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Modest first night effect on sleep in healthy school-age children using home-based polysomnography

Jia Xu Toby Seah1, Nicole A Nazareth2, Tiffany B Koa1

  • 1Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Sleep Health
|June 3, 2026
PubMed

Insights

The first night effect in children

Area of Science:

  • Pediatric Sleep Medicine
  • Neuroscience
  • Child Psychology

Background:

  • The first night effect (FNE) is a common phenomenon where sleep quality and architecture are altered during the initial night of polysomnography (PSG).
  • Understanding FNE in children is crucial for accurate sleep assessment in clinical and research settings.
  • Previous research on FNE has primarily focused on adult populations.

Purpose of the Study:

  • To quantify the first night effect in healthy school-age children using home-based polysomnography.
  • To compare sleep macro- and microstructure between two non-consecutive nights of sleep.
  • To determine the reliability of a single night of at-home PSG for sleep assessment in children.

Main Methods:

  • 41 healthy Singaporean school-age children (mean age 9.77 years) underwent two unattended home-based polysomnography (PSG) recordings.
  • Recordings were separated by at least one week, with participants following habitual school-night sleep schedules.
  • Paired-sample t tests were used to analyze within-subject differences in sleep macro- and microarchitecture.

Main Results:

  • Children spent more time in bed on the first night (15.97 min) but total sleep time did not differ.
  • The first night showed increased wake after sleep onset (10.63 min) and lower sleep efficiency (-2.28%).
  • Rapid eye movement (REM) sleep latency was delayed by 19.39 min on the first night; sleep stage durations and microarchitecture remained consistent.

Conclusions:

  • The first night effect in healthy children sleeping at home is modest.
  • Minor increases in awakenings and delayed REM sleep onset were observed.
  • A single night of at-home PSG may offer reliable sleep estimates for this age group.
Abstract

Keywords:
First night effectPolysomnographySchool-age childrenSleep architectureSleep microstructure

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