Implementation of a nightly bedtime routine: How quickly do things improve?

- A consistent two-week bedtime routine improves sleep in young children within the first three nights of implementation.
- Sleep onset latency rapidly improved over the first three nights, then showed no significant improvement for the remainder of the intervention.
- Maternal perceptions of child bedtime ease, sleep quality, and morning mood improved rapidly over the first three nights.
- Maternal perceptions of those factors showed slower but significant improvement for the remainder of the intervention.

BackgroundInstitution of a consistent bedtime routine has been demonstrated to improve sleep in young children within two weeks. However, no studies have investigated the rate of this change and when most change occurs. The purpose of this study was to examine the nightly change in infant sleep and maternal perceptions after implementing a bedtime routine.MethodsMothers (n = 134) and their infant (8-18 months) were randomly assigned to implementation of a bedtime routine intervention for a two-week period.ResultsTwo-level piecewise linear growth models showed that the intervention resulted in the most rapid change in the first three nights of the intervention across sleep outcomes, including sleep onset latency, the frequency and duration of nighttime awakenings, sleep consolidation, and maternal perceptions of bedtime ease, sleep quality, and infant mood. No significant additional improvement in sleep onset latency emerged after these first three nights, whereas small additional improvements occurred for all other outcomes throughout the remainder of the intervention period.ConclusionsThese results indicate that sleep disturbances in infants and toddlers can be quickly ameliorated within just a few nights after implementation of a consistent bedtime routine, including a bath, massage, and quiet activities. Future research should consider the potential mechanisms behind these relatively fast improvements in sleep, such as reduced household chaos or physiological changes (e.g. core body temperature, cortisol).