Late last year 96 primary caregivers of 101 children aged 2 to 5 years (average age 4 years) participated in an anonymous survey titled ‘Bedding, Diet and Sleep in Children aged 2 to 5 Years’. The survey was funded by Australian Wool Innovation.  The following is a summary of the main findings.

Sleep

Children

Overall, caregivers reported that 55% of their children had a sleep problem; a larger proportion of children with autism spectrum disorder (Autism) had a sleep problem than did other children.  Sleep problems are common in 2-5 years olds and are generally more common in Autistic children.  Two thirds of children had trouble falling asleep, about one third took more than 30 minutes to fall asleep and one third woke during the night most nights of the week. Early morning waking occurred for about half the children with a sleep problem, and this was more likely to be the Autistic children.  Children with a sleep problem had higher scores (i.e., poorer sleep) on the ‘Children’s Sleep Habits Questionnaire’ (CSHQ).

As expected, younger children slept more than older children.  On average caregivers reported that they would like their child to regularly get 10-11 hours sleep. According to caregivers, children’s average daily sleep (including naps) was about 11 hours, except for children with ASD and a sleep problem who averaged 9.5 hours sleep. The recommended amount of sleep for 2-5 year-old children (including naps) is 11-12 hours, with younger children needing more sleep.

Caregivers

Nearly half of caregivers reported poor sleep quality on the caregiver sleep questionnaire, and caregivers of children with a sleep problem tended to have poorer sleep.

Sleep Relationships

Relationships between children’s sleep and a range of demographic and environmental factors that may be associated with children’s sleep quality (CSHQ total score) or daily hours that children slept were examined.

Demographics

Caregivers who worked part- or full-time tended to report that they had better sleep quality. Children whose primary caregiver worked either full- or part-time or had post-graduate qualifications were somewhat more likely to have better sleep quality than other children. It is unclear why this occurred but it may be that these primary caregivers have to follow daily routines more strictly to fit everything into their day. Regular daily and bedtime routines can assist in promoting better sleep.

Children’s Diet

Children’s sleep was not associated with night meal times or drinks before bed, meal composition, special diets or dietary supplements.

Television and Computers

Children’s sleep was associated with time spent watching television or on computers or tablets. Children who spent more time per day engaged in these activities were more likely to have poorer sleep quality and/or to sleep fewer hours. On average children spent just over an hour watching television and 20 minutes on computers or tablets per day, but there was a lot of variability with some children never doing these activities and others spending much longer engaged in one or both of these activities. Autistic children were more likely to spend time on computers or tablets than other children. Screen time has been recently associated with poorer sleep in school-age children and sleep experts recommend that children do not have television, computers or tablets in their bedroom.

Bedroom Environment and Bed Wear

Children who were ‘too hot’ or ‘too cold’ during sleep were more likely to have poorer sleep quality, and children who had a warm bath before bed tended to have better sleep quality.  Being at a comfortable temperature when sleeping helps promote better sleep.

There was a tendency for children who slept under a synthetic doona to have poorer sleep, and for children who slept under a woollen doona to have better sleep. However as children slept under a range of bedcovers also including woollen blankets, cotton blankets and feather doonas, there was only a small number of children using each kind of bedcover so these findings need to be considered with caution. The properties of different fibres may affect sleep quality due to the fibre’s ability to help regulate bed and skin temperature during sleep, but more research is needed.

What next?

The results of this survey have been presented in a report to Australian Wool Innovation. The results may be reported at conferences or published in scientific journals, and may be used to inform future research.

Thank-you to everyone who participated in the survey, research such as this cannot proceed without you, the families.

Published June 2013