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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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“Children’s sleep problems have been associated with adjustment difficulties, including poor grades in school, low impulse control, hyperactivity and inattention, conduct problems, and emotional difficulties (Astill et al., 2012; Carvalho Bos et al., 2009; McLaughlin Crabtree & Witcher, 2008).”
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Spaeth, A. M., Hawley, N. L., Carskadon, M. A., Raynor, H. A., Jelalian, E., Owens, J. A., Wing, R. R., & Hart, C. N. (2024) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000001303 · Cited by 4
“17 Despite the importance of sleep for self-control, to our knowledge, no studies have directly examined whether enhancing sleep duration using a behavioral intervention leads to improved self-control among school-age children.”
The Cross-Sectional and Longitudinal Association Between 24-Hour Movement Behavior Compositions With Body Mass Index, Waist Circumference, and Internalizing and Externalizing Symptoms in 6-Year-Old Children
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Iwasaki, S., Yoshimura, Y., Hasegawa, C., Tanaka, S., Ikeda, T., Yaoi, K., Hirosawa, T., & Kikuchi, M. (2025) · Scientific Reports · doi:10.1038/s41598-025-08581-3 · Cited by 4
“relationship between sleep duration and cognitive performance 20 .”
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Olaithe, M., Nanthakumar, S., Eastwood, P. R., & Bucks, R. S. (2015) · Translational Issues in Psychological Science · doi:10.1037/tps0000021 · Cited by 4
Modifiable Lifestyle Factors and Cognition Through Midlife
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Sleep and physical activity in healthy 8–9-year-old children are affected by oily fish consumption in the FiSK Junior randomized trial
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Early childhood sleep problems predict increased risk for the later development of suicidal thoughts.
Hoyniak, C. P., Whalen, D. J., Hennefield, L., Tillman, R., Barch, D. M., & Luby, J. L. (2022) · Journal of Psychopathology and Clinical Science · doi:10.1037/abn0000787 · Cited by 4
“…sleep problems are thought to lead to deficits in higher-order cognitive functions, including cognitive flexibility and decision making, as well as emotional reactivity and regulation processes (Astill et al., 2012; Palmer & Alfano, 2017; Turnbull et al., 2013; Van Dongen et al., 2003).”
Background
An Exploratory Study of Sleep Habits in School-Aged Survivors of Retinoblastoma
Chahin, S., Morse, M., Qaddoumi, I., Phipps, S., Crabtree, V., Brennan, R., Wilson, M. W., Rodríguez-Galindo, C., Russell, K. M., Parris, K. R., et al. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.01.026 · Cited by 2
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Effects of Sleep Disorders on Academic Achievement and Cognitive Functioning in Children and Adolescents: A Meta-Analysis of Polysomnographic Studies
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Partial blue light blocking glasses at night advanced sleep phase and reduced daytime irritability, disruptive behavior and improved morning mood, but did not alter salivary melatonin secretion in Japanese male schoolchildren
Nishino, N., Yoshimoto, R., Ono, T., Chiba, S., & Nishino, S. (2025) · PLoS ONE · doi:10.1371/journal.pone.0332877 · Cited by 6
“This trend towards sleep loss and delayed bedtimes, especially among schoolchildren, has adverse consequences on academic attendance, performance, and social interactions [1,4].”
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Liang, X., Qiu, H., Haegele, J. A., Xiao, L., Li, M., Li, J., & Li, S. X. (2025) · Journal of Exercise Science & Fitness · doi:10.1016/j.jesf.2025.200429 · Cited by 5
“…meta-analysis that reported a significant positive relationship between sleep duration and cognitive performance in TD school-aged children, 54,55 we found a significant but weak correlation ( r = 0.21) between sleep duration and EF, suggesting that a longer sleep duration is associated with…”
Influential
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Background
Pilot Intervention Targeting Sugary Drink Intake Associated With Improvements in Adolescent Sleep Duration
Egan, K. A., Waring, M. E., & Wang, M. L. (2021) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2021.08.017 · Cited by 4
“Insufficient sleep among children and adolescents is associated with increased risk for obesity, depression,(1,2) and poorer cognitive performance and behavior problems.(2,5) The American Academy of Sleep Medicine recommends that children aged 6−12 years sleep 9 −12 h/d.”
Background
Changes in Sleep and Association with Screen Exposure and Diet among Preschool Children During the COVID-19 Pandemic: A Mixed Methods Study
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Frontoparietal Response to Working Memory Load Mediates the Association between Sleep Duration and Cognitive Function in Children
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Sleep problems in preschool mediate the association between chronotype and socioemotional problems at school-age
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Salivary IL-1 Beta Level Associated with Poor Sleep Quality in Children/Adolescents with Autism Spectrum Disorder
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Children’s sleepiness facilitates the effect of vicarious learning on the development of fear
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Longitudinal changes in sleep patterns and circadian rhythm metrics in preschool-age children from Northern Mexico
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The Effect of Leisure Time Sport on Executive Functions in Danish 1st Grade Children
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Background
Sleep disturbances are associated with feeding practices and age in preterm infants
da Silveira, K. S. R., Serra‐Negra, J. M., Prado, I. M., Abreu, L. G., Reis, T. V. D., & Auad, S. M. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.08.030 · Cited by 3
The association of circadian rhythms with academic, physical, and cognitive performance: A systematic review
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Überblick zu chronobiologischen und schlafmedizinischen Aspekten bei Depressionen im Jugendalter
Ghotbi, N., Scherff, A. D., Greimel, E., & Schulte‐Körne, G. (2024) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-024-03853-1 · Cited by 3
The Role of Sleep for Age-Related Differences in Neurobehavioral Performance
Tzischinsky, O., & Barel, E. (2024) · Life · doi:10.3390/life14040496 · Cited by 3
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Background
Parental and Child Sleep: Children with Vision Impairment, Autistic Children, and Children with Comorbid Vision Impairment and Autism
Guner, N., & Hayton, J. (2024) · Brain Sciences · doi:10.3390/brainsci14050485 · Cited by 3
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Background

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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