To examine prospectively the relationship between teething and infant sleep using objective sleep measurements.

Over a 4-week period, 849 infants aged 3-18 months (mean = 8.4 ± 1.8) from the US and Canada were monitored using auto-videosomnography, based on computer-vision technology to decode video footage from crib camera monitors. Parents also provided reports of tooth eruption timing, symptoms, and management strategies. Objective sleep metrics, including total sleep time, night-time awakenings, and parental crib visits, were compared between teething and nonteething nights using generalized estimating equations and changepoint analysis.

Both analytic approaches showed no significant differences in sleep metrics between teething and nonteething nights. Although over one-half of the parents reported sleep disturbances during teething, these subjective reports were not corroborated by the objective data.

These findings challenge the widely held belief that teething disrupts sleep and highlight the need for pediatric health care professionals to consider alternative explanations for infant sleep problems. Educating parents with evidence-based information may prevent potentially harmful management strategies for teething (eg, excessive use of analgesics and local anesthetics) and improve sleep problem management. Future research should explore these relationships using multiple objective measures and more diverse populations.