Sleep hygiene—which includes practices like providing a cool and quiet sleeping environment or reading before bedtime to help kids unwind—is increasingly popular among parents looking to ensure their children get a good night’s rest.
But are these practices all they’re cracked up to be? UBC sleep expert and nursing professor Wendy Hall recently led a review of the latest studies to find out.
In this Q&A, she talks about which practices seem to be consistently effective, and which ones require further study.
What is sleep hygiene and why is it important?
Good sleep hygiene gives children the best chances of getting adequate, healthy sleep every day. And healthy sleep is critical in promoting children’s growth and development. Research tells us that kids who don’t get enough sleep on a consistent basis are more likely to have problems at school and develop more slowly than their peers who are getting enough sleep. The American Academy of Sleep Medicine recommends the following amounts of sleep, based on age group:
For our review, we wanted to systematically analyze the evidence for sleep hygiene across different countries and cultures. We honed in on 44 studies from 16 countries, focusing on four age groups in particular:infants and toddlers (four months to two years), preschoolers (three to five years), school-age children (six to 12 years) and adolescents (13 to 18 years). These studies involved close to 300,000 kids in North America, Europe and Asia.
What were some of the best sleep hygiene practices?
We found good-to-strong endorsement of certain sleep hygiene practices for younger kids and school-age kids: regular bedtimes, reading before bed, having a quiet bedroom, and self-soothing—where you give them opportunities to go to sleep and go back to sleep on their own, if they wake up in the middle of the night.
Even for older kids, keeping a regular bedtime was important. We found papers that showed that adolescents whose parents set strict guidelines about their sleep slept better than kids whose parents didn’t set any guidelines.
We found extensive evidence for limiting technology use just before bedtime, or during the night when kids are supposed to be sleeping. Studies in Japan, New Zealand and the United States showed that the more exposure kids had to electronic media around bedtime, the less sleep they had.
One big problem with school-age children is it can take them a long time to get to sleep, so avoiding activities like playing video games or watching exciting movies before bedtime was important.
Many of the studies also highlighted the importance of routines in general. A study in New Zealand showed family dinner time was critical to helping adolescents sleep.
Information provided by Chinese studies and one Korean study linked school-age children’s and adolescents’ short sleep duration to long commute times between home and school and large amounts of evening homework. With more children coping with longer commutes and growing amounts of school work, this is an important area for future study in North America.
Surprisingly, there wasn’t a lot of evidence linking caffeine use before bedtime to poor sleep; it appeared to be the total intake during the day that matters.
Going forward, what do you recommend for promoting better sleep hygiene among kids?
We need more studies to systematically examine the effect of certain sleep hygiene factors on sleep quality. We need to know more about which factors affect sleep problems like night waking or taking a long time to fall asleep. For now, I would still strongly recommend that parents set bedtimes, even for older kids, and things like sitting down for a family dinner, establishing certain rituals like reading before bed, and limiting screen time as much as possible.
Sleep education can form part of school programming. There was a project in a Montreal school where everyone was involved in designing and implementing a sleep intervention—the principal, teachers, parents, kids, and even the Parent Advisory Council. The intervention was effective, because everyone was on board and involved from the outset.