Sleep Hygiene Practices and Bedtime Resistance in Low-Income Preschoolers: Does Temperament Matter?

Abstract

Objective To test the association of home sleep hygiene practices with bedtime resistance among preschoolers, and to determine whether this association differs by child temperament. Methods Parents of Head Start preschoolers (n=374, 56% non-Hispanic white) completed questionnaires, including the 5-item Going to Bed subscale of the Children’s Sleep-Wake Scale (GTB; higher score reflects less bedtime resistance), 22-item Children's Sleep Hygiene Scale (CSHS; higher score reflects better sleep hygiene practices) and Child Behavior Questionnaire-Short Form anger, activity, and impulsivity subscales (our measure of difficult temperament). Monte Carlo simulation adjusted for child age, gender, race/ethnicity, and maternal education and tested the association of CSHS with GTB in children with more difficult vs. less difficult temperaments. Results Children with more difficult vs. less difficult temperaments experienced worse sleep hygiene practices (p<.0001) and had more bedtime resistance (p<.0001). Among children with more difficult temperaments, better sleep hygiene was linearly associated with less bedtime resistance (GTB β = 1.28, 95% CI 0.77, 1.78). Among children with less difficult temperaments, the association followed a piecewise linear tread: sleep hygiene was not associated with bedtime resistance when CSHS scores were < 4.1 (GTB β = 0.15, 95% CI -4.87, 3.13), but for CSHS scores ≥ 4.1, an increase in CSHS was associated with lower bedtime resistance (GTB β = 1.33, 95% CI 1.00, 1.79). Conclusions Consistency in sleep hygiene practices are associated with less bedtime resistance and may be especially helpful in reducing bedtime resistance among children with more difficult temperaments.

Too indulgent or not sensitive enough: mothering in the current historical era and its relevance to childhood obesity

“…Parenting routines are also more strongly associated with children's outcomes when the child is at biobehavioral risk. 7,8 These observations align with the fact that most research on the effects of routines on children's outcomes has been among children at risk. 9 The intervention potential of routines for typically developing, healthy children may be modest.…”

“…For example, households with more routines have children with easier temperaments. 6,7 These associations may be due to shared genetics between parents and child (both of whom may have rhythmic temperaments that easily adapt to routines) as opposed to parenting that causes children to have easier temperaments. Parenting routines are also more strongly associated with children's outcomes when the child is at biobehavioral risk.…”

Family Chaos and Child Functioning in Relation to Sleep Problems Among Children at Risk for Obesity

“…Child factors that influence bedtime problems related to sleep duration include difficult temperaments and emotional and behavioral problems (Wilson, Lumeng, et al, 2014). A large (n=8950), longitudinal study indicated that over-activity, anger, aggression, impulsivity, tantrums, and annoying behaviors predicted shorter sleep duration, (Scharf, Demmer, Silver, & Stein, 2013).…”

Child cortisol moderates the association between family routines and emotion regulation in low‐income children

“…Routines have been proposed as a mechanism that supports early childhood emotion regulation (Bridley & Jordan, ; Ferretti & Bub, ; Zajicek‐Farber, Mayer, & Daughtery, ) as well as general well‐being and health (Anderson & Whitaker, ; Henderson, Barry, Bader, & Jordan, ). Yet, routines may not have the same effect for all children in part due to individual differences (Spagnola & Fiese, ; Wilson et al, ). Child factors such as difficult temperament (Churchill & Stoneman, ; Spagnola & Fiese, ; Wilson et al, ) or sex (Churchill & Stoneman, ; Ferretti & Bub, ) may drive the ease of establishing routines and also the effectiveness of routines in promoting positive outcomes.…”

“…Yet, routines may not have the same effect for all children in part due to individual differences (Spagnola & Fiese, ; Wilson et al, ). Child factors such as difficult temperament (Churchill & Stoneman, ; Spagnola & Fiese, ; Wilson et al, ) or sex (Churchill & Stoneman, ; Ferretti & Bub, ) may drive the ease of establishing routines and also the effectiveness of routines in promoting positive outcomes. Given that children with high temperamental difficulty or poorly regulated psychobiology are at risk for developing maladaptive parent–child interaction patterns over time (Spagnola & Fiese, ; Sprunger, Boyce, & Gaines, ), such children may also be most in need of family routines.…”