Sleep in Infants, Children, Adolescents, and Pregnant Women
Knowledge Path
Knowledge Path Table of Contents
General Resources for Professionals
- Websites
- Additional Electronic Publications
- Databases: Data, Literature and Research, and Programs
- News and Commentary
Resources on Specific Aspects of Sleep
- Anxiety, Depression, Trauma, and Stress
- Attention Deficit Hyperactivity Disorder (ADHD)
- Autism Spectrum Disorders
- Bruxism, Parasomnias, and Rhythmic Movement Disorder
- Caffeine
- Insomnia
- Narcolepsy
- Polysomnography
- Pregnancy
- Restless Legs Syndrome (RLS)
- Sleep Apnea
- Sleep Deprivation
- Sleep Practices
- Autism Spectrum Disorders
- Emotional, Behavioral, and Mental Health Challenges
- Health Insurance and Access to Care
- Infant Mortality and Pregnancy Loss
- Medications
- Oral Health
- Overweight and Obesity
- Preconception and Pregnancy
- Reaching Out to Children and Youth Following Disasters
- Screening
- Social and Emotional Development
Please provide feedback on this knowledge path.
This knowledge path directs readers to a selection of current, high-quality resources about sleep in infants, children, adolescents, and pregnant women. This knowledge path can be used by health professionals, researchers, educators, community advocates, and families to learn more about sleep, to improve diagnosis and treatment of sleep disorders, for program development, and to locate training resources and information to answer specific questions. Separate briefs present resources for families and schools. This knowledge path has been developed by the six national Pediatric Pulmonary Training Programs and the MCH Library at Georgetown University, all of whom are funded by the Maternal and Child Health Bureau (MCHB). It will be updated periodically.
Sleep is an important component of daily life for people of all ages, with children spending an average of 30 percent to 50 percent of their day sleeping. Sleep is especially important for infants, children, adolescents, pregnant women, and new mothers. Good sleep is essential to a well-functioning family. Poor sleep and/or sleep disorders in children can have an impact on the child and the entire family. Infants, children, and adolescents are particularly vulnerable to sleep disorders and are at higher risk than adults for getting insufficient sleep. Sleep problems are increasingly being recognized as a public health issue with ties to obesity, attention deficit hyperactivity disorder (ADHD), autism, and poor school performance. Underserved populations are at higher risk for sleep problems. Health professionals, families, and communities need to be knowledgeable about how to improve sleep and be able to recognize sleep disorders.
General Resources for Professionals
- American Academy of Sleep Medicine (AASM). Sleep medicine practice tools and guidelines and information about membership, accreditation, coding, and legislation. Some information is accessible to members only, including journal articles and a state policy directory. Patient education brochures, learning modules, webinars, and some other materials
are available for a fee. Also see AASM's blog.
- Healthy People 2020. National health-promotion and disease-prevention initiative of the Department of Health and Human Services (DHHS). View the overview, objectives, and recommended interventions and resources for sleep health.
- National Center on Sleep Disorders Research (NCSDR). Initiative to coordinate government-supported sleep research, training, and education. NCSDR is located within the National Heart, Lung, and Blood Institute (NHLBI). See the SLEEPRFA-L listserv and a publications list.
- National Sleep Awareness Roundtable (NSART). National coalition of government, professional, voluntary,
and other organizations that aims to address public and professional awareness
and education about sleep and sleep disorders. NSART is a program of the National Sleep Foundation (NSF).
- National Sleep Foundation (NSF). Information about sleep and sleep disorders in infants, children, adolescents,
and pregnant women. Includes findings from the Sleep in America polls, which address topics such as technology use and sleep, adolescents and
sleep, and children and sleep. NSF is an independent nonprofit organization
dedicated to achieving a better understanding of sleep and sleep disorders
and supporting education, sleep-related research, and advocacy.
Additional Electronic Publications
- Birch LL, Parker L, Burns A, eds. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: National Academies Press. [Report, Brief]. This report contains a chapter about sleep.
- Graham MG, ed. 2000. Sleep Needs, Patterns and Difficulties of Adolescents: Summary of a Workshop. Washington, DC: National Academies Press. [Report].
The databases listed below are excellent tools for identifying data, additional literature and research, and programs about sleep and sleep disorders. Many of the entries below contain tips on how to use the databases efficiently. Please note that databases vary in how terms should be entered; for example, some require quotation marks and others don't. Enter search phrases as shown in bold below.
- Data Resource Center for Child and Adolescent Health (DRC). Data from the National Survey of Children's Health, 2003 and 2007, and the
National Survey of Children with Special Health Care Needs, 2001 and 2005/2006.
For data about sleep, see the search box for the National Survey of Children's
Health. Select a year; select nationwide or a state; and select Family Health and Activities. Click on Go. Select a measure (e.g., 6.9
Adequate amount of sleep, age 6–17, 6.10b Child has TV in bedroom, age 6–17)
and click on Next to view results. DRC is a project of the Child and Adolescent Health Measurement Initiative (CAHMI).
- Health Indicators Warehouse (HIW). National, state, and community health indicators organized by topic, geography, and initiative. To identify indicators, type sleep in the box, Search for Indicators, and click on the search icon. Select an indicator (e.g., School health education—rest and sleep, Sufficient sleep among 9th to 12th graders. Toggle between an overview of the survey and the data. HIW serves as the data hub for the Department of Health and Human Services (DHHS) Community Health Data Initiative, a collaboration of many agencies and offices within DHHS.
- National
Quality Measures Clearinghouse
(NQMC).
Evidence-based health-care-quality
measures and measure sets for physicians,
hospitals, and health plans to evaluate
and improve the quality of health care
for consumers. Identify measures by
selecting Advanced Search. Type sleep in the Keyword field. Scroll down
on the search form to select Age Range (e.g., Adolescent).
Hold down
the control key (ctrl) or Apple command
key and click your mouse to make multiple
selections. Click on Show results to get your
results. The
database is sponsored by the Agency
for Healthcare Research and Quality (AHRQ).
- Center on Media and Child Health (CMCH). Online catalog of research articles examining the relationship between media exposure and health-risk
behaviors. To identify articles, type sleep in the Text field. Under All fields, select Subject term. Click on Search Now! to get your results. CMCH is a joint project of Children's Hospital Boston, Harvard Medical
School, and Harvard School of Public Health.
- Centre for Reviews and Dissemination (CRD) Databases.
Summaries of systematic reviews, economic evaluations, and health technology assessments that have met strict quality criteria and address the effectiveness and cost-effectiveness of health care
interventions. To identify summaries, type sleep AND (infants OR children OR adolescents OR pregnancy) in the Quick search field. Click on Go to get your results. CRD is located at the University of York, United Kingdom.
- ClinicalTrials.gov.
Information about
clinical research studies for a wide
range of diseases and conditions, including
sleep disorders. Included
are a summary of the purpose of the
study, the recruiting status, criteria
for patient participation, the trial location, and
contact information. To identify studies,
select Search for Clinical
Trials. Select Advanced Search. Enter sleep in the Search Terms
field. Scroll to Age Group and select Child (birth–17). Click on Search
to get your results. Conduct another search, by entering sleep AND pregnancy in the Search Terms field. Click on Search to get your results. ClinicalTrials.gov
is a service of the National
Institutes of Health (NIH).
- Cochrane Reviews. Abstracts for systematic reviews of health care interventions internationally.
To access the abstracts of reviews, go to the box, Search abstracts & summaries. Type sleep AND (infants OR children OR adolescents OR pregnancy). Click on Search Reviews to get your results. Access to the full-text article requires a subscription that is available in many
hospital and university health sciences libraries.
The database is published by the Cochrane Collaboration,
an international nonprofit organization based in
the United Kingdom.
- Health Services Research Projects in Progress (HSRProj). Information about ongoing health services research and public health projects. To identify projects, click on Advanced Search. Enter (infant OR child OR adolescent OR pregnancy) AND sleep in the search box. HSRProj is funded by the National Library of Medicine (NLM).
- MCH Library at
the National
Center for Education in Maternal
and Child Health (NCEMCH),
Georgetown University. Databases to collect, manage,
and disseminate knowledge about MCH,
with special emphasis on knowledge
gained from initiatives and programs
supported by the Maternal
and Child Health Bureau (MCHB).
The library's bibliographic database
is
MCHLine®. An online catalog of materials in the MCH Library with several items about safe sleep environments for infants. To identify them, type sleep in the keyword field of the database search form.
The MCH Library also offers an organizations database.
- National Guideline Clearinghouse (NGC). Evidence-based clinical practice guidelines and related materials for health professionals. Identify guidelines about pediatric sleep disorders by selecting Advanced Search. Enter sleep in the Keyword field. Scroll down on the search form
to select Age of Target Population
(e.g., Adolescent). Hold down the control key (ctrl)
or Apple command key and click
your mouse to make multiple selections. Click on
Show results to get your results. The database is an initiative of the Agency for Healthcare Research and Quality (AHRQ).
- National Institutes of Health (NIH) Research Portfolio Online Reporting Tool (RePORT): RePORTER. Access to reports, data, and analyses of NIH research activities, including information on NIH expenditures and the results of NIH-supported research. To identify information, enter sleep AND (infants OR children OR adolescents OR pregnancy) in the Text Search field. Click on Advanced and Submit Query to get your results. Narrow your searches by selecting a project start date or adding terms to other search fields.
- PubMed. Citations
for biomedical articles from MEDLINE
and life science journals. Citations
may include links to full-text content
from PubMed Central and publisher websites. To identify
citations on the topic, enter sleep in the search box.
Refine your search
by clicking on Limits and making the
following selections
on the page: select a date (e.g. Published
in the last 2 years); click on Languages:
English; click on Species: Humans; click on Ages:
All Child; and select Search Field Tags: MeSH Major Topic.
Click on Search to get your results. For citations
about sleep and pregnancy, enter sleep AND pregnancy in the search box. Click on Limits. Click on Reset and make the
following selections
on the page: select a date (e.g. Published
in the last 2 years); click on Languages:
English; click on Species: Humans; and select
Search Field Tags: MeSH Major Topic. Click on Search to get your results. To narrow your
search further or for additional searches, use the
MeSH (Medical Subject Headings) database to identify terms (e.g., Sleep Disorders, Sleep Apnea Syndromes, Sleep Bruxism).
PubMed is a service of the National
Library of Medicine (NLM).
- Discretionary Grant Information System (DGIS). Information about grants issued annually by the Maternal and Child Health Bureau (MCHB). Identify grants by selecting Abstracts. Type sleep in the Search Word or Phrase field. Click on Search to get your results. To
find products and publications produced by MCHB training grantees, select Program
Data. Select Training and click on Search Products and Publications. Type sleep in the Search Word or Phrase
field. Click on Search to get your results.
- MCH Organizations Database. Over 2,000 government, professional, and voluntary organizations involved in MCH activities, primarily at a national level. To identify organizations, type sleep in the keyword field of the database search form. Click on Search MCH Organizations to get your results. The database is a service of the MCH Library at the National Center for Education in Maternal and Child Health (NCEMCH).
- American Academy of Sleep Medicine (AASM): Sleep Education. This blog covers news and information about sleep and sleep disorders.
- National Center on Sleep Disorders Research: SLEEPRFA-L List. This monthly e-mail alert service presents information about NIH initiatives and activities of potential interest to sleep and circadian researchers.
- See the MCH Library family resource brief Sleep in Babies, Kids, Teens, and Pregnant Women for links to sleep specialists, sleep centers, and websites.
- See the MCH Library school resource brief Sleep.
Resources on Specific Aspects of Sleep
- Anxiety, Depression, Trauma, and Stress
- Attention Deficit Hyperactivity Disorder (ADHD)
- Autism Spectrum Disorders
- Bruxism, Parasomnias, and Rhythmic Movement Disorder
- Caffeine
- Insomnia
- Narcolepsy
- Polysomnography
- Pregnancy
- Restless Legs Syndrome (RLS)
- Sleep Apnea
- Sleep Deprivation
- Sleep Practices
Anxiety, Depression, Trauma, and Stress
- Children's Anxiety Institute: Sleep Habits Can Affect Levels of Stress and Anxiety
in Children and Teens. Information about the relationship between sleep and stress and anxiety levels.
- Depression and Bipolar Support Alliance: Sleep. Information for families about sleep in children and adolescents and early onset of bipolar disorder. Links to information about the importance of sleep, getting a good night's sleep, depression and sleep, and sleep tools.
- National Child Traumatic Stress Network (NCTSN). Resources for families, educators, health and social services professionals,
policymakers, and the media about child and adolescent traumatic stress, effective
interventions, data, and terrorism and disaster preparedness to lessen traumatic
effects. Several items broadly address sleep difficulties as a behavior associated with exposure to trauma.
Attention Deficit Hyperactivity Disorder (ADHD)
- American Academy of Sleep Medicine (AASM): Sleep Problems Are Common in Children with ADHD. Information about common sleep problems in children and adolescents with ADHD.
- National Sleep Foundation: ADHD and Sleep. Information about the link between ADHD and a variety of sleep problems.
- Autism Speaks: Sleep Disturbance. Information about the Autism Treatment Network Sleep Committee and its work to develop a sleep hygiene toolkit and an algorithm for carrying out the initial diagnostic and treatment steps for sleep disturbances in children with autism.
- Malow BA. 2007. A Good Night’s Sleep in Children with ASD: What We Know, and What We Still Need To Understand Through Research. Nashville, TN: Vanderbilt Sleep Disorders Center. [Report]. Also view Dr. Malow's PowerPoint presentation, Promoting Sleep in Children with Autism Spectrum Disorders (2007).
- WebMD Medical Reference. 2010. Helping Your Child with Autism Get a Good Night's Sleep. New York, NY: WebMD LLC. [Article].
- Wheeler M. 2003. Good Night, Sleep Tight, and Don’t Let the Bed Bugs Bite: Establishing Positive Sleep Patterns for Young Children with Autism Spectrum Disorders. Bloomington, IN: Indiana Resource Center for Autism. [Article].
Bruxism, Parasomnias, and Rhythmic Movement Disorder
- American Academy of Sleep Medicine (AASM).
Childhood Parasomnias. Information about parasomnias in children (nightmares, sleep terrors, sleep walking, confusional arousals, or bedwetting). Includes a chart comparing childhood parasomnias and tips for parents.
Rhythmic Movement. Information about rhythmic movement disorder (body rocking, head banging, or head rolling).
- KidsHealth: Bruxism. Information about bruxism (teeth grinding or clenching) in children.
- American Academy of Sleep Medicine (AASM): Sleep and Caffeine. Information about the effects of caffeine on sleep and the caffeine content
of drinks. Includes information about caffeine and adolescents.
- American Academy of Sleep Medicine (AASM): Behavioral Insomnia of Childhood. Information about symptoms and when to seek treatment.
- Society of Behavioral Sleep Medicine: Childhood Insomnia. Information about symptoms, diagnoses, and treatment.
- Children's Hospital of Philadelphia Sleep Center: Narcolepsy. Information about the symptoms, possible causes, and treatment for narcolepsy.
- Narcolepsy Network. Information about narcolepsy in children and adolescents. Resources include brochures, a sleep log, and contact information for support groups, sleep centers, and sleep professionals.
- Beck SE, Marcus CL. 2009. Pediatric Polysomnography. Sleep Medicine Clinics 4(3): 393–406. [Journal article].
- Carroll JL. [Accessed 2011]. Sleep Apnea in Children. Little Rock, AR: University of Arkansas for Medical Sciences. [Case study].
- Children's Hospital of Philadelphia Sleep Center. [Accessed 2011]. Your Child's Study: General Instructions. Philadelphia, PA: Children's Hospital of Philadelphia. [Fact sheet].
- Kidshealth. 2010. Polysomnography (Sleep Study). Wellington, NZ; Auckland, NZ: Paediatric Society of New Zealand; Starship Foundation. [Fact sheet].
- Porquez EJ. 2009. Polysomnography and the Pediatric Patient. RT: For Decision Makers in Respiratory Care. January 2009. [Article].
- Also see the American Academy of Sleep Medicine (AASM) guidelines, Practice Parameters for the Respiratory Indications for Polysomnography in Children (2011).
- American Academy of Sleep Medicine (AASM): Sleep and Pregnancy. Information about how sleep may be affected during each stage of pregnancy and during the postpartum period. Includes tips to help improve sleep and links to related articles.
- National Sleep Foundation: Pregnancy and Sleep. Information about sleep problems that may occur during pregnancy, treatment options, and coping tips.
- Cleveland Clinic. 2009. Periodic Limb Movement Disorder in Children and Adolescents. Cleveland, OH: Cleveland Clinic Foundation. [Fact sheet].
- KIDZZZSLEEP. 2010. Restless Legs Syndrome. Providence, RI: Lifespan Sleep
Disorders Center. [Fact sheet].
- National Institute of Neurological Disorders and Stroke (NINDS). 2011. Restless Legs Syndrome Fact Sheet. Bethesda, MD: National Institute of Neurological Disorders and Stroke (NINDS). Also available in Spanish.
- Restless Legs Syndrome (RLS) Foundation. Information about RLS, treatment, and research. Includes online discussion
groups, an electronic newsletter, and contact information for health professionals
and support groups. Resources include
Restless Legs Syndrome and Periodic Limb Movement Disorder in Children and Adolescents: A Guide for Healthcare Providers. (2007).
- Also see the Pregnancy section for resources about RLS during pregnancy.
- American Sleep Apnea Association (ASAA): Children's Sleep Apnea. Information about sleep apnea in children. Includes a directory of pediatric sleep specialists and an online support forum for pediatric sleep apnea.
- Cataletto ME, Lipton AJ, Murphy TD. 2011. Childhood Sleep Apnea. New York, NY: WebMD LLC. [Article].
- KIDSAPNEA.COM. Information about obstructive sleep apnea in children and its causes, consequences, and treatment. Topics include failure to thrive and orthodontics. KIDSAPNEA.COM was developed and is maintained by Allen J. Moses, D.D.S.
- Childhood obesity is associated with sleep apnea. See the MCH Library knowledge path, Overweight and Obesity in Children and Adolescents for resources about the prevention, identification, management, and treatment of overweight and obesity in children and adolescents.
- Boyse K. 2010. Sleep Problems. Ann Arbor, MI: University of Michigan Health System. This brief presents information
about sleep in infants, children, and adolescents and includes a section about sleep deprivation.
- Colten HR, Altevogt BM, eds. 2006. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: National Academies Press. [Report, Brief].
- Breus MJ. 2011. Co-Sleeping Neither Helps nor Hurts Child Development. New York, NY: WebMD LLC. [Article]. Please note: This article addresses bed sharing
when a child is 1, 2, and 3 years old. It also refers to the American Academy of Pediatrics recommendation against bed sharing with infants under age 1 because of the risk of Sudden Infant Death Syndrome (SIDS).
- Cleveland Clinic: Sleep and Children. Information about sleep and encouraging healthy sleep practices by age group: infants, toddlers and preschoolers, school-age children, and adolescents.
- First Candle: Bedtime Basics. Information and materials for this educational outreach campaign to help prevent infant deaths caused by unsafe sleep practices including bed sharing. Resources include
Room Sharing Is Safer Than Bed Sharing/¡Compartir la Habitación Is Mejor Que Compartir la Cama! (2010). [Brochure].
- National Sleep Foundation: Sleep Hygiene. Information and examples of healthy sleep practices. Includes information about adolescents.
- National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource
Center: Safe Sleep. Information for parents, caregivers, and health professionals about safe sleep
for infants, including bed sharing. Materials include
Helping Baby "Back to Sleep" (rev. ed.). (2009). [Brochure]. Also available in Spanish.
Hot Topics in Infant Safe Sleep: An Interactive Workshop with Rachel Moon, M.D. (2011). [Webinar from the ASIP-Pregnancy Loss and Infant Death Alliance 2010 International Conference on Perinatal and Infant Death].
Safe Sleep for Your Baby Around the Clock: Birth to 12 Months (rev. ed.). (2009). [Brochure]. Includes information about bed sharing.
- Also see the sleep environment section of the Infant Mortality and Pregnancy Loss knowledge path.
- Autism Spectrum Disorders knowledge path, family resource brief, school resource brief
- Emotional, Behavioral, and Mental Health Challenges in Children and Adolescents knowledge path, family resource brief, school resource brief
- Health Insurance and Access to Care for Children and Adolescents knowledge path, family resource brief
- Infant Mortality and Pregnancy Loss knowledge path (Includes a section about sleep environment), family resource brief
- Medications resource brief
- Oral Health for Infants, Children, Adolescents, and Pregnant Women knowledge path, family resource brief, school resource brief
- Overweight and Obesity in Children and Adolescents knowledge path, family resource brief, school resource brief
- Preconception and Pregnancy knowledge path, family resource brief
- Reaching Out to Children and Youth Following Disasters resource brief
- Screening resource brief
- Social and Emotional Development in Children and Adolescents knowledge path,
family resource brief, school resource brief
Sleep in Infants, Children, Adolescents, and Pregnant Women:
Knowledge Path. (October 2011).
Authors: Susan Chauncey Horky, L.C.S.W., M.S.W., University of Florida; Susan Brune Lorenzo, M.L.S., MCH Library; Mary H. Wagner, M.D., University of Florida.
Contributors: Kristen Hedger Archbold, R.N., Ph.D., University of Arizona; Candace Dreier, R.R.T., University of Wisconsin; Carla Salldin, Parent Consultant, University of Washington; Sarah Walker, M.S., M.P.H., R.D., University of New Mexico.
Reviewers: Jeanne Anastasi, M.A., National Sudden and Unexpected Infant/Child
Death and Pregnancy Loss Resource Center; Olivia Pickett, M.A., M.L.S., MCH Library.
Editor: Ruth Barzel, M.A., MCH Library.