Bedtime routines for young children: a dose-dependent association with sleep outcomes

• Published in: Sleep (New York, N.Y.) Vol. 38; no. 5; pp. 717 - 722
• Main Authors: Mindell, Jodi A, Li, Albert M, Sadeh, Avi, Kwon, Robert, Goh, Daniel Y T
• Format: Journal Article
• Language: English
• Published: United States Associated Professional Sleep Societies, LLC 01.05.2015
• Subjects: Asian Continental Ancestry Group - statistics & numerical data; Bedtime Routines for Young Children; Child Behavior - physiology; Child, Preschool; European Continental Ancestry Group - statistics & numerical data; Female; Humans; Infant; Infant Behavior - physiology; Infant, Newborn; Internationality; Male; Mothers - psychology; Sleep - physiology; Sleep Medicine Specialty - methods; Surveys and Questionnaires; Time Factors; United States; Wakefulness - physiology; United States; sleep; bedtime routine; toddler; infant; preschooler
• ISSN: 0161-8105; 1550-9109
• DOI: 10.5665/sleep.4662

Establishment of a consistent bedtime routine (the activities that occur right before lights out) is often recommended as part of healthy sleep habits. However, no studies have investigated the dose-dependent association of a bedtime routine with sleep outcomes, especially in young children for whom they are particularly recommended. Thus, the aim of this study was to examine the associations of a consistent bedtime routine with sleep outcomes in young children (ages 0 through 5 y) in a large global sample and assess whether there is a dose-dependent relationship between the frequency of a bedtime routine both concurrently and retrospectively with sleep outcomes. Mothers of 10,085 children (Australia-New Zealand, Canada, China, Hong Kong, India, Japan, Korea, Malaysia, Philippines, Singapore, Thailand, United Kingdom, United States) completed the Brief Infant/Child Sleep Questionnaire. A consistent bedtime routine was associated with better sleep outcomes, including earlier bedtimes, shorter sleep onset latency, reduced night wakings, and increased sleep duration. Decreased parent-perceived sleep problems and daytime behavior problems were also related to institution of a regular bedtime routine. Furthermore, there was a dose-dependent relationship, with better outcomes associated with increased "doses" of having a bedtime routine, both currently and retrospectively, and was found within both predominantly Asian and predominantly Caucasian cultural regions. These results indicate that having a regular nightly bedtime routine is associated with improved sleep in young children, and suggests that the more consistently a bedtime routine is instituted and the younger started the better.