Counseling for healthy sleep habits during childhood: a randomized controlled trial

The research developed a sleep counseling program for parents of children from three months to two years old and evaluated the possible effects of the program on improved sleep and on the growth and motor and psychological development of the children who received the intervention.

586 mothers with three-month-old children were recruited. Of this total, 298 were selected at random to receive visits and another 288 were part of the control group, which did not receive guidance. During visits, the team guided parents on the best practices to ensure quality sleep for babies. Through a questionnaire, for this purpose called Brief Infant Sleep Questionnaire (BISQ), researchers assessed the sleep of the children who participated in the counseling at three, six, 12 and 24 months of life. In addition, they used an actigraphy, a method to monitor people’s activities and rest. Mothers also filled out a child’s activity diary at three and six months, which included details on the amount of time they slept and woke up throughout the entire day. Researchers measured the growth of the children at one and two years old. During this same period, they also assessed the children’s development using two instruments specifically designed for this purpose. All mothers, from both groups, were also interviewed when their children were six, 12 and 24 months old.

The study found that the greatest effects of the counseling program were observed at three times in the child’s life:

1. at six months, with longer sleep at night
2. at one year, they performed better on the psychomotor development test than those in the control group
3. the time in which the children were awake at night without signaling for their parents’ attention (that is, they went back to sleep without needing the presence of a parent) was longer than in the control group (31 against 14 minutes, respectively), but the difference was not statistically significant.
4. In general, researchers found differences in sleep for children at 6 and 24 months old, but these differences were not statistically significant.

It is the first time that a sleep counseling program for children up to two years old has been implemented and evaluated in Brazil and in middle-income countries. Most of these evaluations have been conducted in high-income countries. This is important because, culturally, Brazilian children have different sleep habits than English children, for example. Brazilian children go to sleep and wake up on average two hours later than British children. And in Brazil the practice of sleeping in the parents’ bed is very common, which rarely occurs in Europe. The impact of high-quality sleeping on child development is still a new topic in the area of ​​early childhood development.

The harmful impacts of poor sleep quality on the development of children up to two years old.

The intervention can be implemented by other health professionals, it is cheap because it can be applied to mothers at home, without requiring large costs.

With appropriate cultural adaptations, it is possible to expand this study to other countries. In the context of global health, the study may also shed more light on the importance of adopting regular sleep routines to encourage child development.

Transform the program into a folder to be disseminated to parents and offered elsewhere. In parallel to this project, the same university collected sleep data from a cohort of 4,400 children from Pelotas, which will allow them to draw a broader and more accurate sample for research on the subject in Brazil.