Child routines moderate a brief behavioral intervention to enhance sleep in school-aged children

Abstract Objective To examine whether child routines (the consistency or variation in children’s daily routines, household responsibilities, discipline routines, and homework routines) moderated the effectiveness of a brief behavioral intervention to enhance sleep in school-aged children. Methods Secondary analysis was conducted with a subset of 66 families with short sleeping (≤9.5 hr/day) children, 8–11 years old (female = 68%; mean age = 9.76, SD = 1.02) who completed the Child Routines Inventory at baseline and were then randomized to receive a behavioral sleep intervention (n = 32) or to control (n = 34). Sleep period was objectively measured using wrist actigraphy at baseline and 2 months post-randomization. Moderation analysis was performed using ordinary least squares regression using the PROCESS macro for SPSS. Results Controlling for sleep period at baseline, treatment condition was significantly related to the sleep period at 2 months post-randomization, with the intervention group achieving a longer sleep period compared to the usual sleep period group (control) (b = 46.30, p .01). Intervention response was moderated by child routines (b = 1.43, p .05). Specifically, the intervention produced the greatest change in sleep period for children who engaged in greater routine behaviors at baseline than those who engaged in fewer routine behaviors. Conclusions Families that engage in routine behaviors may be better equipped to adopt the behavioral modifications required to get a good night’s sleep. The findings highlight the importance of working with families to establish routine behaviors to improve responses to behavioral sleep interventions.