In a study of 315 Danish children, between 2-6 years, over a 15-month follow-up period, assessments of night sleep duration showed a significant dose-response trend for subsequent changes in measurements in four domains: hyperactivity/inattention, conduct problems, peer relationships, and prosocial behavior (Blog Post 75). “Compared with children who decreased or had no change in nighttime sleep duration from baseline to follow-up 15 months later, those children who increased their sleep duration had a concurrent decrease in measurements (less hyperactivity/inattention, fewer conduct problems, better peer relationships, more prosocial behavior). Nighttime sleep duration at baseline was a predictor of measurements at follow-up.” I asked the author whether the quality of night sleep (Blog Post 15) might be more important than the night sleep duration (Blog Post 6) and specifically on the importance of an early bedtime as a contributor to better quality sleep (and longer sleep duration). Her response: “This is a great point, and I couldn’t agree more.” Helping your 2-6 year old sleep better is effective therapy to reduce emotional and behavioral problems in a dose-response fashion.
Professor Harriet Hiscock studied a group of children between 2-13 years of age. Over a period of only 7-14 days, parents utilized a mobile app offering tailored sleep strategies to improve sleep. “At follow up, care givers reported fewer moderate/severe sleep problems, improved child sleep patterns, better temperament and improved care giver mental health. The percentage of care givers rating their child as ‘more difficult than average’ decreased from 51 to 36%.” Helping your child sleep better will improve your child’s temperament between 4 months-3 years and between 2-13 years.!
Children with nonregular bedtimes examined at age 3, 5, and 7 years had more behavioral difficulties at age 7 than children with regular bedtimes. The effect of nonregular bedtimes was cumulative—the more years of nonregular bedtimes, the worse the behavior. Thus, the effect of nonregular bedtimes builds up throughout early childhood. The good news is that the harm is reversible. That is, when children change from nonregular to regular bedtimes, they show improvements in their behavior.
My daughter Zaylin was born with complex birth defects requiring multiple surgeries and prolonged hospitalizations during her first few years. The consequence of this medical history, that resolved approximately one year ago, at age five, is that she had many behavioral problems not only at school but also in our home. We regularly got reports from her teachers for “acting out” and she had an Individualized Education Plan as she struggled with academics in school. In addition, she was very mean and nasty to her brother and very defiant at bedtime. I sought out many therapists and advice in an effort to help her, but nothing seemed to work. Part of the stress for me was Zaylin’s struggles and also, the difficulty for doctors to properly diagnose her problem. At first, she was diagnosed with autism. She was later diagnosed with developmental delay and PTSD (from her repeated and prolonged hospitalizations). After many tests and many therapists, none of these diagnoses seemed to fit my daughter.
We used Sleep Rules (page 309, Healthy Sleep habits, Happy Child) and she protested. I started by taking away her stuffed animals one by one. She loves them and has plenty of them on her bed. Then I offered her a cookie for breakfast. I would let her dad put her to sleep because I would baby her and he didn’t. Her normal bedtime was 9:00 p.m. and we moved it to 6:00 p.m.It was not until I got Zaylin on a better sleep schedule, at age 6 years, that I realized that her sleep deprivation was causing all of these behavioral issues. I was skeptical because of my past failed attempts. After one week of applying Dr. Weissbluth’s advice, I saw some changes. It has been four months and my daughter is a new person! The sleep strategy allowed Zaylin to sleep longer through the night without any more bedtime battles and her improved behavior in school was noticed by her teachers, and, at home, she turned into an entirely new child, saving my daughter and our family.
Two years after her mother wrote her story, her bedtime is 7:00 p.m. and she continues to thrive academically, socially, and artistically!
Adding one hour in bed for five nights in children 7-11 years-old provided an additional 27 minutes of sleep with improvements in emotional lability and restless-impulsive behavior. Another study of 7-11 years-old showed that 18 minutes of extra sleep caused improvement in grades for mathematics and languages.
Parent-set bedtimes among 14-year-olds caused an earlier bedtime which was associated with an extra 19 minutes of night sleep which caused improved daytime functioning.
There are many studies proving that just small amounts of extra sleep help children (Blog Post 6). Delaying school start times allowed 15-year-olds to sleep in later and five months later, they demonstrated improved mental health, better prosocial behavior, peer relationships, and attention level but the average increase in night sleep was only 2.4 minutes. In another study, lower levels of sleepiness and improvement in alertness and well-being among 15-year-olds was observed by delaying school start times even though the increase in night sleep time after nine months was just 10 minutes. Similar results were observed in three other studies involving delaying school start times with an additional 17 minutes, 29 minutes, and 34 minutes more sleep producing less sleepiness, less tardiness, and increase in grades. In an additional study, a 15-year-old was “classified as having low mood if he answered “yes” to the following question: During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities?” Delaying the school start time caused a significant reduction of almost 5 per cent of the prevalence of low mood with a 30-minute increase in sleep duration. Also, in this study, among 13-year-olds, starting school earlier caused a decrease of sleep duration of 15 minutes and a 2 per cent increase in low mood prevalence. So, a few minutes less sleep every night also makes a big difference!
Experimentally extending sleep by adding one hour in bed for five nights caused adolescents to sleep 13 minutes more at night with a reduction of insomnia and depressive symptoms.
Adolescents, aged 15-17 years, all of whom were good sleepers with more than 8 hours of sleep per night, were experimentally studied in a sleep laboratory for 10 nights. The first two nights were used to gather baseline data and all were given 10 hours of sleep opportunity. One group was experimentally sleep deprived for the next 8 nights followed by 2 nights of 10 hours of sleep opportunity for recovery. Another group was the control group; they were given 10 hours of sleep opportunity throughout the 10-day experiment. As expected, the sleep deprived group showed increased negative emotions and decreased positive emotions during the sleep deprivation phase of days 3-8 compared to baseline days 1-2, and they did not fully recover during the last 2 days of 10-hour sleep opportunity for recovery.
But what was surprising and unexpected was the increased happiness that the control group showed when comparing days 3-8 to the baseline days 1-2. Furthermore, they observed even more happiness during days 9-10 compared to days 3-8. The authors concluded that, “In apparently well-rested adolescents, who are sleeping more than 8 hours a night, this study demonstrates that obtaining even more sleep increases happiness by more than 10% over the course of the study.”