Sleep/Wake Patterns Derived from Activity Monitoring and Maternal Report for Healthy 1- to 5-Year-Old Children

Abstract

STUDY OBJECTIVES: To describe behavioral sleep/wake patterns of young children from actigraphy and mothers' reports, assess age-group and sex differences, describe daytime napping, and investigate the impact of family demographic variables on sleep-wake measures. DESIGN: Cross-sectional sample of children wore actigraphs for 1 week; mothers kept concurrent diaries. SETTING: Children studied in their homes. PARTICIPANTS: 169 normal healthy children in 7 age groups (12, 18, 24, 30, 36, 48, and 60 months old); 84 boys and 85 girls. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Nocturnal sleep/wake measures estimated from activity recordings using a validated algorithm; mothers' reports of nocturnal sleep/wake patterns and daytime naps obtained from concurrent diaries. Bedtimes and sleep start times were earliest and time in bed and sleep period times were longest for 12-month-old children. Rise time, sleep end time, and nocturnal sleep minutes did not differ across age groups. Actigraphic estimates indicated that children aged 1 to 5 years slept an average of 8.7 hours at night. Actigraph-based nocturnal wake minutes and wake bouts were higher than maternal diary reports for all age groups. Daytime naps decreased monotonically across age groups and accounted for most of the difference in 24-hour total sleep over age groups. Children in families with lower socioeconomic status had later rise times, longer time in bed, more nocturnal wake minutes and bouts, and more night-to-night variability in bedtime and sleep period time. Children with longer naps slept less at night. CONCLUSIONS: Individual differences in sleep/wake measures reflect characteristics of children, parents, or parent-child interactions.