Preschooler bedtime routines in a disadvantaged population: A longitudinal analysis of behavioral, cognitive, and health outcomes

Introduction: Despite interest in assuring preschool children obtain adequate sleep, current understanding of whether advised sleep-related techniques (e.g., regular bedtimes, earlier bedtimes, soothing routines) promote child wellbeing in disadvantaged populations is poor.

Methods: We use data on approximately 2,300 children from birth to age 5, drawn from the Fragile Families and Child Wellbeing Study (FFCW). FFCW is a longitudinal birth cohort study of children born in 20 U.S. cities with populations over 200,000. The study includes a substantial over sample of unmarried births, such that children are more likely to live in low-income families, to have nonresident fathers, to be Black or Hispanic, and to have parents with lower levels of education than children in a nationally-representative sample. We use ordinary least squares and probit regressions to estimate associations of sleep-related routines and behaviors at age 3 with cognitive, behavioral, and health outcomes at age 5, net of the full set of child and family background characteristics.

Results: We observed a positive association between the interactive bedtime routines (i.e. reading a story, singing a song) and increased verbal test scores, net of other child and family characteristics. Regular and earlier bedtimes are associated with some decreased behavior problems (i.e. anxious behavior and withdrawn behavior, but not aggressive behavior). While bedtime routines are associated with decreased behavioral problems at age 5, adjustment for family background characteristics attenuates the association.

Conclusion: This research has implications for interventions intended to reduce behavior problems and increase verbal test scores among disadvantaged children.