STUDY OBJECTIVES: To evaluate the impact of bed provision and sleep education through the Beds for Kids (BfK) program on early childhood sleep and behavior, and maternal mood and sleep.

METHODS: Twenty-seven mother-child dyads (child= 2-5 yrs, 85.2% Black) living in poverty and without an individual child bed were randomly assigned (multi-method randomized waitlist control trial design) to BfK intervention ~1-week post-baseline (initial intervention) or ~2 weeks post-baseline (waitlist control), with follow-up at one-month. BfK intervention (home bed delivery and written sleep health education) was provided to all families. Children wore actigraphs and mothers completed daily diaries to assess child and maternal sleep, child behavior, and maternal mood for the initial one-week comparison period. Maternal-reported child sleep and behavior (internalizing and externalizing problems) were collected at one-month post BfK-participation for all families; n=11 completed a qualitative interview at one-month assessment.

RESULTS: At one-week post-BfK, mothers' sleep duration increased by 1 hour compared to waitlist controls. No changes were found in child sleep, child behavior, or maternal mood. However, at one-month post-BfK intervention, improvements were found in mother-reported child night awakenings, sleep quality and sleep problems, and behavior. Mothers qualitatively reported significant BfK benefits for child sleep and family wellbeing, although noted challenges to transitioning young children to sleeping independently.

CONCLUSIONS: Bed provision and sleep education for families living in poverty has a more immediate impact on maternal sleep and reported wellbeing. Child sleep and behavioral improvements are seen by one month, with children experiencing an initial adjustment period to sleeping independently.

CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Impact of Beds for Kids Program on Child Sleep; Identifier: NCT03392844; URL: https://www.clinicaltrials.gov/ct2/show/NCT03392844.

<p>In 2014, Buysse published a novel definition of sleep health, raising awareness for the importance of this construct for individuals, populations, clinical care, and research. However, the original definition focused on adults, with the recommendation that it should be adapted for children and adolescents. As children live within a complex and dynamic system, and may not always have control over their own sleep, this theoretical review will examine and apply Buysse's five dimensions of sleep health within the context of pediatrics. In addition, using examples from the pediatric sleep literature we introduce a modified definition that takes into consideration the influence of the socio-ecological system within which children live, and the sleep-related behaviors that are critical in supporting or hindering sleep health. Finally, we discuss how the proposed theoretical framework, Peds B-SATED, can be applied to clinical practice, research, and training in the field of pediatric sleep.</p>

<p>More than 50% of US children are crushed with debt—sleep debt. The 2014 National Sleep in America poll found that half of youth obtain less sleep than recommended on school nights, meaning approximately 29 million children in the United States are deprived of one of the most important basic needs for optimal health and well-being. This debt is especially salient because insufficient, irregular, and poor-quality sleep is a risk factor for common concerns that dominate pediatric practice, including obesity, mental health problems, and learning difficulties. However, sleep is rarely effectively addressed in primary care.</p>