To examine the associations between sleep hygiene and sleep patterns in children ages newborn to 10 years. The relationships between key features of good sleep hygiene in childhood and recognizable outcomes have not been studied in large, nationally representative samples.
A national poll of 1473 parents/caregivers of children ages newborn to 10 years was conducted in 2004. The poll included questions on sleep hygiene (poor sleep hygiene operationally defined as not having a consistent bedtime routine, bedtime after 9:00 PM, having a parent present when falling asleep at bedtime, having a television in the bedroom, and consuming caffeinated beverages daily) and sleep patterns (sleep onset latency, frequency of night wakings, and total sleep time).
Across all ages, a late bedtime and having a parent present when the child falls asleep had the strongest negative association with reported sleep patterns. A late bedtime was associated with longer sleep onset latency and shorter total sleep time, whereas parental presence was associated with more night wakings. Those children (ages 3+) without a consistent bedtime routine also were reported to obtain less sleep. Furthermore, a television in the bedroom (ages 3+) and regular caffeine consumption (ages 5+) were associated with shorter total sleep time.
Overall, this study found that good sleep hygiene practices are associated with better sleep across several age ranges. These findings support the importance of common US based recommendations that children of all ages should fall asleep independently, go to bed before 9:00 PM, have an established bedtime routine, include reading as part of their bedtime routine, refrain from caffeine, and sleep in bedrooms without televisions.
"6 to 12 months 39 -Assessment of parents' quality of life after improvement of the child's sleep quality -Minimal checking with systematic extinction -Improvement of sleep quality and depressed mood symptoms of parents -Decrease in co-sleeping Rickert & Johnson, 27 1988 6-54 months 33 (11 in each intervention group, 11 in control group) -Evaluation of the reduction in the number of nocturnal awakenings -Programmed awakening -Systematic extinction -Control -Lower number of nighttime awakenings in both groups that underwent interventions Mindell et al., 24 2009 7 to 18 months 18 to 36 months 206 (7-18 m) 199 (18-36 m) -Changes in maternal mood after improved sleep quality of the child -Positive routines -Decreased sleep latency in children -Decrease in the duration of nocturnal awakenings -Decrease in depressive symptoms in mothers Mindell et al., 25 2011 18 to 48 months 171 -Change in sleep quality of child and mother -Change in maternal self-confidence -Positive routines -Decrease in sleep latency, difficulty falling asleep, number and duration of nocturnal awakenings -Maternal self-confidence improvement -Temporary improvement of the quality of maternal sleep Skuladottir et al., 18 2005 3 to 24 months 79 -Changes in the nocturnal sleep pattern with improved daytime sleep pattern -Positive routines for daytime sleep -Gradual extinction for nighttime sleep -Remodeling for daytime sleep -Increase in nocturnal sleep -Decrease in nocturnal awakenings Adams & Rickert, 26 1989 18 and 48 months 36 (12 in each intervention group; 12 in control group) -Effect on the number of temper tantrums -Positive routines -Gradual extinction -Lower number of temper tantrums and shorter episodes in both intervention groups -Best score in the parents' group positive routines in the Marital Adjustment Scale Eckerberg, 19 2002 4 to 30 months 39 -Effectiveness of written information over verbal instructions by the physician -Gradual extinction -Decrease in sleep latency in both groups -Decrease of awakenings in both groups -Increased chance to go back to sleep on their own in both groups "
[Show abstract][Hide abstract] ABSTRACT: Aim:
To analyze the interventions aimed at the practice of sleep hygiene, as well as their applicability and effectiveness in the clinical scenario, so that they may be used by pediatricians and family physicians for parental advice.
Source of data:
A search of the PubMed database was performed using the following descriptors: sleep hygiene OR sleep education AND children or school-aged. In the LILACS and SciELO databases, the descriptors in Portuguese were: higiene E sono, educação E sono, educação E sono E crianças, e higiene E sono E infância, with no limitations of the publication period.
Summary of the findings:
In total, ten articles were reviewed, in which the main objectives were to analyze the effectiveness of behavioral approaches and sleep hygiene techniques on children's sleep quality and parents' quality of life. The techniques used were one or more of the following: positive routines; controlled comforting and gradual extinction or sleep remodeling; as well as written diaries to monitor children's sleep patterns. All of the approaches yielded positive results.
Although behavioral approaches to pediatric sleep hygiene are easy to apply and adhere to, there have been very few studies evaluating the effectiveness of the available techniques. This review demonstrated that these methods are effective in providing sleep hygiene for children, thus reflecting on parents' improved quality of life. It is of utmost importance that pediatricians and family physicians are aware of such methods in order to adequately advise patients and their families.
Jornal de Pediatria 06/2014; 90(5). DOI:10.1016/j.jped.2014.05.001 · 1.19 Impact Factor
"These lifestyle behaviors and routines are rarely practiced in isolation and are typically associated with one another. For example, decreased sleep has been associated with increased screen-viewing (e.g., Owens et al., 1999; Thompson and Christakis, 2005), and having a bedroom TV (e.g., Mindell et al., 2009). In turn, having a bedroom TV has also been associated with other health-risk behaviors such as having fewer family meals (Barr-Anderson et al., 2008). "
[Show abstract][Hide abstract] ABSTRACT: Many daily routines and behaviors are related to the prevalence of obesity. This study investigated the association between routines and behaviors that act as protective factors related to lower prevalence of obesity in parents (BMI ≥ 30 kg/m(2)) and overweight in preschool children (BMI ≥ 85th percentile). Socio-demographic characteristics were assessed in relation to protective routines (PRs), and prevalence of obesity/overweight data from 337 preschool children and their parents. The two PRs assessed with parents included adequate sleep (≥7 h/night) and family mealtime routine (scoring higher than the median score). The four PRs assessed in children included adequate sleep (≥10 h/night), family mealtime routine, limiting screen-viewing time (≤2 h/day of TV, video, DVD), and not having a bedroom TV. Overall, 27.9% of parents were obese and 22.8% of children were overweight, and 39.8% of the parents had both parent PRs, and only 11.6% of children had all four child PRs. Results demonstrated that several demographic factors were significantly related to the use of PRs for parents and children. The lack of PRs was related to increased risk for overweight in children, but not for obesity in parents. However, in the adjusted models the overall cumulative benefits of using PRs was not significant in children either. In the multivariate adjusted logistic regression models, the only significant individual PR for children was adequate sleep. In a path analysis model, parent sleep was related to child sleep, which was in turn related to decreased obesity. Overall, findings suggest that parent and child PRs, especially sleep routines, within a family can be associated and may play an important role in the health outcomes of both parents and children. Understanding the mechanisms that influence how and when parents and children use these PRs may be promising for developing targeted family-based obesity-prevention efforts.
Frontiers in Psychology 04/2014; 5:374. DOI:10.3389/fpsyg.2014.00374 · 2.80 Impact Factor
"6-12 months), the relationship between breastfeeding and night wakings appears to be largely mediated by parental presence at sleep onset or nursing to sleep, rather than breastfeeding per se  . A later bedtime (after 9pm), caffeine usage, and a television in the bedroom have been linked to sleep disturbance across youth of all ages . Finally, there is some emerging evidence that regular daytime routines are predictive of longer sleep duration in preschoolers and early school-aged children . "
[Show abstract][Hide abstract] ABSTRACT: Night wakings and bedtime problems in infants and young children are prevalent, persistent, and associated with a variety of impairments in youth and their families. Assessment strategies include clinical interview, sleep diaries, actigraphy, and subjective measures. A number of treatment approaches with varying degrees of empirical support are available, and several novel strategies have been evaluated in recent years. Appropriate sleep scheduling and a bedtime routine are important components of any treatment program.
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