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Enforcing bedtime rules may help children get necessary amount of sleep
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Enforcing rules about bedtimes led to more children meeting sleep guidelines on weekdays, according to research recently published in BMC Public Health.
Researchers noted that because the lack of sleep is increasingly being recognized as a factor in the development of obesity, primary care physicians should use the findings to initiate discussions on the importance of children getting enough sleep.
“During routine clinical visits, primary care physicians can ask about the child’s 24-hour activity habits, and enquire specifically about sleep duration and sleep-related behaviors such as having a consistent bedtime routine. Primary care physicians can also advise parents on the links between sleep and health, including to their child’s cognitive, behavioral and physical development and well-being,” researcher Heather Manson, MD, Public Health Ontario and University of Toronto, told Healio Family Medicine.
To gather more information on what researchers called the optimal role of parental support for child sleep, Manson and colleagues conducted phone interviews among 1,622 parents or guardians with at least one child between 5 and 17 years of age. Two multivariable logistic regression models — one for weekdays and one for weekends — were built to predict whether parents reported their child was meeting sleep guidelines. Independent variables included parent and child age and gender, motivational and regulatory parental support behaviors, and sociodemographic characteristics.
Researchers also used the Canadian 24-Hour Movement Guidelines for Children and Youth to determine if a child’s sleep duration met sleep recommendations for their age. These guidelines align closely on several fronts with the AAP recommendations outlined in “The Role of Pediatrician in the Primary Prevention of Obesity.”
Pyper and colleagues found that for both weekdays and weekends, the child’s age group was an important predictor of children meeting sleep guidelines. In addition, on weekdays, enforcing rules about child bedtime was a significant positive predictor of children meeting sleep guidelines (OR = 1.59; 95% CI, 1.03–2.44), but encouraging the child to go to bed at a specific time was a significant negative predictor of child meeting sleep guidelines (OR = 0.29; 95% CI, 0.13–0.65). None of the parental support behaviors contributed significantly to the predictions of child sleep on weekends.
Manson suggested other ways primary care physicians can implement their findings into their practices.
“Physicians can advise on of the important role that parents play in setting and supporting bedtimes routines to achieve recommended sleep targets, and can assist by providing guidance on how parents can best support their child’s sleep [and] advise parents to take a positive and proactive role in supporting their child’s sleep, for example, through setting — and following through on — bedtime rules and related routines,” she said. – by Janel Miller
References:
Canadian 24-Hour Movement Guidelines for Children and Youth (accessed 06-05-17)
The Role of the Pediatrician in Primary Prevention of Obesity (accessed 06-07-17)
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Shalini Paruthi, MD
This new study adds to the growing evidence of how parental support impacts children’s sleep duration and supports findings from multiple other studies.
It is critical that parents and clinicians (primary care physicians) become much more aware of the benefits associated with sufficient amounts of sleep as well as the poor outcomes associated with insufficient amounts of sleep.
For example, when developing the American Academy of Sleep Medicine Consensus Statement on sleep duration for children, we found that sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior and learning problems. Insufficient sleep also increases the risk for accidents, injuries, hypertension, obesity, diabetes and depression. Insufficient sleep in teenagers is associated with increased risk for self-harm, suicidal thoughts and suicide attempts.
Additionally, it is critical for parents to model good sleep routines and durations themselves. It is important to discuss sleep just like we all discuss healthy nutrition and daily exercise with our children. No matter a child’s age, they are always looking to their parents for verbal and non-verbal guidance as to what is ‘normal.’ When a parent develops a good bedtime routine and sleep schedule, and helps the child develop one from an early age (even birth), those good sleep habits can last a lifetime. If parents consistently sleep in on weekends, then children may learn that it is ok to sleep in on weekends, despite the chaos it causes to the circadian rhythm (internal clock) and sleep schedule (not being sleepy enough at the regular school-night bedtime Sunday night).
Lastly, as we all know, it is truly the parent who is the expert on the child, and therefore, over time, each parent typically figures out what their unique, growing child responds to best in terms of motivation-type discussions vs. rule enforcement-type actions through rewards or punishments. A child goes through dramatic changes developmentally, socially and physically over 18 years. Therefore, it is most likely that parents will motivate and enforce rules in some combination while raising their children.
The bottom line is that it’s critical to be aware of the benefits of sufficient sleep and the possible dangers of insufficient sleep, to have frequent discussions with children about the benefits of healthy sleep, and model healthy sleep. When parents make sleep a priority, then their children can also make sleep a priority.
Reference:
Paruthi S, et al. J Clin Sleep Med. 2016;doi: 10.5664/jcsm.5866.
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