There are multiple factors that affect a child's behavior and it is not always obvious what may be contributing factors. Some studies have shown that poor sleep habits are common in children with behavior issues but it was unclear if behavior problems were causing sleep difficulties or sleep difficulties were causing behavior problems.
Researchers from London wanted to examine the impact of irregular bedtime on behavior in young children. The study, published in Pediatrics, found that irregular bedtime was associated with increased behavioral problems in 7 year old children.
The Millennium Cohort Study is a large research project that is following 19,000 children born in the United Kingdom, collecting information on health, behavior and family/social environment. This study specifically examined bedtime habits of 10,230 children at 3, 5, and 7 years old and reports of behavior problems from parents and teachers at age 7. Bed time habits included time children were put to bed and how regular the times were kept throughout the week. The study found that:
- Children without regular bedtimes were more likely to have behavioral problems than those with regular bedtimes
- Behavioral problems increased as the length of time with irregular bedtimes increased
- Behavior improved in children who moved from irregular to regular bedtime
Children with irregular bedtime or bedtimes at 9 pm or later were more likely to have social disadvantages such as lower income households, lower parental education, and poorer maternal mental health.
Cohort studies are a type of observational study, which means reviewers are only watching a select group for changes and looking for trends. The researchers are not interfering with any elements of the study and can not control numerous other factors that may affect the outcome. As a result, this type of study can not determine cause and effect but can only suggest a connection between two factors. This trial did try to address some limitations by not only looking at the connection between sleep and behavior but also what happened to behavior when sleep factors changed. It is important to note that children with irregular sleep routines were also more likely to be in environments that also have an increased risk of behavioral issues which likely means sleep is only one of many factors influencing behavior.
This study did not focus on the amount of sleep children had but instead on the time they went to bed each night. Sleep itself is important for brain function and development throughout our life but it seems that a consistent schedule may also play an important role. Regular sleep schedules allow the body develop an internal routine that will help the child fall asleep easier and stay awake during the day, also called a circadian rhythm. It may be difficult to start a sleep routine but it may be worth the effort in the long run. Try to establish a regular bedtime routine that allows your child to relax just before bedtime, provides a calm consistent environment to sleep in, and encourages your child to fall asleep on their own. If your child has behavioral issues talk about a sleep routine with your doctor, some sleep changes may become a helpful part of your child's care plan.
Kelly Y, Kelly J, Sacker A. Changes in Bedtime Schedules and Behavioral Difficulties in 7 Year Old Children. Pediatrics. Published online October 13, 2013.
Last reviewed October 2013 by Michael Woods, MD
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