The Bedtime Boost trial

The Bedtime Boost Trial is a feasibility pilot randomised controlled trial of a parent-administered intervention on children’s pre-bed activities.

During the first years of life, changes in infant sleep can be characterised by a gradual increase in night-time sleep and a decrease in daytime sleeping. Critically, poor-quality sleep during infancy (i.e. delayed sleep onset, frequent night awakenings, shortened total sleep duration) has been shown to predict sleep and behavioural problems during the pre-school years. Sleep is vital for brain maturation and the clearance of neurotoxins. Poor sleep is bidirectionally associated with a child’s ability to focus their attention: reduced concentration may follow insufficient sleep, as well as difficulties falling/staying asleep being higher in children with attention problems. Certain pre-bed activities such as having a bath, quiet play, reading and dimming lights are thought to help calm infants and prepare their bodies for sleep. The Bedtime Boost Trial will directly test the impact of such activities on toddler sleep and attention in a randomised control trial.

In this feasibility pilot randomised control trial, families with a 16- to 18-month-old toddler will be recruited and either asked to continue with their normal pre-bed activities (the control arm) or to engage their child in a range of calming and developmentally-appropriate activities in the hour before bed (the intervention arm). All intervention materials will be co-created with early years stakeholder partners (National Childbirth Trust [NCT], Early Years Alliance [EYA], The Sleep Charity & Parent representatives). Families will be asked to deliver the intervention for a period of 7 weeks.

To assess the success of the intervention on infant sleep and attention the trial will make use of multiple technologies. Actigraphy technology, in the form of an infant wearable MotionWatch, will be used to collect an objective measure of sleep quality (e.g., sleep duration and night awakenings). While baseline and follow up measures of attention and general development will be gathered at the Birkbeck Centre for Brain and Cognitive Development (the Babylab). Retention of families throughout the trial and their experiences of intervening in their infants’ bedtime routine will be key to assessing the feasibility of this pilot for expanded future studies.

The findings will be published in peer-reviewed papers and in a main public report available on the Nuffield Foundation website.