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• Context matters in children's experiences of napping and night-time sleep
  Caroline H. D. Jones
  Published on: 27 April 2015

• Published on: 27 April 2015

  Context matters in children's experiences of napping and night-time sleep

  • Caroline H. D. Jones, Senior Researcher
  • Other Contributors:
    • Helen L. Ball, Durham University

  Given the media headline in response to this paper--that "Daytime naps 'should stop at the age of two'" (http://www.dailymail.co.uk/health/article-2957907/Daytime-naps-stop-age- two.html)--we would like to emphasise that napping can be an effective strategy for children to achieve sufficient amounts of sleep. This is particularly important when children experience inconsistent nighttime sleep arrangements, in which they...

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  Given the media headline in response to this paper--that "Daytime naps 'should stop at the age of two'" (http://www.dailymail.co.uk/health/article-2957907/Daytime-naps-stop-age- two.html)--we would like to emphasise that napping can be an effective strategy for children to achieve sufficient amounts of sleep. This is particularly important when children experience inconsistent nighttime sleep arrangements, in which they are unable to achieve recommended amounts of sleep at nighttime alone; and for children from more socio- economically deprived backgrounds, who are already at a health disadvantage.

  In interviewing parents of over 80 three-year-old children about their child's sleep, we were struck by the many households in which sleep hygiene behaviours were not, and probably could not, be implemented, for reasons including household crowding, irregular schedules, fluctuating sleep environment, lack of parental knowledge, support or motivation. 21% of children did not have a regular bedtime implemented by their parents on all or most nights, and 23% did not fall asleep in their own bed each night with some children sleeping in multiple households every week (e.g. mother's home, father's home, grandparents' homes)1. These children, more commonly from socio-economically deprived areas, had significantly shorter nighttime sleep: but not shorter sleep over 24 hours. This suggests that napping compensates for shorter nighttime sleep in some children without 'healthy' nighttime sleep behaviours, preventing these children from experiencing insufficient sleep duration.

  There is a lack of high quality evidence on whether consolidated nighttime sleep versus combined nighttime sleep and daytime napping is better for health. Furthermore, as the authors point out, there is insufficient evidence to conclude whether napping results in delayed nighttime sleep onset and shorter nighttime sleep, or whether short nighttime sleep results in daytime napping (we suspect both are at play in different groups of children, depending on their home environment).

  Given the lack of high quality evidence, discouraging naps in those children with corresponding shorter nighttime sleep duration could unnecessarily penalise children who rely on daytime napping to achieve sufficient sleep amounts. In the context of crowded, perhaps chaotic, households, preventing naps where nighttime sleep is unlikely to be improved would lead to a reduction in 24 hour sleep duration, thereby negatively impacting health and development and increasing health-related inequalities.

  It should not be assumed that one approach fits all children. Blanket recommendations about the suitability of napping might increase inequalities in outcomes. Children's sleep behaviours and sleep environments are diverse. For some, regular and early bedtimes, in a quiet, dark room, enable them to achieve sufficient sleep through nighttime sleep alone. However others operating under more constrained contexts exhibit different strategies, including irregular, later bedtimes combined with napping, to achieve similar sleep amounts over 24 hours. Until there is good evidence that there are negative consequences to this second strategy, and that preventing napping will not result in decreased, insufficient sleep for some children, then napping should not be dismissed.

  1Jones CHD & Ball H (2014) Exploring socioeconomic differences in bedtime behaviours and sleep duration in English preschool children. Infant and Child Development, DOI: 10.1002/icd.1848

  Conflict of Interest:

  We are the authors of one of the papers included in this systematic review.

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  Conflict of Interest:
  None declared.

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