How sleep interventions improve sleep duration in children

Sleep duration in children may be increased after interventions focused on earlier bedtime, leading to important benefits in their health, according to a recent review.

Individual health is significantly affected by childhood experiences, with adequate sleep being vital to well-being. This involves proper sleep timing, quality, and duration, and can affect mental well-being, growth, effective social interactions, cognitive processing, and metabolic health.

Trends have indicated that children are not receiving adequate sleep durations, which has been attributed to increased screen time, electronic media use, stimulant intake, and unhealthy sleep behaviors such as poor bedtime routines. This has created a need for the development of effective strategy to encourage proper sleep behavior in children.

Recent reviews have focused on sleep in individuals with sleep problems or medical issues. There are few studies with quantitate data available, and the data available is modest. To improve the data available, investigators sought to estimate the effectiveness of sleep-related interventions in healthy children.

Investigators used key words and index terms to search for studies throughout 7 databases: CENTRAL, MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), Web of Science Core Collection, ClinicalTrials.gov, and World Health Organization trials databases. Individual and cluster randomized clinical trials analyzing the effects of intervention on sleep at a class and school level were gathered and studied.

After excluding duplicates and certain records, 13,728 studies were included for screening. Of these, 411 underwent full text screenings. Over 13,000 participants were included in the studies, of which about 51% were in an intervention group and about 49% were in a control group. The average age of participants ranged from 18 moths to 19 years.

Sleep duration estimates did not see significant differences between age groups, nor did social disadvantage and reported sleep problems affect estimates. Pooled estimates often changed between regions, with North America and Asia showing the greatest differences in sleep duration compared to regions such as Australia.

Significant changes were observed after intervention which focused on lengthening sleep duration. Location of delivery, parental involvement, or medium of delivery did not cause changes in sleep duration. Trials which focused on an earlier bedtime saw a significant and substantial effect on sleep duration.

General sleep interventions led to an average 10.5 minutes of increased sleep duration in children aged 1 to 18 years. The most significant interventions focused on earlier bedtime, leading to an average 47-minute increase in sleep duration.

Based on these results, investigators concluded that specific intervention elements, such as focus on earlier bedtime, should be further studied to support adequate sleep in children.

Reference

Magee L, Goldsmith LP, Chaudhry UAR, Donin AS, Wahlich C, Stovold E, et al. Nonpharmacological interventions to lengthen sleep duration in healthy children: a systematic review and meta-analysis. JAMA Pediatr. 2022. doi:10.1001/jamapediatrics.2022.3172