, reasonably rapid, and durable treatment for infant sleep disturbance [three citations]…mothers became less anxious as the study proceeded… [the data show that extinction] is consistent with previous reports on improvements in parental self-esteem, depression, marital satisfaction, and sense of control following extinction-based treatments of sleep disturbances [cites two additional supporting studies]. Some have argued, sometimes forcefully, against the use of extinction procedures with infants, on the grounds that such procedures will damage the infant-caregiver (mother) bond and impair the infants sense of security. A measure of infant security was explicitly included in this study to test this hypothesis, and again, the results are clear. Infant security improved significantly over the course of the study…we can reject the hypothesis that exposure to extinction…will impair security."
Journal of Pediatric Psychology (1992): "Measured and compared the behaviour characteristics and security scores of infants (6-24 months) treated with extinction for sleep disturbance.. There was no evidence of detrimental effects on the treated infants whose security, emotionality/tension, and likeability scores improved."
Journal of the American Academy of child and adolescent psychiatry (1994): Sleep training improved daytime mother and infant interactions.
Journal of Paediatrics and Child Health (1998): "Cold turkey extinctions [and other methods improved] problematic childhood sleep behavior [and] is associated with significant improvement in maternal mood. It is likely significant numbers of mothers diagnosed as having postnatal depression are suffering the effect of chronic sleep deprivation'
Journal of Abnormal Child Psychology (1999): "Both [extinction and graduated extinction] treatments improved bedtime and nighttime sleep problems and only positive side effects were associated with both treatments. Graduated extinction was easier to implement."
Gunnar, M.R. and B. Donzella. Social regulation of the cortisol levels in early human development. Psychoneuroendocrinology. 27(1-2): p. 199-220. 2002.
Jansen, J., R. Beijers, M. Riksen-Walraven, and C. de Weerth. Cortisol reactivity in young infants. Psychoneuroendocrinology. 35(3): p. 329-38. 2010
Middlemiss, W., D.A. Granger, W.A. Goldberg, and L. Nathans. Asynchrony of mother-infant hypothalamic-pituitary-adrenal axis activity following extinction of infant crying responses induced during the transition to sleep. Early Hum Dev. 88(4): p. 227-32. 2012.
A CIO study which showed no increase in cortisol between the pre-bed time sample and the CIO sample.
Ahnert, L., M.R. Gunnar, M.E. Lamb, and M. Barthel. Transition to child care: associations with infant-mother attachment, infant negative emotion, and cortisol elevations. Child Dev. 75(3): p. 639-50. 2004.
Karraker, K.H. and M. Young. Night Waking in 6-Month-Old Infants and Maternal Depressive Symptoms. J Appl Dev Psychol. 28(5-6): p. 493-498. 2007.
Despite these widespread claims of negative outcomes for babies who are sleep trained, there is no real evidence to back it up. As some researchershave pointed out, the only evidence that crying can be detrimental to infant development comes from studies on long term abuse and neglect; none of these studies look at the effect of brief periods of crying in an otherwise loving family. Sleep training generally doesn’t involve sustained crying for long periods of time—only brief and controlled periods of crying that usually doesn’t last more than a few days.
One recent study looked at children who had been sleep trained as babies five years later to see if there was anything different about these now 6-year-olds when compared to 6-year-olds that weren’t sleep trained as infants. The study found that there were absolutely no differences between these kids: Sleep trained kids were no more likely to have emotional problems, sleep problems, or attachment issues than kids that weren’t sleep trained as babies. In fact, there was nothing positive or negative about sleep training in the long-term, and kids were all sleeping well at age six whether they were sleep trained or not. This study suggests that there aren’t any negative long-term effects of sleep training, and that there aren’t any positive ones either. That means whether you choose to sleep train or not, your baby will probably be fine and eventually sleep through the night.
Despite there being no evidence of negative consequences of sleep training, there’s a lot of evidence that there are serious long-term negative consequences of sleep deprivation, including depression, inattentiveness, and marital problems.
Price, A.M.,M Wake, et al (2012) “Five-Year Follow-up of Harms and Benefits of Behavioural Infant Sleep Intervention: Randomized Trial” Pediatrics. Published online September 10, 2012.
Hiscock, H. J. K. Bayer, et al (2008) “Long-term mother and child mental health effects of a population-based infant sleep intervention: Cluster-randomized, controlled trail” Pediatrics 122 (3) e621-627.
Hiscock, H, J. K. Bayer, et al (2007). “importing infant sleep and maternal mental health: a cluster randomized trial” Arch Dis Child 92 (11): 952-958.
http://scienceofmom.com/2012/03/30/helping-babies-cope-with-stress-and-learn-to-sleep/
The following references all show the benefits of great sleep!
1Tarullo, A.R., P.D. Balsam, and W.P. Fifer. Sleep and Infant Learning. Infant Child Dev. 20(1): p. 35-46. 2011.
Scher, A. Infant sleep at 10 months of age as a window to cognitive development. Early Hum Dev. 81(3): p. 289-92. 2005.
Gomez, R.L., R.R. Bootzin, and L. Nadel. Naps promote abstraction in language- learning infants. Psychol Sci. 17(8): p. 670-4. 2006.
Hupbach, A., R.L. Gomez, R.R. Bootzin, and L. Nadel. Nap-dependent learning in infants. Dev Sci. 12(6): p. 1007-12. 2009.
Ross, C.N. and K.H. Karraker. Effects of fatigue on infant emotional reactivity and regulation. Infant Mental Health Journal. 20(4): p. 410-428. 1999.
Mindell, J.A., B. Kuhn, D.S. Lewin, L.J. Meltzer, and A. Sadeh. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 29(10): p. 1263-76. 2006.
Tikotzky, L., D.E.M. G, J. Har-Toov, S. Dollberg, Y. Bar-Haim, and A. Sadeh. Sleep and physical growth in infants during the first 6 months. J Sleep Res. 19(1 Pt 1): p. 103-10. 2010.
Taveras, E.M., S.L. Rifas-Shiman, E. Oken, E.P. Gunderson, and M.W. Gillman. Short sleep duration in infancy and risk of childhood overweight. Arch Pediatr Adolesc Med. 162(4): p. 305-11. 2008.
Wake, M., E. Morton-Allen, Z. Poulakis, H. Hiscock, S. Gallagher, and F. Oberklaid. Prevalence, stability, and outcomes of cry-fuss and sleep problems in the first 2 years of life: prospective community-based study. Pediatrics. 117(3): p. 836-42. 2006.
Martin, J., H. Hiscock, P. Hardy, B. Davey, and M. Wake. Adverse associations of infant and child sleep problems and parent health: an Australian population study. Pediatrics. 119(5): p. 947-55. 2007.
Bayer, J.K., H. Hiscock, A. Hampton, and M. Wake. Sleep problems in young infants and maternal mental and physical health. J Paediatr Child Health. 43(1-2): p. 66-73. 2007.
Hiscock, H., J. Bayer, L. Gold, A. Hampton, O.C. Ukoumunne, and M. Wake. Improving infant sleep and maternal mental health: a cluster randomised trial. Arch Dis Child. 92(11): p. 952-8. 2007.
Hiscock, H. and M. Wake. Randomised controlled trial of behavioural infant sleep intervention to improve infant sleep and maternal mood. BMJ. 324(7345): p. 1062-5. 2002.
Martins, C. and E.A. Gaffan. Effects of early maternal depression on patterns of infant-mother attachment: a meta-analytic investigation. J Child Psychol Psychiatry. 41(6): p. 737-46. 2000.
Murray, L. and P. Cooper. Effects of postnatal depression on infant development. Arch Dis Child. 77(2): p. 99-101. 1997.
Essex, M.J., M.H. Klein, E. Cho, and N.H. Kalin. Maternal stress beginning in infancy may sensitize children to later stress exposure: effects on cortisol and behavior. Biol Psychiatry. 52(8): p. 776-84. 2002.
Murray, L., A. Arteche, P. Fearon, S. Halligan, I. Goodyer, and P. Cooper. Maternal postnatal depression and the development of depression in offspring up to 16 years of age. J Am Acad Child Adolesc Psychiatry. 50(5): p. 460-70. 2011.
Connor, J., R. Norton, S. Ameratunga, E. Robinson, I. Civil, R. Dunn, J. Bailey, and R. Jackson. Driver sleepiness and risk of serious injury to car occupants: population based case control study. BMJ. 324(7346): p. 1125. 2002.
Study often used against sleep training
[1] Middlemiss W, Granger DA, Goldberg WA, Nathans L. Asynchrony of mother-infant hypothalamic-pituitary-adrenal axis activity following extinction of infant crying responses induced during the transition to sleep. Early Human Development 2012; 88: 227-32.
This study was done on 25 infants and mothers. In a hospital setting. https://expectingscience.com/2016/04/21/the-middlemiss-study-tells-us-nothing-about-sleep-training-cry-it-out-or-infant-stress/
