Original Article
Investigation of dose-dependent association between bedtime routines and sleep outcomes in infants and toddlers
Yang Fang, Lin Qingmin, Wang Guanghai, Jiang Yanrui, Song Yuanjin, Dong Shumei, Sun Wanqi, Deng Yujiao, Wang Yan, Xu Xiaojuan, Zhu Qi, Jiang Fan
Published 2017-06-02
Cite as Chin J Pediatr, 2017, 55(6): 439-444. DOI: 10.3760/cma.j.issn.0578-1310.2017.06.009
Abstract
ObjectiveTo investigate the current bedtime routine among Chinese children less than 3 years of age and explore its dose-dependent association with sleep duration and sleep quality.
MethodHealthy full-term born children aged 0-35 months were selected by stratified cluster random sampling method from 8 provinces in China following the "Hospital of Province-City-County" sampling technical route during 2012-2013.Brief Infant Sleep Questionnaire(BISQ) was used to assess sleep conditions of these children.Children′s personal and family information was obtained by Shanghai Children′s Medical Center Socio-demographic Questionnaire.Both of these questionnaires were filled in by parents. The effects of bedtime routine on children′s sleep duration and quality were analyzed by multivariate analysis of variance.
ResultThe children′s average age was(12±10) months(n=1 304), of whom 689 were males (52.8%, 689/1 304). There were 48.5%(632/1 304)of the parents reported that their children had not established regular sleep routines. There was a consistent dose-dependent association between bedtime routine and sleep duration, as well as other indicators for sleep quality (all P<0.05). The more regular the sleep routines, the longer the sleep duration, the earlier the children went to sleep, the shorter the sleep onset latency, the fewer the nighttime wakeup and the shorter the nighttime waking.The nighttime sleep duration was significantly longer for those with a bedtime routine 'every night’ than those who 'never’ had a bedtime routine (9.5(95%CI: 9.4-9.6)vs. 8.9(95%CI: 8.6-9.3)h, t=3.345, P=0.001). Compared with children who never had bedtime routines, children with regular bedtime routines had fewer night wakeup (1.3(95%CI: 1.2-1.4) vs. 2.4( 95%CI: 2.0-2.9), t=3.182, P=0.001) and shorter night waking duration(16.6(95%CI: 14.6-18.8) vs. 59.2 (95%CI: 47.0-72.7)min, t=6.383, P<0.01).
ConclusionThe percentage of children who have established regular bedtime routine is low in China. There is significant dose-dependent association between regular bedtime routine and sleep outcomes, especially sleep quality. The more regular the sleep routines, the better the sleep quality.
Key words:
Infant; Child; Sleep; Bedtime routine
Contributor Information
Yang Fang
Department of Developmental and Behavioral Pediatrics, Shanghai Children′s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Ministry of Education Shanghai Key Laboratory of Children′s Environmental Health, Shanghai 200127, China
Lin Qingmin
Wang Guanghai
Jiang Yanrui
Song Yuanjin
Dong Shumei
Sun Wanqi
Deng Yujiao
Wang Yan
Xu Xiaojuan
Zhu Qi
Jiang Fan
