What Is Cry It Out
Cry it out is a colloquial term for behavioral sleep training where a parent or caregiver places a child in bed while awake and does not intervene when the child cries or protests. The child must self-soothe to fall asleep without parental comfort, reassurance, or physical contact. This approach differs from methods that include periodic check-ins or graduated intervals of parental presence.
The term is informal and often misused interchangeably with full extinction, though they describe the same core technique. Sleep researchers and pediatricians use "unmodified extinction" as the clinical terminology. The method gained popular attention through parenting literature starting in the 1980s, though controlled sleep research on extinction methods dates back to behavioral psychology studies in the 1970s.
How It Relates to Sleep Disorders
Cry it out is a behavioral intervention designed to address learned sleep associations and conditioned arousal. It is not a treatment for physiological sleep disorders like obstructive sleep apnea or narcolepsy. Understanding this distinction matters because polysomnography or other diagnostic testing should rule out underlying medical conditions before implementing any sleep training method.
Research shows that extinction methods can work for behavioral insomnia of childhood, where a child has developed dependency on parental presence, rocking, or feeding to initiate sleep. Sleep efficiency typically improves within 3 to 7 nights of consistent application, though some children show slower response. Studies from the American Academy of Pediatrics and pediatric sleep journals indicate success rates between 70 and 80 percent when parents follow the protocol consistently.
The method does not address circadian rhythm disorders, where the child's sleep-wake cycle is genuinely misaligned with the desired sleep schedule. Circadian-based insomnia requires chronotherapy, light exposure adjustment, or melatonin timing, not behavioral extinction.
Implementation and Consistency
- Baseline requirement: The child must be healthy and medically cleared. Any breathing concerns, reflux, ear infections, or neurological conditions should be evaluated first.
- Sleep hygiene foundation: Consistent bedtime, appropriate room temperature (65 to 68 degrees Fahrenheit), darkness, and white noise support the method but do not replace it.
- No intervention period: Once the child is placed in the crib or bed awake, the parent does not return until morning or a predetermined time, regardless of crying duration.
- Parental consistency: Partial extinction, where parents occasionally give in, is less effective and may reinforce crying through intermittent reinforcement, actually prolonging the process.
- Age consideration: Most effective between 6 months and 3 years. Older children often benefit from cognitive behavioral approaches that address worry and sleep anxiety directly.
Common Questions
- Is cry it out harmful to the child? Large-scale studies from 2016 and 2012 published in Pediatrics found no long-term behavioral, emotional, or attachment harm from extinction methods. However, the method creates significant parental stress and sleep disruption, which affects family well-being. It is not suitable for all families.
- How does cry it out differ from the Ferber Method? The Ferber Method includes scheduled check-ins at increasing intervals. Cry it out involves no check-ins. Ferber is technically "graduated extinction" while cry it out is "unmodified extinction."
- Can cry it out treat adult insomnia? No. Adults with insomnia benefit from cognitive behavioral therapy for insomnia (CBT-I), which addresses negative sleep thoughts, anxiety, and conditioned arousal through structured cognitive and behavioral interventions, not extinction.