What nonpharmacologic interventions increase sleep in children?
Although we now know that putting children to bed earlier increases sleep duration by approximately 47 minutes, these studies don’t provide data on the more important child-oriented outcomes of health or school performance. On the other hand, the effect on the parent-oriented outcome of gaining more time at the end of the day is incalculable!
Plan de l'etude:
Meta-analysis (randomized controlled trials)
These authors searched multiple databases and registries to identify randomized trials of nonpharmacologic interventions to increase sleep duration in children with no medical or disabling conditions. They included 45 trials with 13,728 children. Very few of the studies were at low risk of bias. The children in the intervention groups had an average 10.5 minutes longer sleep duration than children in the control groups, but the data were quite heterogeneous across the studies (I2 = 87%). The authors did many subgroup analyses to identify potential sources of the heterogeneity (e.g., school level, socioeconomic status, sleep assessment techniques, intervention venue, parental presence, etc.) and found that studies conducted in North America (15.6 minutes) and Asia (16.9 minutes) had larger effect sizes. More interesting, though was that simply putting a child in bed earlier resulted in 47 minutes longer sleep duration! While the authors were prepared to evaluate other outcomes, such as sleep quality, they were unable to synthesize these data because of scant reporting and marked heterogeneity.
Henry C. Barry, MD, MS
Michigan State University
East Lansing, MI