Theoretical ReviewBenefits of a bedtime routine in young children: Sleep, development, and beyond
Section snippets
Definition, prevalence, and components of a bedtime routine
Childhood routines refer to observable, predictable, and repetitive behaviors that occur daily or weekly in the context of caregiver–child interactions in the home environment [21], [22]. For the purposes of this paper, a bedtime routine is defined as the predictable activities that occur in the hour or so before lights out, and before the child falls asleep [23]. Activities that occur as the child is falling asleep, such as rocking or feeding to sleep, are not conceptualized as part of the
A conceptual model for the benefits of a bedtime routine for broad child development
Research demonstrates that increased engagement in general, everyday routines is associated with positive child outcomes, including enhanced language development, academic achievement, and social-emotional and behavioral functioning [21], [33], ∗[34]. Everyday routines can also benefit family functioning, with some research indicating that routines are associated with higher levels of marital satisfaction [35] and lower levels of maternal distress [36]. Additionally, engaging in regular
Benefits of a bedtime routine on sleep
Although simply following the same general daily routines in early childhood has been associated with increased sleep duration [46], research has demonstrated that engaging in a regular bedtime routine is particularly beneficial for multiple aspects of early childhood sleep [19]. Cross-sectional, longitudinal, and intervention studies (Table 1), have provided robust evidence that following a bedtime routine is associated with a number of positive sleep outcomes, including an earlier bedtime,
Benefits of a bedtime routine beyond improved sleep
As noted above, we hypothesize that having a bedtime routine has benefits beyond improved sleep, including the broad domains of child mood and emotional–behavioral regulation, parent and family stress/functioning, and child literacy-related outcomes (see Fig. 1 and Table 1). To our knowledge, the conceptual model outcomes of child self-care/health and parent–child bonding/attachment have yet to be examined in the context of bedtime routine research.
Several studies have shown that a bedtime
Benefits of bedtime routine activities
In the following sections, we present evidence from the broader literature on early child development to identify how each bedtime routine activity within the broader domains of 1) nutrition, 2) hygiene, 3) communication, and 4) physical contact can contribute to positive developmental outcomes. While we provide examples of common activities and related literature within each domain (e.g., reading in the communication domain), we acknowledge that activities may vary across cultures and contexts
Implications
Bedtime is a time when most caregivers are present and can engage interactively with their children. An adaptive bedtime routine generates rich opportunities to support positive early childhood developmental outcomes, and is a clear framework for promoting nurturing care (adequate health, nutrition, security and safety, responsive caregiving, and early learning opportunities) and early child stimulation ∗[1], [3]. A bedtime routine provides the seemingly obvious benefits to sleep and to
Future directions for research
There are a number of areas for future empirical focus. For example, more intervention studies on both typically developing children and those with neurodevelopmental conditions are needed to examine causal effects and potential mechanisms of a bedtime routine in general, and for specific bedtime routine activities, on broader outcomes. These studies are particularly important given that observational studies cannot disentangle the effects of a bedtime routine on child outcomes from the effects
Future directions for practice
We propose that the implementation of a consistent bedtime routine is beneficial for many aspects of sleep in early childhood, including sleep onset latency, sleep duration, and sleep quality and consolidation, and has benefits that are just as important for overall child development and wellbeing, including health, emotional–behavioral development, literacy, parent–child interactions, and family functioning, to name just a few. Thus, our hope is that a nightly bedtime routine that includes
Acknowledgments
Dr. Williamson was supported during this study by postdoctoral fellowship T32HL007953-17 from the National Heart, Lung, and Blood Institute.
Conflicts of interest
Dr. Mindell has acted as a consultant and received grant support from Johnson & Johnson Consumer Inc. However, this paper is an independent endeavor with no relevant financial relationships. There has been no financial support or review of content of this paper.
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