Beyond bedtime routines: sleep-schedule organization, sleep-onset conditions, and nighttime parental practices associated with early-childhood sleep quality in Armenia

Background Parental sleep-related behaviors may have different functional meanings depending on whether they occur before sleep or are maintained as sleep begins. We examined associations of sleep-schedule organization, sleep-onset conditions, and nighttime resettling practices with BISQ-R Infant Sleep scores among Armenian children aged 6–36 months. Methods This cross-sectional study included 417 families recruited by systematic random sampling at Wigmore Women's and Children's Hospital between December 2025 and March 2026. Mothers completed the culturally adapted Armenian Brief Infant Sleep Questionnaire-Revised (BISQ-R). Univariable analyses assessed reported bedtime, bedtime-preparation start time, and bedtime regularity. Hierarchical regression sequentially included child/family, sleep-schedule, and behavioral/contextual variables. Nighttime breastfeeding was examined among children with nighttime awakenings. Results Later reported bedtime and later bedtime-preparation start time were associated with lower Infant Sleep scores, whereas greater bedtime regularity was associated with higher scores in univariable analyses. Sleep-schedule variables added 2.7% of variance (Δ R 2 = 0.027, p = 0.004), and behavioral/contextual factors an additional 15.5% (Δ R 2 = 0.155, p < 0.001). The final model explained 18.7% ( R 2 = 0.187; adjusted R 2 = 0.157). Bedtime regularity remained positively associated with Infant Sleep score (unstandardized coefficient [ B ] = 0.936, standardized coefficient [β] = 0.091, p = 0.047), whereas reported bedtime was non-significant ( p = 0.101). Compared with being held/rocked, falling asleep with an adult present without being held/rocked ( B = 4.861, β = 0.136, p = 0.009) or independently ( B = 15.758, β = 0.176, p < 0.001) was associated with higher scores. Breastfeeding/nursing following nighttime awakening was associated with lower scores ( B = −12.095, β = −0.319, p < 0.001), with an attenuated association among children with nighttime awakenings ( n = 386; B = −7.14, β = −0.215, p = 0.003). Conclusions Bedtime regularity, but not reported bedtime, remained associated with Infant Sleep scores after adjustment. Sleep-onset conditions and post-awakening nursing showed associations; behavioral/contextual factors added more explained variance than sleep-schedule variables. Despite modest explanatory power, these findings highlight how parental support accompanies sleep initiation and resettling, rather than treating all assistance as equivalent. Parental involvement showed practice-specific associations with Infant Sleep scores, including lower scores with post-awakening nursing. Whether the endpoint of bedtime preparation functions as a transition cue remains a hypothesis requiring direct investigation.