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Feasibility of a Single-Subject Protocol to Shift Young Children's Sleep Schedules
Rachel S Fisher1, Kendra N Krietsch2, David M Janicke3
1Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA. Rachel.Fisher@nationwidechildrens.org.
Insights
Children adhered to bedtime and wake-up times in a sleep schedule experiment but struggled to adjust sleep onset and offset. This study explored children's sleep schedule adherence during a 2-hour phase delay.
Area of Science:
- Pediatric Sleep Research
- Chronobiology
- Behavioral Sleep Medicine
Background:
- Understanding children's sleep patterns is crucial for development and well-being.
- Sleep schedule adherence can be challenging for children during transitions.
Purpose of the Study:
- To evaluate children's adherence to manipulated sleep schedules in a controlled at-home setting.
- To assess the impact of a 2-hour phase delay on children's sleep timing.
Main Methods:
- A single-subject, at-home sleep manipulation experiment involving six healthy children (ages 6-8).
- Participants completed a baseline, a stabilized sleep period (Condition A1), a 2-hour phase-delayed sleep period (Condition B), and a return to stabilized sleep (Condition A2).
- Parental reports were used to assess adherence to assigned times for getting into and out of bed, as well as sleep onset and offset.
Main Results:
- All children successfully completed all experimental conditions.
- Parental reports indicated good adherence to assigned times for entering and exiting bed.
- Adherence to actual sleep onset and offset times was variable, suggesting difficulty in synchronizing sleep with the assigned in-bed times.
Conclusions:
- Children can adhere to externally assigned bedtimes and wake times, even with a 2-hour shift.
- Children exhibit challenges in adjusting their natural sleep onset and offset to match manipulated sleep schedules.
- Short-term, at-home sleep schedule manipulations reveal specific difficulties in sleep timing regulation among school-aged children.
Abstract:
The objective of this study is to describe children's adherence to changing sleep schedules within a small-scale, single-subject, at-home sleep manipulation experiment. Subjects were six healthy children (male = 4, ages 6-8). Children underwent: baseline, a 7-day self-selected sleep pattern; Condition A1, a 3- to 12-day stabilized sleep pattern (assigned time into/out of bed set at baseline averages); Condition B, a 3- to 12-day phase-delayed sleep pattern (time into/out of bed 2 h later than Condition A); and Condition A2, a 3- to 7-day return-to-stabilized sleep pattern (time into/out of bed at Baseline averages, identical to Condition A1). All children completed conditions. Per parent report, adherence to assigned time into/out of bed was good; sleep onset/offset adherence was variable. Within this small-scale, short-term sleep manipulation, children effectively got into/out of bed at assigned times despite manipulating sleep schedules by 2 h. However, they struggle to shift their sleep onset and offset times to match the time they were in bed.