A nightly bedtime routine: impact on sleep in young children and maternal mood

Sleep. 2009 May;32(5):599-606. doi: 10.1093/sleep/32.5.599.


Background: Establishment of a consistent bedtime routine is often recommended to parents of young children, especially those with sleep difficulties. However, no studies have investigated the efficacy of such a routine independent of behavioral intervention. Thus, the purpose of this study was to examine the impact of a consistent bedtime routine on infant and toddler sleep, as well as maternal mood.

Methods: 405 mothers and their infant or toddler (ages 7-18 months, n=206; ages 18-36 months, n=199) participated in 2 age-specific 3-week studies. Families were randomly assigned to a routine or control group. The first week of the study served as a baseline during which the mothers were instructed to follow their child's usual bedtime routine. In the second and third weeks, mothers in the routine group were instructed to conduct a specific bedtime routine, while the control group continued their child's usual routine. All mothers completed the Brief Infant Sleep Questionnaire (BISQ) on a weekly basis and a daily sleep diary, as well as completed the Profile of Mood States.

Results: The bedtime routine resulted in significant reductions in problematic sleep behaviors for infants and toddlers. Significant improvements were seen in latency to sleep onset and in number/duration of night wakings, P < 0.001. Sleep continuity increased and there was a significant decrease in the number of mothers who rated their child's sleep as problematic. Maternal mood state also significantly improved. Control group sleep patterns and maternal mood did not significantly change over the 3-week study period.

Conclusion: These results suggest that instituting a consistent nightly bedtime routine, in and of itself, is beneficial in improving multiple aspects of infant and toddler sleep, especially wakefulness after sleep onset and sleep continuity, as well as maternal mood.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affect*
  • Behavior Therapy*
  • Ceremonial Behavior*
  • Child Behavior Disorders / psychology
  • Child Behavior Disorders / therapy*
  • Child, Preschool
  • Female
  • Habits*
  • Humans
  • Infant
  • Male
  • Maternal Behavior / psychology
  • Mother-Child Relations
  • Mothers / psychology*
  • Sleep Initiation and Maintenance Disorders / psychology
  • Sleep Initiation and Maintenance Disorders / therapy*