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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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Sleep–wake dysregulation and altered melatonin in neurofibromatosis type 1
Pride, N. A., Payne, J. M., Haebich, K. M., Arnold, S. S., Bournazos, A., Habib, J., Yates, C., Guzzetti, J. R., Darke, H., Pascouau, R., et al. (2026) · SLEEP · doi:10.1093/sleep/zsag037 · Cited by 2
Infant Motor Competence Predicts Executive Functions in Preschoolers: The Role of Sleep
Liu, C., Zhang, Y.-Z., & Liang, X. (2026) · Behavioral Science · doi:10.3390/bs16020288 · Cited by 1
“Children’s sleep problems are associated with deficits in higher-order cognitive functions and dysregulation (Astill et al., 2012; Williams et al., 2023).”
Impact of early life exposure to active play and movement on health and wellbeing across the lifespan: A narrative review of RCTs from 2020-2025
Hills, A. P., Alkhattabi, F., AlAhmed, R. S., Alessy, S. A., Jayasinghe, S. U., Aldarwesh, S., Bawaked, R. A., Abdulla, L., Albalawi, S., Alsagheir, A., et al. (2026) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2026.103399 · Cited by 1
Associations between sleep disturbance, sleep-related impairment, and attention and learning disorders in youth with NF1
Walsh, K. S., Nielsen, J. D., Payne, A. D., Levitt, R. S., Goyette, M. J., Tiplady, K., Weisman, H. S., & van Terheyden, S. (2026) · Child Neuropsychology · doi:10.1080/09297049.2026.2647217 · Cited by 1
“These effects are especially concerning in childhood, as disrupted sleep may interfere with neurodevelopmental processes and contribute to long-term functional impairment (Astill et al., 2012; Durmer & Dinges, 2005; J. Liu et al., 2024; Palmer et al., 2023).”
The mental health and wellbeing outcomes and mechanisms of change in arts inclusive programs for children aged 6–12: a systematic review
Vasilopoulos, F., Oliver, E., Nguyen, A., Ivison, I., Birrell, L., Varley, D., Rowlinson, K., Sun, Y., Saw, E., Karaolis, O., et al. (2026) · Frontiers in Health Services · doi:10.3389/frhs.2026.1827784 · Cited by 1
“…quality was identiﬁed as a mechanism in one study and classiﬁed under biological mechanisms, as sleep regulation involves HPA axis and autonomic nervous system function (biological processes included in Fancourt’s framework) and is particularly relevant to child development and mental health (22).”
Potential Contributions of Sleep and Circadian Rhythms to Behavioral Difficulties in Children with Smith–Magenis Syndrome in Real Life: An Actigraphy-Based Study
Comajuan, M., Plancoulaine, S., Demily, C., Babinet, M.-N., Lioret, J., Brunel, L., Rivet, L., Schroder, C. M., Guyon, A., & Franco, P. (2026) · Children · doi:10.3390/children13080987 · Cited by 1
“Similar associations between sleep problems and behavioral outcomes have been reported in children without neurogenetic disorders [16,17].”
Normal Polysomnographic Characteristics in Korean Children and Adolescents
권순학, 이호원, 서혜은, & 구윤모 (2014) · Annals of Child Neurology · doi:10.26815/jkcns.2014.22.3.110 · Cited by 1
The Relationship Among Parenting Practice Creativity and Parents Mental Health With Intelligence Quotient and Behavioral Disorder of 7-8 Years Old Children in Qaemshahr City
Hasanli, N. (2019) · International Clinical Neuroscience Journal · doi:10.15171/icnj.2019.05 · Cited by 1
Comparison of behavioral problems between the children with one schizophrenic parent and children with healthy parents
Sadeghi, N., Etedali, F., Moghadam, M. F., & Shamsi, A. (2020) · Psychiatria · doi:10.5603/psych.2020.0023 · Cited by 1
“These complications usually occur for the first time in middle childhood and adolescence with a peak in the age of 8–15 years [5].”
Background
Study of Sleep Habits and its Effective Factors in Children Admitted to the Pediatric Wards of Besat Hospital in Hamadan
Mashhadi, M., Nasiri, M., Khalili, M., & Shadi, D. (2021) · Pajouhan Scientific Journal · doi:10.61186/psj.19.3.41 · Cited by 2
Kinderschlafmedizin
Wiater, A. H. (2016) · Pädiatrie up2date · doi:10.1055/s-0041-108898 · Cited by 1
Observational Study of the Impact of COVID-19 on Sleep in Children With and Without Special Educational Needs
Elphick, H., Howsley, P., Mills, N., Beevers, V., & Artis, L. (2022) · Journal of Sleep Medicine · doi:10.13078/jsm.220004 · Cited by 1
What Is Positive Neuropsychology?
Randolph, J. J. (2022) · Springer eBooks · doi:10.1007/978-3-031-11389-5_1 · Cited by 1
Hubungan Kualitas Tidur dan Memori pada Anak Usia Dini: Pendekatan Formatif Orde Kedua
Gracia, A., Puspojudho, S., & Yudha, R. P. (2023) · Jurnal Obsesi Jurnal Pendidikan Anak Usia Dini · doi:10.31004/obsesi.v7i3.4554 · Cited by 1
Sleep problems and duration in school-aged children at different levels of giftedness
Sun, J., Lu, R., Sun, W., Deng, Y., Liu, J., Jiang, Y., Zhu, Q., Xu, H., Wang, G., & Jiang, F. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.07.030 · Cited by 2
Sleep problems and executive dysfunctions in pre‐school children
Tangwijitsakul, H., Likhitweerawong, N., Boonchooduang, N., Chonchaiya, W., & Louthrenoo, O. (2024) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.16662 · Cited by 5
“10 13 The role of sleep in cognition and behavioural problems has been proposed through several hypotheses, including the trace reactivation (memory consolidation), the synaptic homeostasis (re ﬁ ning synaptic connections made during wakefulness) and the overnight therapy hypotheses (emotional…”
Neoplasms and Sleep: Impact and Implications
Crabtree, V. M., LaRosa, K. N., & Wise, M. S. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-75566-5.00047-2 · Cited by 1
Sleep parameters and its effect on the level of job stress in hospital employees
Osmani, H., Jaberi-Asl, A., & Rezapour, R. (2024) · The Neuroscience Journal of Shefaye Khatam · doi:10.61186/shefa.12.4.33 · Cited by 1
Effects of sleep deprivation on neurocognitive capacities in obese individuals not qualifying for sleep treatment: A systematic review
Sivanesan, H., & Bhatti, J. A. (2017) · Obesity Medicine · doi:10.1016/j.obmed.2017.06.002 · Cited by 1
“We entered terms related to obesity, neurocognitive tasks, and SD used in previous systematic reviews (Astill et al., 2012; Kohler et al., 2010; Lal et al., 2012).”
Method
The Effectiveness Companion of Cognitive Behavioral Interventions and the Sensory Processing Styles Training on Behavioral Problems in Children Aged 7-12 Years
Ghazijahani, N. E., Hassanzadeh, R., & Doosti, Y. (2019) · International Clinical Neuroscience Journal · doi:10.15171/icnj.2019.03 · Cited by 1
Cognitive Behavioral Treatment for Pediatric Sleep Difficulties
Fehr, K. K., Chambers, D. E., & Ramasami, J. (2019) · Autism and child psychopathology series · doi:10.1007/978-3-030-21683-2_18 · Cited by 2
A Longitudinal Examination of Bedtime Routines and Sleep in Toddlers
Prokasky, A. (2019) · Lincoln (University of Nebraska) · Cited by 1
Neurodevelopmental Disorders in Children
Haskell, M. A. M. (2020) · Springer eBooks · doi:10.1007/978-3-030-30730-1_30 · Cited by 1
Neuropsychological Outcomes of Disordered Sleep
Copeland, C. T., Holster, J. L., & Glusman, M. B. (2021) · Springer eBooks · doi:10.1007/978-3-030-59309-4_18 · Cited by 1
Emergent academic skills growth in New Zealand pre-school children undergoing treatment for sleep disordered breathing: a case–control pilot study
Maessen, S. E., Schaughency, E. A., Dawes, P. J. D., & Galland, B. C. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.01.027 · Cited by 1
Phenotypic and genetic correlation between sleep, behavior, and macroscale cortical grey matter
Tahmasian, M., Samea, F., Khazaie, H., Zarei, M., Masouleh, S. K., Hoffstaedter, F., Camilleri, J., Kochunov, P., Yeo, B. T. T., Eickhoff, S. B., et al. (2022) · Sleep Medicine · doi:10.1016/j.sleep.2022.05.241 · Cited by 1
Sleep habits and disorders among school students in the Jazan Region, Saudi Arabia
Hakami, M. I., Juraybi, I. A., Jaafari, A. A., Ibrahim, A. M. A., Kariri, A. M., Kariri, A. M., Khawaji, B. Y., Wassly, A. H., Wali, S., Alhejaili, F. F., et al. (2022) · International Journal of Medicine in Developing Countries · doi:10.24911/ijmdc.51-1666779154 · Cited by 1
Sleep Problems in Children with Anxiety and Attention Deficit Hyperactivity Disorders
Hansen, B. H. (2013) · NORA - Norwegian Open Research Archives · Cited by 1
Effect of Sleep on Vigilance, Short-Term Memory, and Learning in College Students
Uddin, A. (2015) · ScholarWorks (Walden University) · Cited by 1
Sleep and its timing – longitudinal and cross-sectional associations with cognitive performance and health in youth
Kuula, L. (2018) · Työväentutkimus Vuosikirja · Cited by 1
Academic Stress among University Students and Its Effect on Mental Health
Banu, R. P. (2015) · Shodhganga · Cited by 1
Impaired sleep-dependent memory consolidation predicted by reduced sleep spindles in Rolandic epilepsyPreprint
Kwon, H., Chinappen, D. M., Kinard, E. A., Goodman, S. K., Huang, J. F., Berja, E. D., Walsh, K. G., Shi, W., Manoach, D. S., Kramer, M., et al. (2024) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2024.05.16.594515 · Cited by 1
Learning loss intervention in primary school children: Differences in mathematics performance, confidence, and self-efficacy across term-time and a school holiday
Timewll, C. (2014) · e-space (Manchester Metropolitan University)
Sleep and Neuropsychological Development among Infants and Toddlers.
Sun, W., Tseng, C., Jiang, F., Spruyt, K., Jiang, Y., Xu, X., Zhu, Q., & Sheu, C. (2015)
Große Schulen der Psychologie und darauf aufbauende Psychotherapietheorien
Schuster, B. H. (2016) · Springer eBooks · doi:10.1007/978-3-662-48392-3_2
The relationship between sleep and working memory in school-aged children
McCann, M. (2016) · UWA Profiles and Research Repository (UWA)

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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