September 30, 2015—(BRONX, NY)—An estimated 25 to 50 percent of preschoolers do not get enough healthy sleep. Now, researchers at Albert Einstein College of Medicine have been awarded a five-year, $2.9 million grant from the National Institutes of Health to promote healthy sleep among these children. The investigators will partner with Head Start, the early childhood program for disadvantaged preschool children and their families.

Karen Bonuck, Ph.D."Insufficient and/or poor quality sleep impairs young children's development—socially, emotionally, cognitively and physically," said Karen Bonuck, Ph.D., professor of family and social medicine and of obstetrics & gynecology and women's health at Einstein and principal investigator on the grant. "Sleep problems that peak during the preschool years include short sleep duration, behavioral sleep problems such as getting to sleep or staying asleep, and sleep-related breathing problems such as snoring or apnea. They all affect the developing brain and may thus impair school readiness—a main goal of Head Start and other early childhood programs."

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Dr. Bonuck's previous research showed that sleep problems in early childhood are linked to an increased risk for emotional and behavioral difficulties and obesity in children and also increase the likelihood that children will need special educational later on. Her new grant will provide parents and children with the knowledge needed to foster healthy sleep and to recognize sleep problems. It builds on the Early Childhood Sleep Education Program (ECSEP™), which instructs Head Start teachers, children, and parents about healthy sleep in an easy-to-understand way.

The ECSEP was developed by Dr. Bonuck's collaborator on the study, Sweet Dreamzzz, Inc., the nation's only non-profit organization devoted to sleep health education. (In a prior study, the children of families exposed to the ECSEP slept 30 minutes longer per night, compared with a control group.) The new study will add print and video materials and family visits to reinforce the ECSEP.

“Augmenting early childhood programs with useful information about sleep could improve the lives and development of upwards of four million children.”

– Karen Bonuck, Ph.D.

Key aspects of the study make it novel. "First, it takes place in the real-world setting of routine Head Start practices," said Dr. Bonuck. "Head Start staff delivers the sleep health education and even collects the data. Second, it is multi-level, meaning that researchers will promote awareness of the need for healthy sleep at community health councils and among local providers in addition to the on-site education. Finally, there is a five-year plan to develop and evaluate strategies for embedding "sleep health literacy' into early childhood education policy at the state and federal level."

The study's first phase will involve seven participating Head Start agencies from across New York in designing materials and rolling out the interventions. The second phase is a randomized controlled trial that will enroll 540 parent-child pairs. A third phase will study the feasibility of screening children and referring them for treatment of sleep problems.

The researchers will look at how their interventions affect outcomes such as children's sleep duration, sleep difficulties, parental knowledge, and children's behavior. "Augmenting early childhood programs with useful information about sleep could improve the lives and development of upwards of four million children," Dr. Bonuck noted.

The title of Dr. Bonuck's study is "Increasing Sleep Health Literacy in Head Start: A Social-Ecological Approach" (grant number 1R01HD082129). Collaborators also include leading experts in health literacy (University of California, Los Angeles Anderson School of Management) and sleep medicine (University of Michigan Sleep Disorders Center).