Bedtime routine: The earlier, the better

Research Summary
By: 
Hayley Roper
Research Assistant

Implementing a daily routine creates a predictable environment, and predictability can help manage stress, especially at bedtime. One study published in Sleep looked at bedtime routines in 10,000 children, ages 0-5 years, from 13 countries. Controlling for the child’s age and maternal education, those with a consistent bedtime routine (at least 3 nights a week) had earlier bedtimes, took less time to fall asleep once in bed, had fewer and shorter night wakings, and slept more during the night than those with no bedtime routine.

Frequency also matters. Compared to children with a bedtime routine 3-4 times a week, sleep outcomes were better for those who had a bedtime routine 5-6 nights a week, and even better for a bedtime routine carried out every night. Compared to children with no bedtime routine, mothers of children with a consistent bedtime routine were less likely to report sleep problems and daytime behavioral issues like hyperactivity and attention deficit.

The benefit of a bedtime routine is long-lasting. Mothers of preschoolers who had a bedtime routine as an infant were less likely to report sleep and behavioral problems.

In some cases, a total lack of consistency of a bedtime routine led to worse outcomes than never having a bedtime routine. Specifically, infants and toddlers (0-3 years) with a bedtime routine 1-2 nights a week took longer to fall asleep than those with no bedtime routine. Preschoolers (3-5 years) with a bedtime routine 1-2 nights a week had more frequent and longer night wakings than those with no bedtime routine. While a bedtime routine at any age is beneficial, the earlier and more frequent a routine is implemented, the better the sleep and behavioral outcomes.

In another article published in Sleep, researchers carried out two studies, one with infants, 7-18 months and the other with toddlers, 18 months to 3 years. Both studies included a control group and a routine group. The mothers in the routine group were provided a 3-step bedtime routine: bath, massage (infants) or applying lotion (toddlers), and night activities (cuddling or singing), with lights out 30 minutes after the bath. The control group carried out their usual bedtime practices for 3 weeks. The routine group did their usual practice for one week then the 3-step bedtime routine for the following 2 weeks.

Similar to the previous study, after 2 weeks of a bedtime routine, infants took less time to fall asleep, had fewer and shorter night wakings, and mothers perceived sleep as less of a problem than the control group. For toddlers, there was a significant decrease in number and duration of night wakings, increase in duration of continuous sleep, decrease in reported times the child called out at night and climbed out of the bed/crib, and a decrease in the mother’s perception of sleep as a problem. These changes in sleep outcomes occurred regardless of how the child was put to sleep after “lights out”. But there were no changes in the control group.

Maternal and child mood also benefits from a consistent bedtime routine. In the same study, for mothers of both infants and toddlers in the routine group, there was an improvement in the mother’s perception of how the child slept and an improvement in the mother’s perception of the child’s mood. Mothers of both infants and toddlers reported feeling less tension, depression, anxiety, anger, fatigue, confusion, and more vigor. Maternal mood did not change for the control group.

By relying on parental report, some sleep behaviors reported in these studies may not be completely accurate. Additionally, temperament, or aspects of an individual’s personality present from birth, might influence how easily a child complies with a bedtime routine. It is unclear which specific bedtime routines work better than others, but it seems that having a few consistent activities that happen in the same order, at the same time every night can improve sleep and behavioral outcomes. While starting a bedtime routine earlier in life seems most beneficial, it is never too late to improve your child’s sleep. Below are resources to assist you in starting or improving your child’s bedtime routine.

Consistency may be the “secret sauce”

How do I start a bedtime routine? My child has never had one

How can I help my toddler or preschooler follow directions a bedtime?

The best sleep schedules for kids

Ideas for bedtime rituals