Sleep in the first three years of life: Age-related patterns and predictors in a South African sample

Sleep is integral to early neurodevelopment and health, yet most normative data derive from high-income, global North populations. Context-specific data from sub-Saharan Africa, and South Africa in particular, remain scarce. This study describes sleep patterns across the first three years of life in a South African sample and examines caregiver and child characteristics associated with variation in sleep outcomes. A cross-sectional online survey was completed by 340 South African caregivers of children aged 0-36 months. Sleep was assessed using items from the Brief Infant Sleep Questionnaire-Revised. Several sleep outcomes were examined across six age bands. One-way ANOVAs examined age-related differences, and multiple linear regression analyses identified caregiver and child correlates of sleep. Significant age-related differences were observed for total sleep duration, nighttime consolidation, and daytime sleep, with large effect sizes for daytime sleep. Bedtime, bedtime consistency, and sleep onset latency remained similar across the six age groups (0-3-25-36 months). Child age was the most consistent predictor of sleep outcomes. Caregiver unemployment was associated with shorter and less consolidated nighttime sleep. Second-born or later children showed more frequent night wakings and greater daytime napping. Intermediate temperament was associated with longer sleep onset latency. Age-related differences in sleep patterns during the first three years are broadly consistent with international findings, though aspects of sleep timing appear more contextually shaped. Findings provide preliminary data for South Africa and highlight the need for age-stratified, culturally sensitive sleep guidance and interventions.