ABCs of SLEEPING: A review of the evidence behind pediatric sleep practice recommendations

What is it about?

This article is a review of research literature that evaluated 77 articles regarding sleep, insomnia, and bedtime practices for children ages 1-12 years old. Through this review the authors developed a new mnemonic that more broadly captures this body of work and specifically attends to behavioral and environmental practices that promote both good quality and quantity of sleep in children called the “ABCs of SLEEPING.” This mnemonic stands for 1) age-appropriate bedtimes and wake-times with consistency, 2) schedules and routines, 3) location, 4) exercise and diet, 5) no electronics in the bedroom before bed, 6) positivity, 7) independence when falling asleep, 8) needs of the child met during the day, 9) equals great sleep. Specifically, the article indicated the level of strength of empirical support for common pediatric sleep recommendations in each of these areas. Areas of strong research evidence support determined in the article included children getting the recommended number of hours of sleep for their age group, consistent bedtime routines, limiting use of electronics before bed, and children establishing sleep independence (e.g., settling into bed and sleep on their own, tolerating night wakings independently). Areas of moderate support included having a bedtime by 9pm, maintaining a routine sleep schedule (e.g., sleep-time, naptimes, wake-times) and having a positive atmosphere in the home environment.

Featured Image

Photo by Isaac Quesada on Unsplash

Photo by Isaac Quesada on Unsplash

Why is it important?

This article highlights the research literature indicating that even minor disruptions in sleep can have impacts on behavior and cognitive functioning in children. Per the article, an estimated 20-30% of children have a clinically significant sleep problem and approximately 70% of children experience at least one sleep-related problem multiple days of the week, which highlights how pervasive these impacts may be. The authors note that most of these sleep concerns are behavioral rather than due to an intrinsic sleep or sleep-related disorder and indicate the important role behavioral health clinicians can play in supporting families with adherence to sleep-based health recommendations. The detailed outlining of the strength of empirical support for a variety of sleep practices also serves as a useful way for clinicians to help determine prioritized goals for children and families. There are a vast number of recommendations including both medical and behavioral interventions for sleep and this article highlights that there is varied empirical strength to these recommendations. While this article did not address sleep recommendations for children older than 12-years-old, many appear relevant to older age groups, such as obtaining adequate sleep quantity for one’s age and consistency in bedtime routines and sleep times.