Children With Nightly Bedtime Routines Have Better Sleep Outcomes

Sweet dreams. G’nite. Shubh ratri. No matter how you say it, a consistent bedtime routine makes a difference in children’s sleep outcomes, according to a study that included mothers of 10,000 young children from 14 countries.

Sleep problems in children are a common concern among parents, and increasing evidence suggests that inadequate sleep can lead to behavioral and cognitive consequences. Most parenting books and pediatricians recommend a bedtime routine as an effective way to improve children’s sleep difficulties, but this research is the first to demonstrate its importance in a dose-dependent way.

“With each additional night that a family institutes a bedtime routine, their child’s sleep is better,” said Jodi A. Mindell, PhD, associate director of the Sleep Center at The Children’s Hospital of Philadelphia, who reported the results in the journal Sleep. “It was a universal finding. We found it across a multitude of countries, which is amazing.”

Dr. Mindell and her co-investigators collected the data online from a questionnaire offered on a popular parenting website and through emails. The questions asked mothers of children ages 0 to 5 about their child’s daytime and nighttime sleep patterns and behaviors.

Overall, the results suggest that a regular nightly bedtime routine is associated with earlier bedtimes, shorter time needed to fall asleep, fewer awakenings after sleep onset, more total sleep, decreased parent-perceived sleep problems, and decreased daytime behavior problems. They also found that children who start sleep routines as infants are likely to have better sleep outcomes as they grow into toddlers and preschoolers.

“This is a clear message that for every family a bedtime routine should be recommended,” Dr. Mindell said. “A pediatric practitioner should ask how many nights a week they do it, and then encourage them to try to increase it, even it’s just by one night.”

In future studies, the researchers would like to take a closer look at which activities before lights out are most effective at improving children’s sleep. For example, does a relaxing bath before bed or reading a book result in better outcomes? Or, on the other hand, does an energetic 2-year-old benefit from more lively engagement before being tucked in?

“Sometimes I think it is frustrating for families because they have a hard time making bedtime calm for a child who has a lot of energy and won’t sit still for books,” Dr. Mindell said. “Maybe it’s OK to have a more active aspect of your bedtime routine, as long as it’s done every night and it’s an effective signal to your child. We don’t know yet.”