A Healthy Child Needs a Healthy Brain, A Healthy Brain Needs Healthy Sleep

Some statements are easy to understand and easy to study, for example: “teething causes sleep disruptions”. This popular myth, and others (Blog Posts 36 and 37) are clearly identified as false statements in scientific publications.  

Other popular, but false, beliefs arise from an incomplete understanding or a simplistic point of view. For example, healthy sleep might be viewed only from the perspective of sleep duration. Thus, a parent might incorrectly conclude that early bedtimes are not that important because they believe that their child will sleep in longer in the morning and/or take longer naps. Stated another way, a parent might believe in the ‘myth’ that a later bedtime associated with a later wake-up time and/or longer naps is equivalent to an early bedtime associated with an earlier wake-up time. With this mind-set, the timing of the sleep period or the consolidation of sleep is ignored. But sleep quality is more than just sleep duration (Blog Posts 6, 8, 11, and 15).  

In the past, “Early to bed and early to rise, makes a man healthy, wealthy, and wise” was a popular proverb. But today, modern parents may struggle with long commute times and may conduct business online at home. Or they may be distracted by digital devices at home. Thus, early bedtimes for their babies and children are especially challenging.  

Here are some reasons why early bedtimes are especially important:

1. Often, when children have a late bedtime, the later wake-up time (and/or longer naps) does not fully compensate for the late bedtime, so the night and total sleep duration is short.
   
   
2. Mental health problems or obesity (Blog Post 81) are more likely to occur with late bedtimes even when night sleep duration is normal due to late wake up times, or total sleep duration is normal due to long naps.
   
   
3. Frequent bedtime routines are valuable, unrelated to sleep, and they are also associated with longer night sleep duration (Blog Post 10). However, I asked the authors whether longer night sleep durations were more associated with frequent bedtime routines or early bedtimes. Answer: “the biggest drive of nighttime sleep is what time a child goes to sleep.”
   
   
4. Consistent bedtime routines produce longer night sleep durations (Blog Post 87). However, I asked the authors whether longer night sleep durations were more associated with consistent bedtime routines or early bedtimes. Answer: “[Early] bedtime is a more direct and stronger predictor of [longer] concurrent sleep durations from 3 to 24 months, above and beyond bedtime routine”
   
   
5. Parental sleep-related cognitions are important for children, unrelated to sleep, and some sleep-related parental cognitions predict longer night sleep duration (Blog Post 88). However, I asked the authors whether longer night sleep durations were more associated with parental sleep-related cognitions or early bedtimes. Answer: “[Early] bedtime is more strongly correlated with [long] sleep durations than maternal cognitions.”
   
   
6. Over A 15-month 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. Children who increased their sleep duration had a concurrent decrease in measurements, less hyperactivity/inattention, fewer conduct problems, better peer relationships, and more prosocial behavior.  Nighttime sleep duration at baseline was a predictor of measurements at follow-up but not vice versa.  “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 (Blog Post 75). However, I asked the author 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). Answer: “This is a great point, and I couldn’t agree more.”
   
   
7. Early bedtimes are associated with taller children (Blog Post 23).

Moving the bedtime only a few minutes earlier, over time, may produce dramatic results; it’s as easy as ABC:

A. Begin soothing and bedtime routines when drowsy signs (Blog Post 9) begin to appear or just start 10-20 minutes earlier than you customarily do this.

        and/or

B. Do not allow a late afternoon or early evening nap to occur.  

Start this on a weekend when both parents are available to help distract and soothe your child through a possible rough patch.

and/or

C. Control the wake-up time. Nobody wants to wake a sleeping child. But if your pre-school child is falling asleep late at night and waking up way too late in the morning, then start waking your child in the morning around 7:00am to reset his sleep-wake cycle to be in synchrony with his circadian rhythm.

The importance of small differences in sleep duration cannot be overstated (Blog Post 6). A few minutes of extra sleep in the early evening might make a world of a difference! Please don’t get stressed if circumstances make it impossible to get ideal early bedtimes on weekdays. Remember, a bedtime that is a little too late is still better than a bedtime that is way too late.  Maybe your child can get some catch-up sleep on weekends.

Late bedtimes coupled with late wake-up times and/or long naps are not a substitute for early bedtimes.

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