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Multilevel factors associated with sleep duration and bedtime regularity in U.S. children with and without

Freda Patterson1, Shannon M Robson2, Lauren B Covington2,3

  • 1Department of Health Behavior and Nutrition Sciences, College of Health Sciences, University of Delaware, 100 Discovery Blvd, Newark, DE, 19716, USA. fredap@udel.edu.

World Journal of Pediatrics : WJP
|October 3, 2025
PubMed

Insights

Children with neurological and developmental disorders (NDD) experience poorer sleep. Increasing family meals and improving sleep duration and regularity are key targets for interventions to enhance children's sleep health.

Area of Science:

  • Pediatric Health
  • Sleep Science
  • Developmental Pediatrics

Background:

  • Neurological and developmental disorders (NDD) impact children's sleep patterns.
  • Understanding factors influencing sleep duration and regularity is crucial for this population.
  • A nationally representative sample was utilized to investigate these factors.

Purpose of the Study:

  • To compare multilevel factors associated with sleep duration and bedtime regularity in children with and without NDDs.
  • To identify key modifiable variables for improving sleep health in children.
  • To examine the relationship between individual, social, and environmental factors and sleep outcomes.

Main Methods:

  • Utilized data from the National Survey of Children's Health (2016-2021) for 86,014 children aged 9-17.
  • Assessed parent-reported adequate sleep duration and bedtime regularity.
  • Employed random survival forest decision trees and regression analyses to identify predictive variables.

Main Results:

  • Children with NDDs showed higher rates of inadequate sleep duration (34.0%) and bedtime irregularity (18.8%) compared to typically developing peers.
  • Achieving bedtime regularity, adequate sleep, and frequent family meals were significant predictors for both groups.
  • Family meals and sleep regularity emerged as critical factors for children with NDDs.

Conclusions:

  • Increasing family meal frequency is a potential intervention to improve sleep in children.
  • Addressing both sleep duration and bedtime regularity can enhance sleep health, particularly for children with NDDs.
  • These findings highlight modifiable targets for pediatric sleep interventions.
Abstract

Keywords:
Bedtime regularityChildrenMachine learningNeurological and developmental disordersSleep duration

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