A nightly bedtime routine: impact on sleep in young children and maternal mood
Open accessAbstract
BACKGROUND: Establishment of a consistent bedtime routine is often recommended to parents of young children, especially those with sleep difficulties. However, no studies have investigated the efficacy of such a routine independent of behavioral intervention. Thus, the purpose of this study was to examine the impact of a consistent bedtime routine on infant and toddler sleep, as well as maternal mood. METHODS: 405 mothers and their infant or toddler (ages 7-18 months, n=206; ages 18-36 months, n=199) participated in 2 age-specific 3-week studies. Families were randomly assigned to a routine or control group. The first week of the study served as a baseline during which the mothers were instructed to follow their child's usual bedtime routine. In the second and third weeks, mothers in the routine group were instructed to conduct a specific bedtime routine, while the control group continued their child's usual routine. All mothers completed the Brief Infant Sleep Questionnaire (BISQ) on a weekly basis and a daily sleep diary, as well as completed the Profile of Mood States. RESULTS: The bedtime routine resulted in significant reductions in problematic sleep behaviors for infants and toddlers. Significant improvements were seen in latency to sleep onset and in number/duration of night wakings, P < 0.001. Sleep continuity increased and there was a significant decrease in the number of mothers who rated their child's sleep as problematic. Maternal mood state also significantly improved. Control group sleep patterns and maternal mood did not significantly change over the 3-week study period. CONCLUSION: These results suggest that instituting a consistent nightly bedtime routine, in and of itself, is beneficial in improving multiple aspects of infant and toddler sleep, especially wakefulness after sleep onset and sleep continuity, as well as maternal mood.
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It is unlikely that all components in the model serve as mechanisms of action; the presence of a positive family-based routine and the cumulative effects of a consistent routine may provide benefits beyond discrete bedtime behaviors and activities.
“it is unlikely that these components all serve as mechanisms of action, particularly as it could be that the presence of a positive, family-based routine and the cumulative effects of a consistent routine provide benefits above and beyond the discrete bedtime behaviors and activities [35,40].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [40]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIncreased bedtime routine consistency and engagement in positive, healthy bedtime routine activities are critical for improved developmental outcomes.
“increased bedtime routine consistency [23,40] and engagement in positive, healthy bedtime routine activities [19,25,26] are critical in conferring improved developmental outcomes.”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [40]
The Discussion reports that a consistent nightly bedtime routine improved sleep and bedtime behavior in infants and toddlers. But the paper does not establish improved developmental outcomes, and its limitations section says it cannot determine whether the specific activities—or any individual component—were essential. (LLM, conf=0.88)
Experimental — accuracy not yet measuredImprovements in child sleep can improve parent mood and family stress, which can enable better management of problematic bedtime behaviors, leading to a more consistent routine and better child sleep.
“improvements in child sleep can improve parent mood and family stress levels, with resulting improvements in parent mood and family stress enabling improved management of problematic bedtime behaviors, leading to a more consistent routine and better child sleep [40].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [40]
The Mood state results (page unavailable) report improved maternal mood after a bedtime routine was introduced, alongside the child-sleep improvements described in the discussion. The paper does not establish the claimed feedback loop: it does not show that improved parent mood or reduced family stress enabled better management of bedtime behavior, producing a more consistent routine and further sleep gains. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSeveral studies have linked a bedtime routine to better child mood and improved emotional-behavioral regulation.
“Several studies have shown that a bedtime routine is associated with positive child mood and enhanced emotional–behavioral regulation.”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [40]
The sleep-diary results (p. unavailable) report improved parent-rated morning mood in infants and toddlers after a bedtime routine. The discussion (p. unavailable) also reports fewer disruptive bedtime behaviors, but the paper does not establish the broader claim of enhanced emotional–behavioral regulation. (LLM, conf=0.86)
Experimental — accuracy not yet measuredBathing before bedtime in childhood may raise core body temperature, and the subsequent drop in core temperature may promote sleep onset.
“bathing prior to bedtime in childhood may increase core body temperature, with a subsequent decrease in core temperature promoting sleep onset”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [40]
The discussion (page not provided) suggests that the bath in the bedtime routine may have improved children's sleep by affecting core body temperature. It does not say that bathing first raises core temperature or that a subsequent drop promotes sleep onset; the study did not measure that proposed sequence. (LLM, conf=0.85)
Experimental — accuracy not yet measured
In a randomized study of 405 mothers of infants and toddlers with sleep problems, the bedtime routine group showed significant improvements from baseline to week three in child sleep onset latency, night awakenings, and sleep consolidation, while controls showed no changes.
“From baseline to study week three, caregivers in the bedtime routine condition reported significant improvements in child sleep onset latency, the frequency and duration of night awakenings, and sleep consolidation, while mothers in the control condition reported no changes in child sleep.”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [40]
Studies that directly implement a bedtime routine have consistently found positive effects on early childhood sleep.
“Studies that focus explicitly on implementing a bedtime routine have consistently shown positive effects on early childhood sleep”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [40]
Compared with control, the bedtime routine condition also showed better maternal-perceived child sleep quality and less maternal-perceived bedtime resistance and broad sleep problems.
“Relative to the control condition, there were also improvements in maternal-perceived child sleep quality, as well as reductions in maternal-perceived child bedtime resistance and broad sleep problems.”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [40]
Two bedtime routine intervention studies found improvements in intervention mothers' self-reported mood compared with control mothers.
“The two bedtime routine intervention studies additionally found improvements in intervention mothers' self-reported mood compared to control mothers”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [40]
Two intervention studies showed that starting a bedtime routine led to more positive maternal-rated child morning mood.
“Two of the intervention studies referenced above also demonstrated that the institution of a bedtime routine results in more positive maternal-rated child morning mood”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [40]
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- Authors
- Mindell, J. A., Telofski, L. S., Wiegand, B., & Kurtz, E. S.
- Affiliations
- Saint Joseph's University (US)
- Johnson & Johnson (United States) (US)
- Corresponding author
- Mindell, Jodi A.
- ORCID
- Mindell, Jodi A.
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-05
- Volume
- 32
- Issue
- 5
- Pages
- 599-606
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2675894
- OpenAlex
- W1951088872
- Cited by
- 328
- References
- 14
- Citations by year
- 2026: 13 · 2025: 21 · 2024: 23 · 2023: 13 · 2022: 15 · 2021: 27 · 2020: 27 · 2019: 24 · 2018: 17 · 2017: 24 · 2016: 19 · 2015: 13 · 2014: 20 · 2013: 11 · 2012: 22
- FWCI
- 25.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- bedtime routines, infant sleep, toddler sleep, sleep latency, nocturnal awakenings, sleep continuity, maternal mood, sleep disorders, young children
- MeSH terms
- Affect, Behavior Therapy, Ceremonial Behavior, Child Behavior Disorders, Child, Preschool, Female, Habits, Humans, Infant, Sleep Initiation and Maintenance Disorders, Male, Maternal Behavior, Mother-Child Relations, Mothers
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