If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial. I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. This is a reference book. Read only the topic of interest to you.
Emotional and behavioral problems (EBPs) “include poor social interaction, abnormal cognitive functioning, delayed school readiness and problems in later childhood, and persistent mental health problems and obesity in adulthood.” In a 2021 study by Dr. Zheng, she followed a group of 315 Danish children, between 2-6 years, over a 15-month follow-up period. Assessment 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.
Results: “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 but not vice versa.”
Discussion: “Among 2- to 6-year-old children, both [more] nighttime sleep duration at baseline and an increase in nighttime sleep duration from baseline to follow-up were associated with lower emotional and behavioral difficulties at a 15-month follow-up. Our study provides new longitudinal evidence toward the potential benefits of longer nighttime sleep duration in reducing EBPs in early childhood. Moreover, our finding that nighttime sleep duration precedes the EBPs, but not vice versa, is promising. Targeting sufficient nighttime sleep duration in early life interventions may be an effective strategy for reducing the prevalence of children’s EBPs and promoting mental and psychosocial health and well-being of young children.”
“Controversy exists as to whether there is a bidirectional relationship between sleep duration and EBPs. That is, whether the short sleep duration contributes to the development of EBPs in children or EBPS are a persistent phenomenon leading to insufficient sleep. Our findings demonstrate that sleep duration was a predictor of EBPs, but the reverse association was not significant.”
The authors cite three additional studies (children at baseline ages 18 months, 2 years, and 3-4 years) in support of their findings that, over time, at follow-up (ages at follow-up, 5 years, 3 years, and 5-7 years respectively), more sleep is associated with fewer emotional and behavioral problems. One of these studies also examined directionally of effects and they also found a unilateral direction of effects: short sleep duration causes EBPs. However, they also cite one study of older children, 4-5 years at baseline and 12-13 years at follow-up that found a bilateral direction of effects. “However the findings from that study are not comparable to results from our study due to different age groups, sleep measures examined, and the longer duration of follow-up.”
Less sleep is associated with more EBPs later.
Helping your 15-month sleep better is effective therapy to reduce EBPs in a dose-response fashion.
More sleep causes more reduction in EBPs.
Sleep Advice – Main Points:
Brain health depends on healthy sleep. More sleep is better. – Blog Posts 1–5
Even a few minutes of extra sleep improves brain health. – Blog Post 6
Just move the bedtime a few minutes earlier (Sleep Tip). – Blog Posts 7 and 69
More sleep makes your child’s temperament easier. – Blog Post 48
More sleep may cure a “mental health problem”. – Blog Post 66
In young children, adverse effects from mild unhealthy sleep are reversible. – Blog Posts 50–51
Over a long time, adverse effects from severe unhealthy sleep may become irreversible. – Blog Posts 50–51
More Information: I asked Dr. Zheng whether the quality of night sleep (Blog Post 15) might be more important than the 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.”
