By: Sarah Bossio, Certified Pediatric Sleep Expert
If your baby struggles with sleep—waking up frequently, taking short naps, or seeming unusually restless—you may wonder: Is this a sleep issue I can fix? Or is there an underlying medical reason?
At Your Zen Baby Sleep, I’ve worked with over 500 families, helping 98% reach their sleep goals. This experience taught me that not all sleep challenges are behavioural. Some require medical attention.
So, how do you know the difference? And more importantly—what can you do about it?
Behavioral vs. Medical Sleep Issues: How to Tell
Not all sleep problems can be solved with better routines and sleep training. Some are caused by discomfort, illness, or undiagnosed conditions that make it impossible for your baby to rest well.
Behavioural Sleep Issues:
Improve with consistency, routine, and self-soothing techniques.
Typical examples are needing to be rocked or fed to sleep and short naps that lengthen with better scheduling.
Medical Sleep Issues:
Caused by illness, discomfort, infection, or breathing problems.
No matter how strong the routine, medical issues require proper treatment.
Let’s explore some everyday medical disruptors.
Common Medical Sleep Disruptors
Breathing Issues: Snoring, Mouth Breathing, and Sleep Apnea
Snoring or mouth breathing isn’t typical in healthy babies. It may indicate:
Enlarged tonsils or adenoids
Nasal blockages
Sleep apnea (which disrupts deep sleep)
What to do: Consult an ENT specialist if your baby snores frequently or breathes through their mouth, even when not sick.
Silent Reflux (GERD)
Some babies experience acid reflux that doesn’t involve spitting up but still causes discomfort.
Signs: Arching the back, frequent hiccups, nighttime coughing
What to do: If you suspect reflux, talk to your paediatrician about possible solutions.
Food Sensitivities & Allergies
Dairy or soy intolerances can cause tummy troubles, eczema, and overall discomfort, leading to sleep disruptions.
What to do: Consider an elimination diet or allergy testing if your baby has frequent digestive issues.
Chronic Ear Infections
Fluid buildup in the ears can make lying down painful, causing frequent night wakings.
What to do: If ear infections are recurrent, speak with your paediatrician about potential treatments.
Sensory Processing Challenges
Some babies crave constant movement, rough play, or tight squeezes and struggle to settle down at bedtime.
What to do: An occupational therapist can help with sensory regulation strategies to improve sleep.
Red Flags That Signal a Medical Concern
Mouth Breathing & Snoring
Frequent mouth breathing and snoring may be signs of airway blockages, which can result in restless nights and exhaustion during the day.
What to do: Bring this up at your next paediatrician visit. If concerns are dismissed, consult an ENT or allergist.
Sleeping a Lot but Still Waking Up Tired
Poor sleep quality could be the issue if your baby sleeps long hours but still seems exhausted and irritable.
What to do: A sleep medicine specialist or ENT can assess for conditions like sleep apnea or chronic infections.
Sensory Seeking & Restless Sleep
Does your baby struggle to settle at night, constantly moving or seeking deep pressure? Sensory challenges can make it difficult for your baby to relax.
What to do: An occupational therapist can provide strategies to support sensory regulation.
What If Your Pediatrician Dismisses Your Concerns?
Have you ever been told, “They’ll grow out of it”—even when your instincts tell you something isn’t right?
Your intuition as a parent is powerful. If you feel something is off, advocate for your child. Paediatricians see a high volume of cases and may not always flag sleep issues as urgent, but that doesn’t mean they should be ignored.
Other Specialists Who Can Help:
If you're not getting the answers you need, consider these specialists:
ENTs & allergists – for breathing and airway concerns
Sleep medicine doctors – for deeper sleep evaluations
Occupational therapists (OTs) – for sensory-seeking behaviours
Physical therapists (PTs) – for body imbalances affecting sleep
The Bottom Line
Whether your baby’s sleep struggles are behavioural or medical, there is a path forward. And you’re already taking the first step by learning more.
If any of these red flags sound familiar, trust your gut. Ask questions. Seek answers. Your baby’s sleep is worth it.
💙 Need one-on-one support? Visit yourzenbabysleep.com. Want more sleep tips? Subscribe and turn on notifications!
Are you worried about how the time change will affect your child's sleep? I’d love to hear about your experience! If you need personalized support, book a free discovery call to learn how we can work together one-on-one.
Did you know? I also host a weekly Q&A on my Instagram. Tune in or send me a DM on the 'gram!
I work with families one-on-one all the time who are experiencing issues with their babies' naps, overnight sleep, and more. If this sounds like you, please book a 15-minute sleep assessment call just so I can understand a little bit more about your child's sleep and then explain ways that I can work one-on-one with you to get it in order.
May your coffee be warm,
Sarah
Sarah is a Certified Pediatric Sleep Expert based in the NY/NJ Tri-State area and has helped over 500 families worldwide get their sleep back on track.
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