Toddler Sleep Duration and Nighttime Awakenings Associated With Regular Bedtime and Sleep Time Routines

• In Event: Poster Session 09
  In Poster Session: PS 09 Topic - Health, Growth, Injury

Abstract

Adequate sleep is important for long-term health. Early implementation of regular bedtimes and nighttime routines could be important for both falling and staying asleep. Our objective was to examine the relationships between routine sleep time behaviors, nighttime awakenings, and sleep duration during toddlerhood among a diverse cohort of toddlers from a Midwestern city in the United States. We used data from 299 parent-child pairs from the Play & Grow study, a prospective cohort study to assess the relationship between parent-child interactions and childhood development. Demographic data were collected at toddler age 18 months and sleep data were collected at toddler age 24 months. Toddler bedtime routines and sleep variables were measured using questions adapted from the Early Child Longitudinal Study, Birth Cohort 24-month parent interview questionnaire. Relationships between a regular bedtime, a nightly sleep time routine, and total hours of toddler sleep duration in a 24-hour period (including daytime naps) were analyzed using linear regression models. Ordered logistic regression was use to assess the relationship between parental report of a regular bedtime, a sleep time routine, and toddler nighttime awakenings (≥ 1 per night, 2-6 per week, 1 per week, and ≤1 per month). All models were adjusted for household income, child race-ethnicity, parental marital status, parental depressive symptoms, and parental education level. At 24-months of age, 89% of parents reported having a nightly sleep time routine with their toddler, while 82% reported their toddler had a regular bedtime. On average, toddlers in this sample received 12.0 hours of sleep within a 24-hour period. Parents with low-income, depressive symptoms, and children identified as non-white were less likely to report a regular bedtime or nightly sleep time routine. Additionally, sleep time routines were less likely among larger households and parents who received less than a high school education and regular bedtimes were less likely among unmarried parents. Parental report of a sleep time routine and a regular bedtime were each associated with an increase in toddler sleep duration [(βSleep time routine: 1.56; 95% CI: 0.97-2.96), (βRegular bedtime: 2.32; 95% CI: 1.87-2.76)]. Parental report of a regular bedtime was also associated with a decreased likelihood of toddler nighttime awakenings (OR: 0.42, 95% CI: 0.22-0.79). The association between parental report of a sleep time routine and nighttime awakenings was insignificant (OR: 0.66, 95% CI: 0.31-1.42). Our analyses show toddler sleep duration is associated with consistent sleep time routines and a regular bedtime. The frequency of toddler nighttime awakenings is associated with a regular bedtime but not a sleep time routine. These associations will be further explored in multivariate models with consideration for how parent-child interaction and child temperament influence these relationships.

Authors

• Alison Nulty, University of North Carolina at Chapel Hill
  Presenting Author

• Bharathi Jayanthi Zvara, University of North Carolina at Chapel Hill
  Non-Presenting Author

• Rebecca R. Andridge, The Ohio State University
  Non-Presenting Author

• Sarah Keim, The Research Institute at Nationwide Children’s Hospital
  Non-Presenting Author

• Sarah Anderson, The Ohio State University
  Non-Presenting Author