Exploring role of sleep aids in sleep problems in preschool children

It is well known that children use sleep aids, such as blankets or soft toys, at bedtime. However, there is a lack of understanding regarding the factors associated with their use and role in addressing sleep problems. This study investigated 96 Japanese children aged 40 to 47 months to examine these associations. We measured children's stress (through a questionnaire and salivary cortisol [cortisol awakening response]), anxiety symptoms, behavioral problems, and temperament, and created a model to predict the status of sleep aid use. Furthermore, we explored the association between sleep aid use and children's sleep problems as evaluated by their caregivers. We found that children who used sleep aids were more likely to experience anxiety symptoms. Moreover, most children used sleep aids even when they co-slept with their caregivers and/or siblings. Their use was not uniquely associated with sleep problems. These findings suggest that sleep aid serves as a defense against anxiety, including that caused by the absence of a caregiver, rather than as a substitute for a caregiver. Our study sheds light on their role and emphasizes the importance of viewing development within the complex interactive processes of humans and objects.