Efficacy of sleep promotion strategies in childcare settings and sleep outcomes in young children: a systematic review.

OBJECTIVES: To summarize findings and provide methodological critique of studies examining the impact of sleep promotion strategies in childcare on young children's sleep outcomes. METHODS: The search run in PubMed, PsycINFO, and CINAHL yielded a total of 3,528 unique articles. Eligible studies included young children (under 5 years old); assessed the impact of at least one sleep promotion strategy whether structural (e.g., mandatory naptime) or behavioral (e.g., music) with both within- and between-subject designs eligible); and included at least one quantitative child sleep outcome. RESULTS: 6 studies met the eligibility criteria. Identified childcare sleep promotion strategies included mandatory naptime (n = 4), music (n = 1), and massage therapy (n = 1). Findings indicated that mandatory naptime was associated with increased napping. One study found that mandatory naptime was associated with reduced nighttime sleep and total daily sleep duration. Music and massage therapy were associated with reduced nap latency. CONCLUSIONS: There is a paucity of research on sleep promotion strategies in childcare. This is an important research gap given the established health benefits of sufficient sleep and that many children from historically disadvantaged backgrounds depend on naps to meet their sleep needs. Future studies examining the effects of sleep promotion strategies other than mandated naptime, such as the sleep environment and provider behaviors, are needed.