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VOLUME 38, ISSUE 05

BEDTIME ROUTINES FOR YOUNG CHILDREN
Bedtime Routines for Young Children: A Dose-Dependent Association with Sleep Outcomes

http://dx.doi.org/10.5665/sleep.4662

Jodi A. Mindell, PhD1; Albert M. Li, MD2; Avi Sadeh, DSc3; Robert Kwon, BS4; Daniel Y.T. Goh, MD5

1Sleep Center, Children's Hospital of Philadelphia and Department of Psychology, Saint Joseph's University, Philadelphia, PA; 2Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong; 3School of Psychological Sciences, Tel Aviv University, Tel Avi, Israel; 4Johnson & Johnson Asia Pacific, Division of Johnson & Johnson Pte, Ltd; 5Yong Loo Lin School of Medicine, National University of Singapore, Singapore



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Background:

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.

Participants:

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.

Results:

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.

Conclusions:

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.

Citation:

Mindell JA, Li AM, Sadeh A, Kwon R, Goh DY. Bedtime routines for young children: a dose-dependent association with sleep outcomes. SLEEP 2015;38(5):717–722.

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