Sleep duration and RSA suppression as predictors of internalizing and externalizing behaviors
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Updated: Mar 15, 2026

Psychophysiological Assessment of the Effectiveness of Emotion Regulation Strategies in Childhood
Published on: February 11, 2017
Sunghye Cho1, Lauren E Philbrook2, Elizabeth L Davis3
1Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania.
Insights
Adequate sleep duration and parasympathetic reactivity are key for toddler adjustment. Longer sleep with greater physiological response suppression predicts fewer internalizing behaviors, while shorter sleep with arousal predicts externalizing behaviors.
Area of Science:
- Child Psychology
- Developmental Neuroscience
- Sleep Medicine
Background:
- The relationship between sleep, arousal, and emotion regulation is complex.
- Limited understanding exists on how sleep duration and parasympathetic reactivity jointly predict early childhood adjustment.
Purpose of the Study:
- To investigate sleep duration and respiratory sinus arrhythmia (RSA) reactivity as predictors of internalizing and externalizing behaviors in toddlers.
- To examine the combined influence of sleep and physiological regulation on child adjustment.
Main Methods:
- Utilized a sample of 123 toddlers.
- Assessed sleep duration and adjustment via parental reports.
- Measured RSA reactivity during fear-eliciting stimuli and an inhibitory control task.
Main Results:
- Longer sleep duration coupled with greater RSA suppression predicted less internalizing behavior.
- Shorter sleep duration and increased RSA augmentation during inhibitory control predicted more externalizing behaviors one year later.
Conclusions:
- Toddler sleep duration is significant for adjustment.
- The context of physiological regulatory difficulties is crucial for understanding behavioral outcomes.
- Findings highlight the interplay between sleep, arousal, and emotion regulation in early development.
Abstract:
Although the conceptual interplay among the biological and clinical features of sleep, arousal, and emotion regulation has been noted, little is understood about how indices of sleep duration and parasympathetic reactivity operate jointly to predict adjustment in early childhood. Using a sample of 123 toddlers, the present study examined sleep duration and RSA reactivity as predictors of internalizing and externalizing behaviors. Parents reported on children's sleep duration and adjustment. RSA reactivity was assessed via children's responses to fear-eliciting stimuli and an inhibitory control challenge. Findings demonstrated that greater RSA suppression to both types of tasks in combination with longer sleep duration was concurrently associated with less internalizing. In contrast, greater RSA augmentation to an inhibitory control task in the context of shorter sleep duration predicted more externalizing 1 year later. The significance of duration of toddlers' sleep as well as the context in which physiological regulatory difficulties occurs is discussed.
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