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Sleep, cognition, and behavioral problems in school-age children: A century of research meta-analyzed.

Astill, Rebecca G., Van der Heijden, Kristiaan B., Van IJzendoorn, Marinus H., Van Someren, Eus J. W.·2012·Psychological Bulletin

DOI 10.1037/a0028204

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Abstract

Clear associations of sleep, cognitive performance, and behavioral problems have been demonstrated in meta-analyses of studies in adults. This meta-analysis is the first to systematically summarize all relevant studies reporting on sleep, cognition, and behavioral problems in healthy school-age children (5-12 years old) and incorporates 86 studies on 35,936 children. Sleep duration shows a significant positive relation with cognitive performance (r = .08, confidence interval [CI] [.06, .10]). Subsequent analyses on cognitive subdomains indicate specific associations of sleep duration with executive functioning (r = .07, CI [.02, .13]), with performance on tasks that address multiple cognitive domains (r = .10, CI = [.05, .16]), and with school performance (r = .09, CI [.06, .12]), but not with intelligence. Quite unlike typical findings in adults, sleep duration was not associated with sustained attention and memory. Methodological issues and brain developmental immaturities are proposed to underlie the marked differences. Shorter sleep duration is associated with more behavioral problems (r = .09, CI [.07, .11]). Subsequent analyses on subdomains of behavioral problems showed that the relation holds for both internalizing (r = .09, CI [.06, .12]) and externalizing behavioral problems (r = .08, CI [.06, .11]). Ancillary moderator analyses identified practices recommended to increase sensitivity of assessments and designs in future studies. In practical terms, the findings suggest that insufficient sleep in children is associated with deficits in higher-order and complex cognitive functions and an increase in behavioral problems. This is particularly relevant given society's tendency towards sleep curtailment.

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Short Sleep Duration: Children’s Mental, Behavioral, and Developmental Disorders and Demographic, Neighborhood, and Family Context in a Nationally Representative Sample, 2016–2019
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Investigating the Role of Hypothalamic Tumor Involvement in Sleep and Cognitive Outcomes Among Children Treated for Craniopharyngioma.
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Vulnerability in Executive Functions to Sleep Deprivation Is Predicted by Subclinical Attention-Deficit/Hyperactivity Disorder Symptoms
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In School-Age Children Who Were Born Very Preterm Sleep Efficiency Is Associated with Cognitive Function
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Children’s sleep and academic achievement
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“overnight) or over several nights (Astill et al., 2012).”
Influential
Measuring sleep in young children and their mothers: Identifying actigraphic sleep composites
Staples, A. D., Bates, J. E., Petersen, I. T., McQuillan, M. E., & Hoyniak, C. P. (2019) · International Journal of Behavioral Development · doi:10.1177/0165025419830236 · Cited by 34
“…of sleep (e.g., latency to fall asleep and frequent night wakings) have been found to be associated with poorer cognitive performance, increased behavior problems and poorer social and emotional development (Astill et al., 2012; Cremone et al., 2018; Hysing, Sivertsen, & Garthus-Niegel, 2016).”
Background
The Family Context of Toddler Sleep: Routines, Sleep Environment, and Emotional Security Induction in the Hour before Bedtime
Hoyniak, C. P., Bates, J. E., McQuillan, M. E., Albert, L., Staples, A. D., Molfese, V. J., Rudasill, K. M., & Deater-Deckard, K. D. (2020) · Behavioral Sleep Medicine · doi:10.1080/15402002.2020.1865356 · Cited by 41
“…we recognize limitations in causal inferences, these findings may be useful clinically, especially considering the number of families facing child sleep difficulties (Owens, 2007) and the sequela of consequences associated with poor sleep in childhood (Astill et al., 2012; Dutil et al., 2018).”
Background
Sleep interventions: a developmental perspective
Harvey, A. G., & McGlinchey, E. L. (2015) · Wiley eBooks · doi:10.1002/9781118381953.ch70 · Cited by 34
Executive function and sleep problems in childhood epilepsy
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“However, our results show no association between sleeping time and behavior problems, which is in discordance with previous evidence.(28) This apparent discrepancy may be explained by the fact that previous studies that report an association between short sleep and behavior problems define a short sleep as having less…”
Result
Umbrella Review and Meta-Analysis: The Efficacy of Nonpharmacological Interventions for Sleep Disturbances in Children and Adolescents
Hornsey, S., Gosling, C. J., Jurek, L., Nourredine, M., Telesia, L., Solmi, M., Butt, I., Greenwell, K., Müller, I., Hill, C. M., et al. (2024) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2024.10.015 · Cited by 34
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Associations of sleep with psychological problems and well‐being in adolescence: causality or common genetic predispositions?
Vermeulen, M. C. M., van der Heijden, K. B., Kocevska, D., Treur, J. L., Huppertz, C., van Beijsterveldt, C. E. M., Boomsma, D. I., Swaab, H., Someren, E. J. W. V., & Bartels, M. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13238 · Cited by 32
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Association of Eveningness With Problem Behavior in Children: A Mediating Role of Impaired Sleep
van der Heijden, K. B., de Sonneville, L. M. J., & Swaab, H. (2013) · Chronobiology International · doi:10.3109/07420528.2013.790041 · Cited by 32
“Interestingly, our finding that sleep duration does not predict sustained attention is in line with recent metaanalytic results, and can be explained by findings that brain networks that are essential in top-down attentional control—particularly the longer range connections along the anterior to posterior axis—start t…”
BackgroundResultInfluential
Duration of sleep at 3 years of age is associated with fat and fat‐free mass at 4 years of age: the Southampton Women's Survey
Baird, J., Hill, C. M., Harvey, N. C., Crozier, S., Robinson, S. M., Godfrey, K. M., Cooper, C. C., Inskip, H. M., & The SWS Study Group (2016) · Journal of Sleep Research · doi:10.1111/jsr.12389 · Cited by 32
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Concurrent developmental course of sleep problems and emotional/behavioral problems in childhood and adolescence as reflected by the dysregulation profile
Wang, B., Eastwood, P., Becker, A., Isensee, C., Wong, J., Huang, R.-C., Runions, K., Stewart, R., Meyer, T., Brüni, L. G., et al. (2018) · Sleep · doi:10.1093/sleep/zsy243 · Cited by 30
“It is consistent with prior evidence on within-time associations [12, 13] and longitudinal”
Result
Sleep: population epidemiology and concordance in Australian children aged 11–12 years and their parents
Matricciani, L., Fraysse, F., Grobler, A. C., Muller, J., Wake, M. A., & Olds, T. (2019) · BMJ Open · doi:10.1136/bmjopen-2017-020895 · Cited by 31
Does Infant Reactivity Moderate the Association Between Antenatal Maternal Depression and Infant Sleep?
Netsi, E., van IJzendoorn, M. H., Bakermans‐Kranenburg, M. J., Wulff, K., Jansen, P. W., Jaddoe, V. W. V., Verhulst, F. C., Tiemeier, H. W., & Ramchandani, P. G. (2015) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000181 · Cited by 31
Effortful Control Moderates the Relation Between Electronic-Media Use and Objective Sleep Indicators in Childhood
Clifford, S., Doane, L. D., Breitenstein, R. S., Grimm, K. J., & Lemery‐Chalfant, K. (2020) · Psychological Science · doi:10.1177/0956797620919432 · Cited by 35
Time Use and Cognitive Achievement among Adolescents in China: Depression Symptoms as Mediators
Cao, X., & Liu, X. (2023) · Journal of Intelligence · doi:10.3390/jintelligence11050088 · Cited by 30
Fenfluramine treatment for dravet syndrome: Real-world benefits on quality of life from the caregiver perspective
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Sleep health in Indigenous Australian children: a systematic review
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Associations of sleep and emotion regulation processes in childhood and adolescence - a systematic review, report of methodological challenges and future directions
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“This high prevalence is concerning, as the health risk associated with problematic sleep includes the development of affective and emotional problems 1,5,6 , and shortcomings in multiple domains of emotion regulation functioning 7,8 .”
Background
Infant sleep predicts trajectories of social attention and later autism traits
Ali, J. B., Gossé, L. K., Mason, L., Pasco, G., Charman, T., Johnson, M. H., Jones, E. J. H., & The STAARS Team (2023) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13791 · Cited by 32
“…variables that are most informative vary between studies, important measures to capture include napping, night awak-enings, night sleep duration and settling parameters (e.g. Astill, Van der Heijden, Van IJzendoorn, & Van Someren, 2012; Field, 2017; Tham, Schneider, & Broekman, 2017 for reviews).”
How did I get so late so soon? A review of time processing and management in autism
Jurek, L., Longuet, Y., Baltazar, M., Amestoy, A., Schmitt, V., Desmurget, M., & Geoffray, M. (2019) · Behavioural Brain Research · doi:10.1016/j.bbr.2019.112121 · Cited by 30
Polysomnography in Bolivian Children Native to High Altitude Compared to Children Native to Low Altitude
Hill, C. M., Carroll, A., Dimitriou, D., Gavlak, J., Heathcote, K., L’Esperance, V., Bayá, A., Webster, R. J., Pushpanathan, M. E., & Bucks, R. S. (2016) · SLEEP · doi:10.5665/sleep.6316 · Cited by 28
Validity and reliability of the Turkish version of Sleep Disturbance Scale for Children
Ağca, S., Görker, İ., Turan, F. N., & Öztürk, L. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.05.016 · Cited by 26
Explainable vision transformer for automatic visual sleep staging on multimodal PSG signals
Lee, H., Choi, Y. R., Lee, H. K., Jeong, J., Hong, J., Shin, H., & Kim, H. (2025) · npj Digital Medicine · doi:10.1038/s41746-024-01378-0 · Cited by 27

Authors: Astill, R. G., Van der Heijden, K. B., Van IJzendoorn, M. H., & Van Someren, E. J. W.
Affiliations: Netherlands Institute for Neuroscience (NL)
Venue: Psychological Bulletin
Publisher: American Psychological Association (APA)
Published: 2012
Volume: 138
Issue: 6
Pages: 1109-1138
ISSN: 0033-2909 (ISSN-L)
1939-1455
DOI: 10.1037/a0028204
OpenAlex: W2151099567
Cited by: 707
References: 226
Citations by year: 2026: 54 · 2025: 55 · 2024: 65 · 2023: 59 · 2022: 62 · 2021: 70 · 2020: 65 · 2019: 51 · 2018: 43 · 2017: 44 · 2016: 39 · 2015: 37 · 2014: 30 · 2013: 24 · 2012: 5
FWCI: 41.18
Type: journal article
Language: en
Open access: closed
Locations: Psychological Bulletin (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
KNAW research portal (Royal Academy of Art and Sciences (KNAW)) (publishedVersion)
VU Research Portal (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
Funders: Netherlands Organization of Scientific Research
The Hague (VICI Innovation Grant 453-07-001)
National Initiative Brain & Cognition Research Program (“Innovative Learning Materials and Methods” Grant 056-32-013)
Sponsor name not included
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Keywords: sleep duration, elementary school students, cognitive performance, behavioral problems, executive function, academic performance, internalizing problems, externalizing problems, sustained attention, memory, sleep deprivation, brain development, intelligence
MeSH terms: Achievement, Child, Child Behavior Disorders, Child, Preschool, Cognition, Female, Humans, Male, Sleep, Sleep Wake Disorders, Time Factors

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Sleep, cognition, and behavioral problems in school-age children: A century of research meta-analyzed.

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