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Updated: Apr 21, 2026

Measuring Neural Mechanisms Underlying Sleep-Dependent Memory Consolidation During Naps in Early Childhood
Published on: October 2, 2019
Bedtime routines for young children: a dose-dependent association with sleep outcomes
Jodi A Mindell1, Albert M Li2, Avi Sadeh3
1Sleep Center, Children's Hospital of Philadelphia and Department of Psychology, Saint Joseph's University, Philadelphia, PA.
Insights
Establishing a consistent bedtime routine is linked to improved sleep in young children. The more consistent the routine, the better the sleep outcomes, showing a dose-dependent relationship.
Area of Science:
- Pediatrics
- Sleep Medicine
- Child Development
Background:
- Healthy sleep habits are crucial for young children.
- Bedtime routines are commonly recommended but their dose-dependent effects on sleep are understudied.
- Young children (0-5 years) are a key demographic for sleep habit research.
Purpose of the Study:
- To investigate the association between consistent bedtime routines and sleep outcomes in young children globally.
- To determine if there is a dose-dependent relationship between bedtime routine frequency and sleep quality.
- To examine concurrent and retrospective effects of bedtime routines on child sleep.
Main Methods:
- A large-scale study involving 10,085 children from diverse global regions.
- Mothers completed the Brief Infant/Child Sleep Questionnaire.
- Data collected from Australia-New Zealand, Canada, China, Hong Kong, India, Japan, Korea, Malaysia, Philippines, Singapore, Thailand, UK, and US.
Main Results:
- Consistent bedtime routines correlated with better sleep: earlier bedtimes, faster sleep onset, fewer night wakings, and longer sleep duration.
- Regular bedtime routines were associated with fewer parent-perceived sleep and daytime behavior problems.
- A dose-dependent relationship was observed: more consistent routines yielded better outcomes across cultural regions.
Conclusions:
- A regular nightly bedtime routine significantly improves sleep in young children.
- The consistency and early initiation of bedtime routines are key factors for enhanced sleep benefits.
- Findings highlight the importance of establishing consistent bedtime routines for pediatric sleep health.
Background:
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.
Participants:
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.
Results:
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.
Conclusions:
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.
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