Children From Disadvantaged Households Often Lack Bedtime Routines, Possibly Affecting Health

Newswise — A study led by Stony Brook University Medical Center finds that preschool age children from socioeconomically disadvantaged families are less likely to have consistent bedtime routines than their more advantaged counterparts. The authors say this pattern may contribute to later disparities in sleep quality and may be linked to various mental and physical health outcomes, such as the capacity to learn, school readiness and childhood obesity. The study will be reported in the early online edition of the Journal of Developmental Behavioral Pediatrics during the week of August 31.

Prior studies have examined racial and ethnic differences in sleep-related behaviors, including napping patterns, sleep duration, and bedtimes. The SBUMC-led study investigated race/ethnic differences in addition to the relative roles of a number of sociodemographic factors and their associations with children’s bedtime routines. These factors included maternal education, family structure, poverty status, and household characteristics, such as number of adults and number of children living in each household.

“The most important finding of our study is that caregiver and household characteristics predict bedtime routines whereas child variables, such as age and sex, do not predict bedtime routines,” says Lauren Hale, Ph.D., Assistant Professor of Preventive Medicine at SBUMC. “Generally speaking, more socioeconomically disadvantaged families and racial minorities have later bedtimes and fewer bedtime routines.”

The researchers used data on 3,217 children followed from birth to three years of age in the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of children born between 1998 and 2000 in 20 U.S. cities with populations of more than 200,000. Using parent-report data from the national study, the researchers examined whether child and family characteristics are associated with the presence, time, and consistency of bedtime routines.

Titled “Social and Demographic Predictors of Preschoolers’ Bedtime Routines,” the SBUMC-led study used the national data on the preschoolers and controlled for maternal education, family structure, and various other household characteristics. They found that low maternal education, increased household size, and poverty are directly associated with decreased use of parent-child interactive and hygiene-related bedtime routines.

“Forgoing interactive or hygiene-related bedtime routines by some of the less advantaged mothers may be due to increased stress in the households, lower levels of structures or routines, or lack of awareness of the benefits of bedtime routines,” says Dr. Hale.

In addition, black and Hispanic children had later bedtimes than white children and reduced odds of using regular bedtimes and bedtime routines. Regular bedtimes were at 22 percent and 29 percent less, respectively; and using bedtime routines were 47 percent and 33 percent less, respectively.

Another finding of the study is that family structure seems to have an association with having but not using a regular bedtime routine, but in an unexpected way. The presence of a biological father in the household is associated with decreased likelihood of having a regular bedtime. The authors report this may be because parents may want their child to stay up later when either or both parents are home for the day.

Dr. Hale says that future studies on the understanding of parent and family characteristics associated with bedtimes and bedtime routines will help identify target populations for the development and implementation of culturally sensitive interventions to promote sleep and child well-being.

Research for the study was funded, in part, by the National Institute of Child Health and Human Development of the National Institutes of Health. Co-authors of the study are Lawrence M. Berger, Ph.D., School of Social Work, University of Wisconsin, Madison; Monique K. LeBourgeois, Ph.D., Department of Education, Brown University; and Jeanne Brooks-Gunn, Ph.D., Teachers College and College of Physicians and Surgeons, Columbia University.