Abstract Introduction Bedtime routines are recommended for young children’s sleep. Most supporting evidence is, however, subjective, and the effects of constituent activities are rarely examined. This study explored pre-bedtime activity and sleep associations using objective measures. Methods In this repeated-measures observational study, 70 healthy 3–4-year-old children wore AX3 actigraphs for seven nights with chest-worn GoPros videoing activities for 2h before bed for five of those nights. Nutrition, self-care, screen, story, and other connection activity data were extracted using a reliable coding scheme developed for this study (κ ≥ 0.8). Exploratory analyses using Bayesian mixed effects linear and Poisson regression investigated associations between activities in the hour before bedtime and that night’s actigraphy-derived sleep measurements. Results Total sleep time (TST) was greater when the pre-bedtime period included connection activities like cuddling (16 min Bayesian 95% credible interval (CrI) -11, 43; 88% chance of a positive association) or bath/shower (15 min 95%CrI -9, 38; 89% chance of a positive association). Screen exposure showed the least evidence of a relationship (TST 1 min shorter per 10 mins of exposure 95%CrI -6, 5). Credible intervals were wide for audiobook use, which was uncommon, although directionality suggested less TST (-42 min 95%CrI -97, 15; 93% chance of a negative association). Adjusting for sociodemographic factors did not substantially change results. Discussion Findings are consistent with connection activities involving caregivers supporting young children’s sleep, but that screen exposure is not a meaningful predictor when measured objectively. Further research on audiobook use is needed, including for reverse causation.
Kuroko et al. (Wed,) studied this question.
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