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Sleep. 2015 May 1;38(5):717-22. doi: 10.5665/sleep.4662.

Bedtime routines for young children: a dose-dependent association with sleep outcomes.

Author information

Sleep Center, Children's Hospital of Philadelphia and Department of Psychology, Saint Joseph's University, Philadelphia, PA.
Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
School of Psychological Sciences, Tel Aviv University, Tel Avi, Israel.
Johnson & Johnson Asia Pacific, Division of Johnson & Johnson Pte, Ltd.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.



Establishment of a consistent bedtime routine (the activities that occur right before lights out) is often recommended as part of healthy sleep habits. However, no studies have investigated the dose-dependent association of a bedtime routine with sleep outcomes, especially in young children for whom they are particularly recommended. Thus, the aim of this study was to examine the associations of a consistent bedtime routine with sleep outcomes in young children (ages 0 through 5 y) in a large global sample and assess whether there is a dose-dependent relationship between the frequency of a bedtime routine both concurrently and retrospectively with sleep outcomes.


Mothers of 10,085 children (Australia-New Zealand, Canada, China, Hong Kong, India, Japan, Korea, Malaysia, Philippines, Singapore, Thailand, United Kingdom, United States) completed the Brief Infant/Child Sleep Questionnaire.


A consistent bedtime routine was associated with better sleep outcomes, including earlier bedtimes, shorter sleep onset latency, reduced night wakings, and increased sleep duration. Decreased parent-perceived sleep problems and daytime behavior problems were also related to institution of a regular bedtime routine. Furthermore, there was a dose-dependent relationship, with better outcomes associated with increased "doses" of having a bedtime routine, both currently and retrospectively, and was found within both predominantly Asian and predominantly Caucasian cultural regions.


These results indicate that having a regular nightly bedtime routine is associated with improved sleep in young children, and suggests that the more consistently a bedtime routine is instituted and the younger started the better.


bedtime routine; infant; preschooler; sleep; toddler

[Indexed for MEDLINE]
Free PMC Article

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