Household rules, regular sleep-wake routines improve sleep in children

Children obtain better and more age-appropriate sleep in the presence of household rules and regular sleep-wake routines, according to sleep researchers.

The researchers found that well-established rules for getting good sleep, such as limited caffeine and a regular bedtime, led to sufficient sleep quantity and adequate sleep quality. In contrast, when parents and children had electronic devices on in the bedroom after bedtime, sleep deficiency was more likely.

Reducing the encroachment of technology and media into sleep time and supporting well-known sleep hygiene principles should be a focus of public health intervention goals for sleep health, the researchers said.

Orfeu Buxton, now an associate professor or biobehavioral health at Penn State, led a team conducting the 2014 National Sleep Foundation Sleep in America Poll, "Sleep in the Modern Family," whose overall objective was to obtain a current picture of sleep in families with at least one school-aged child. The results are published today (Jan. 26) in Sleep Health.

The researchers evaluated U.S. households with children aged 6 to 17 years old through Internet-based interviews. A total of 1,103 parents or guardians of an average age of 42 completed surveys. Fifty-four percent were female.

"We were interested in parental perception of the importance of sleep duration and sleep quality, habits, and routines of the families and children, and obstacles preventing adequate sleep," Buxton said.

According to researchers, although the majority of parents endorsed the importance of sleep, 90 percent of children did not sleep the full amount of time recommended for their age group.

Some of the primary consequences of poor sleep among children and adolescents are behavioral problems, impaired learning and school performance, sports injuries, problems with mood and emotional regulation, and a worsening of health-related issues including obesity.

Evidence also indicates that in adolescence, lack of sleep may be related to high-risk behaviors such as substance abuse, suicidal behaviors and drowsy driving.

Significant predictors of age-adjusted sufficient sleep duration -- estimated conservatively as at least nine hours for ages 6 through 11 years and at least eight hours for ages 12 to 17 years -- included parent education, regular enforcement of rules about caffeine and whether children left technology on in their bedroom overnight.

"We have previously demonstrated the negative effect that use of light-emitting technology before bedtime can have on sleep, and now in this study we see how parental rules and routines regarding technology can influence the quantity and quality of their children's sleep," said Anne-Marie Chang, assistant professor of biobehavioral health at Penn State and co-author of the study. Chang and colleagues recently showed that reading on an iPad before bedtime, compared to reading a print book, can impair sleep, delay circadian timing, and degrade alertness the following morning.

"An important consequence of our modern-day, 24/7 society is that it is difficult for families -- children and caregivers both -- to get adequate sleep," Buxton said. "Sleep in the family context frames sleep as involving interactions between all members of a household and interactions with the environment of the home as well as exogenous factors like work or school affecting any member."

Several potential reasons for poor sleep include the use of technology in the bedroom, complicated and busy daily schedules with competing work, school, social, and recreational activities as well as neighborhood noise from vehicular traffic, commercial or industrial activity and neighbors.

Within the family dynamic, a consistent bedtime routine improves sleep, whereas television use in the bedroom generally is associated with curtailed sleep.

"Good quality and sufficient sleep are vital for children," Buxton said. "Just like a healthy diet and exercise, sleep is critical for children to stay healthy, grow, learn, do well in school, and function at their best."

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