Research has shown that regular routines can benefit kids in numerous ways. however, little research has been done specifically on bedtime and night- time routines. recently a group of rhode island-based therapists examined wheth- er certain sleep habits and routines can have an effect on daytime behavior.

data was gathered from parents of 704 patients in rhode island pediatri- cians’ offices. parents of patients ages two to 13 filled out short 14-question mul- tiple choice surveys on nighttime habits and daytime behavior. researchers com- pared the 14 variables for associations and came up with a number of strong associations.

surveys showed that 68% of kids often or usually go to bed at the same time every night, and 70% of kids usu- ally sleep in their own beds. however, researchers found that children who do not go to bed at the same time every night and those who sleep with their parents are more likely to have tantrums, act physically aggressive toward their parents, and have behavior problems at school than those who do go to bed at the same time every night and in their own beds. For example, 54% of kids who slept with their parents “usuallyor always” acted physically aggressive toward a parent (hitting, kicking, and/or pushing) and parents of 33% of these kids reported having been told their child needed medication for behavioral or learning problems (pressman rM and imber sc, Am J Fam Ther 2011;39:404– 418).

CCPR’s Take: This study finds a correlation between behavior problems and inconsistent bedtime routines and/ or co-sleeping, but the methodology doesn’t convincingly tell us what comes first, the sleep problems or the behavior problems. perhaps kids with adhd and other behavioral problems resist bedtime and sleeping alone as part of their conditions—not the other way around, as is argued by the authors. The authors don’t explore whether changing bedtime rou- tines has any effect on daytime behavior. Nonetheless, sleep hygiene is important for all kids, so taking a brief sleep history with families could be helpful in your evaluation of all of your patients.