This week, a study was published with the innocuous title of “Napping, development and health from 0 to 5 years: a systematic review”. The authors carefully reviewed multiple studies on the effects of napping on development and health in early childhood. They looked at 785 published articles, narrowed the articles down to 26 which met rigorous criteria, and came up with several conclusions:
1. The study designs were variable but mostly observational. They involved children of various ages and had different measures of interest. Thus, it was very difficulty to synthesize these results. Some studied habitual nappers; others studied children who napped sometimes but not other times. Here is a sample sentence
2. The most consistent finding was between napping and later sleep onset, shorter periods of night sleep, and worse sleep at night after age 2.
2a. A few of the studies reviewed suggested that non-habitual napping may precede a night of short/poor sleep, as opposed to occurring after a night of short sleep.
Today, headlines have trumped how napping after age 2 could ruin your child’s sleep. Here’s an example from Today.
However, the lead author, Karen Thorpe, noted in a statement released by her institution:
There is consistent high quality data that indicates napping beyond the age of two lengthens the amount of time it takes for a child to fall asleep. The evidence for napping and its impact on behaviour, health and development of a child is less clear.
How Napping Evolves Through Childhood
Some of the most widely cited information about how much children sleep over time is derived from information gathered from Swiss children. The whole article is worth a read, but here are their findings about napping:
Essentially, most children transition from multiple (2–3 naps) to one nap by 18 months of age. By age 3 half will have given up napping, with most children not napping by the time they enter kindergarten.
Why Napping Can Affect Nighttime Sleep
In prior posts, I have talked about the homeostatic sleep drive. In a nutshell, the longer you are awake, the more tired you are. If you nap, especially for prolonged periods or in the late afternoon, you may be less tired and have a harder time falling asleep. Here’s a graph to refresh your memory:
Why These Results Matter, and May Matter to You
Although there is limited research on the topic, many child care centers and preschools have one size fit all nap policies which do not necessarily fit every child. Hopefully this may lead to more flexibility in this domain.
Additionally, napping needs clearly vary from child to child. Some healthy children easily give up napping around age 2 (and I guarantee that their parents are pretty bummed). Others, (like my older son), may happily take a three-hour nap in until five PM every day then go to bed without a complaint.
Clearly, there is a lot of variability in nap requirements in children. Here are some good rules of thumb:
1. If your child routinely naps past four PM, and struggles to fall asleep at bedtime, you may want to think about shortening his or her nap by an hour.
2. If naps are brief and difficult to obtain, and your child is older than age two, try playing with skipping them for a few days and see if bedtime and night-time sleep goes more smoothly.
2. If you are working on sleep issues, it is also important to avoid unplanned napping. My friend Dr. Wendy Ross calls this “sneaky sleep”– sleep obtained in the car or the stroller, say on the way home from day care. If it is just you and your child in the car, your options for avoiding this may be limited. However, if you have an older child, they will likely be MORE THAN HAPPY to keep their younger or brother sister happy by yelling at them, singing songs, or poking them.
Why These Results May Not Matter To You
If your child is happily napping every day, going to bed without difficulty, and is less than five, enjoy and don’t worry. There is no evidence in this study that you need to change. The worst thing you could do for your child (and your sanity) is to make a change when things are going well.
I find this study to be a great addition to the limited literature on napping in childhood, and that the authors acknowledge the limitation of the available information. For more information about this study, I suggest this article from the Huffington Post, specifically Lisa Meltzer’s take on this.
I’m curious about your take on these results. Please answer the poll below or leave a comment.