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Bedtime Routines for Young Children: A Dose-Dependent Association with Sleep Outcomes
Open accessAbstract
BACKGROUND: Establishment of a consistent bedtime routine (the activities that occur right before lights out) is often recommended as part of healthy sleep habits. However, no studies have investigated the dose-dependent association of a bedtime routine with sleep outcomes, especially in young children for whom they are particularly recommended. Thus, the aim of this study was to examine the associations of a consistent bedtime routine with sleep outcomes in young children (ages 0 through 5 y) in a large global sample and assess whether there is a dose-dependent relationship between the frequency of a bedtime routine both concurrently and retrospectively with sleep outcomes. PARTICIPANTS: Mothers of 10,085 children (Australia-New Zealand, Canada, China, Hong Kong, India, Japan, Korea, Malaysia, Philippines, Singapore, Thailand, United Kingdom, United States) completed the Brief Infant/Child Sleep Questionnaire. RESULTS: A consistent bedtime routine was associated with better sleep outcomes, including earlier bedtimes, shorter sleep onset latency, reduced night wakings, and increased sleep duration. Decreased parent-perceived sleep problems and daytime behavior problems were also related to institution of a regular bedtime routine. Furthermore, there was a dose-dependent relationship, with better outcomes associated with increased "doses" of having a bedtime routine, both currently and retrospectively, and was found within both predominantly Asian and predominantly Caucasian cultural regions. CONCLUSIONS: These results indicate that having a regular nightly bedtime routine is associated with improved sleep in young children, and suggests that the more consistently a bedtime routine is instituted and the younger started the better.
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“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 [23]
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“Cross-sectional associations have been found within the United States [17,26,47] and internationally [23,30,48,49].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [23]
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“a dose-dependent relationship emerged between a bedtime routine and these sleep benefits. As the number of nights per week that a child followed the same bedtime routine increased, there were linear improvements across the sleep outcomes”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [23]
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“preschoolers with both a current and a history of a consistent bedtime routine showed the best sleep outcomes.”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [23]
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“the results of this study held in both the infant/toddler and preschool age groups, in both predominantly Asian and predominantly Caucasian cultural regions, and when controlling for maternal education”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [23]
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“having a bedtime routine is associated with an earlier bedtime, shorter sleep onset latency, longer nighttime sleep duration, fewer night awakenings, and decreased caregiver-perceived child sleep problems [23].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [23]
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Cites
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Metadata
- Authors
- Mindell, J. A., Li, A. M., Sadeh, A., Kwon, R., & Goh, D. Y. T.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Chinese University of Hong Kong (HK)
- Tel Aviv University (IL)
- Johnson & Johnson Asia Pacific, Division of Johnson & Johnson Pte, Ltd
- National University of Singapore (SG)
- Corresponding author
- Mindell, Jodi A.
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-05-01
- Volume
- 38
- Issue
- 5
- Pages
- 717-722
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC4402657
- OpenAlex
- W2000642163
- Cited by
- 218
- References
- 25
- Citations by year
- 2026: 20 · 2025: 22 · 2024: 19 · 2023: 21 · 2022: 23 · 2021: 29 · 2020: 23 · 2019: 18 · 2018: 13 · 2017: 20 · 2016: 10
- FWCI
- 21.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Johnson and Johnson
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Health and Development
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- bedtime routines, young children, sleep outcomes, dose-response relationship, sleep latency, nocturnal awakenings, sleep duration, bedtime timing, cross-cultural comparison
- MeSH terms
- Child Behavior, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Mothers, Surveys and Questionnaires, Sleep, Time Factors, United States, Wakefulness, Infant Behavior, Internationality, White People, Asian People, Sleep Medicine Specialty
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