sion, and all-cause mortality in adults independently of other measured risk factors (Ayas et al., 2003; Gangwisch et al., 2006; King et al., 2008; Patel and Hu, 2008; Williams et al., 2007). A similar inverse association between sleep duration and obesity has been observed in cross-sectional studies of older children and adolescents (Chaput et al., 2006; Eisenmann et al., 2006; Kagamimori et al., 1999; Sekine et al., 2002; von Kries et al., 2002) and increasingly in longitudinal studies, including those of infants and children under age 5 (Agras et al., 2004; Bell and Zimmerman, 2010; Landhuis et al., 2008; Reilly et al., 2005; Snell et al., 2007; Taveras et al., 2008). Nonetheless, several aspects of the relationship between sleep and obesity are not yet sufficiently understood to inform clear policy recommendations beyond those that support the promotion of age-appropriate sleep durations. This chapter summarizes the evidence linking insufficient sleep to childhood obesity and provides recommendations to support the goal of promoting age-appropriate sleep durations for young children. To support and complement the first recommendation on requiring child care providers to adopt practices that promote age-appropriate sleep durations, the second recommendation addresses training for health and education professionals on how to counsel parents about this issue.

Recommendation 6-1: Child care regulatory agencies should require child care providers to adopt practices that promote age-appropriate sleep durations among young children.

Potential actions include

  • creating environments that ensure restful sleep, such as no screen media in rooms where children sleep and low noise and light levels during napping;
  • encouraging sleep-promoting behaviors and practices, such as calming nap routines;
  • encouraging practices that promote child self-regulation of sleep, including putting infants to sleep drowsy but awake; and
  • seeking consultation yearly from an expert on healthy sleep durations and practices.

Recommendation 6-2: Health and education professionals should be trained in how to counsel parents about their children’s age-appropriate sleep durations.



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