Sleep in the modern family: protective family routines for child and adolescent sleep

  • Orfeu M. Buxton
    Corresponding author at: Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802. Tel.: +1 617 507 9177.
    Department of Biobehavioral Health, Pennsylvania State University, 221 Biobehavioral Health Building, University Park, PA 16802

    Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Kresge Building, Boston, MA 02115

    Department of Medicine, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02115

    Division of Sleep Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA 02115
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  • Anne-Marie Chang
    Department of Biobehavioral Health, Pennsylvania State University, 221 Biobehavioral Health Building, University Park, PA 16802

    Department of Medicine, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02115
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  • James C. Spilsbury
    Center for Clinical Investigation, Case Western Reserve University, Wolstein Research Building, 2103 Cornell Rd, Cleveland, OH 44106-7291
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  • Taylor Bos
    The Center for Sleep & Wake Disorders, 5454 Wisconsin Ave, Suite 1725, Chevy Chase, MD 20815
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  • Helene Emsellem
    The Center for Sleep & Wake Disorders, 5454 Wisconsin Ave, Suite 1725, Chevy Chase, MD 20815
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  • Kristen L. Knutson
    Department of Medicine, University of Chicago, 5841 S Maryland Ave MC6076, Chicago IL 60637
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Published:January 14, 2015DOI:


      Study objectives

      The overall objective of the 2014 National Sleep Foundation Sleep in America Poll “Sleep in the Modern Family” was to obtain a current picture of sleep in families with at least 1 school-aged child.


      Cross-sectional poll.


      Internet-based interview.


      Nationally representative Internet panel of US households with a child 6-17 years.

      Measurements and results

      Primary measures included parental perception of the importance of sleep, parental and child sleep quality, child sleep duration and habits, technology in bedroom, and family rules. Parents/guardians (n = 1103; mean age, 42; 54% female) completed the survey. Although the majority of parents endorsed the importance of sleep, 90% of children obtain less sleep than recommended. Significant predictors of age-adjusted sufficient sleep duration (estimated conservatively as ≥9 hours for ages 6-11 years and ≥8 hours for ages 12-17 years) included parent education, regular enforcement of rules about caffeine, and whether children left technology on in their bedroom overnight. Significant predictors of excellent sleep quality included whether a bedtime was always enforced and whether children left technology on overnight.


      Children generally have better age-appropriate sleep in the presence of household rules and regular sleep-wake routines. Sufficient sleep quantity and adequate sleep quality were protected by well-established rules of sleep hygiene (limited caffeine and regular bedtime). In contrast, sleep deficiency was more likely to be present when parents and children had electronic devices on in the bedroom after bedtime. Public health intervention goals for sleep health might focus on reducing the encroachment of technology and media into time for sleep and supporting well-known sleep hygiene principles.
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