Strict bedtime rules can help kids get enough sleep

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[June 02, 2017] By Lisa Rapaport

(Reuters Health) - Parents who stick to a set bedtime schedule and enforce rules for nighttime routines may be more likely to have children who get enough sleep during the week than people who are more relaxed about putting kids to bed, a recent Canadian study suggests.

Under Canadian sleep guidelines, children aged 5 to 13 should get at least nine hours of sleep a night and teens aged 14 to 17 should get at least eight hours. For the study, researchers examined survey data from 1,622 parents with at least one child in these age ranges and found kids were 59 percent more likely to meet these minimum sleep guidelines during the week when parents enforced a set bedtime than when they didn't do this.

"The positive effect of enforcing bedtime rules on weekdays may reflect broader parental expectations, bedtime structure or the proactive nature of rule-setting," said senior study author Dr. Heather Manson of Public Health Ontario in Toronto.

Just encouraging kids by reminding them about bedtimes may not work the way parents expect it to, the study also found. When parents relied on reminders about bedtime without enforcing the rules, children were 71 percent less likely to get the minimum recommended amount of sleep during the week.

"On weekdays, bedtime rule enforcement, not encouragement, was conducive to children achieving sufficient sleep," Manson said by email.

Depending on the age of the child, the proportion of parents reporting that their child met the Canadian sleep guidelines ranged from about 68 percent to 93 percent on weekdays and from 49 percent to 86 percent on weekends.

The number of children getting the minimum recommended amount of sleep increased from ages 5 to 9 but then declined from age 10 to 17, according to the results published in BMC Public Health.

Fifteen-year-olds had the biggest variation between weekday and weekend sleep, with 38 percent fewer kids getting the minimum recommended amount of rest on weekends than on weekdays.

Overall, about 94 percent of parents reported encouraging their child to go to bed at a specific time, and roughly 84 percent reported enforcing bedtime rules.

The study found rule enforcement more effective than simple reminders even after adjusting for other factors like the age and sex of the child, household income, parental education and other rules such as restricting screen time or use of technology in the bedroom.

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One limitation of the study is that it relied on parents to accurately recall and report on their approach to bedtime routines and the amount of sleep kids got. It didn't include any objective measures of sleep duration or quality, and it wasn't a controlled experiment designed to prove how specific parenting behaviors might directly impact children's sleep.

Previous research has found that parents' consistency with enforcing rules about bedtime and media use is critical for good sleep outcomes, said Michelle Garrison of Seattle Children's Research Institute and the University of Washington.

While parents may drive all aspects of these routines for babies, they can start to involve kids in the process more as children age to help them develop healthy independent sleep habits, Garrison, who wasn't involved in the study, said by email. This might mean reading to toddlers every night but letting them choose the book, for example, or allowing teens to choose what relaxing activities will help them prepare for bed.

"The parent may still have responsibility for getting the routine started at the same time each night and helping the child learn to practice self-monitoring to see if they are on track in terms of both time and in calming down before bed," Garrison said.

"As they continue to move towards adulthood, the idea is to keep gradually shifting more of this to the child so that they have the opportunity to practice and grow these skills," Garrison added. "But with enough structure and support so that we aren't expecting them to have the self-regulation of an adult."

SOURCE: http://bit.ly/2qKYOSB BMC Public Health, online May 24, 2017.

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