Normal sleep development in infants: findings from two large birth cohorts

E. Juulia Paavonen, Outi Saarenpää-heikkilä, Isabel Morales-Muñoz, Minna Virta, Niina Häkälä, Pirjo Pölkki, Anneli Kylliäinen, Hasse Karlsson, Tiina Paunio, Linnea Karlsson

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Sleep difficulties are highly prevalent and often persistent in young children, but sometimes parents are worried about sleep symptoms that belong to the normative range rather than to actual disturbances. Therefore, the aim of this study was to describe the normative development of sleep at the ages of 3, 6, 8, 12, 18 and 24 months in healthy children.

The present study is based on two birth cohorts that comprise representative samples of families recruited systematically during pregnancy. In the CHILD-SLEEP cohort, the sample sizes were 1427 at three, 1301 at eight, 1163 at 18, and 950 at 24 months. In the Finnbrain cohort, the sample sizes were 2002 at six months and 1693 at 12 months. Healthy term-born children were eligible for this study. To assess the infants' sleep duration and sleep quality, the Brief Infant Sleep Questionnaire was used in both cohorts and additionally the Infant Sleep Questionnaire in the CHILD-SLEEP cohort. The distributions of the study variables were reported using standard parameters.

We found that sleep quality is highly variable particularly during the first two years of life, but this variability decreased markedly towards the second year. First, sleep latency decreased by the age of six months, while night-time sleep began to consolidate during the second year. However, parent-reported sleeping problems were common during the entire study period.

As many families struggle with infants' sleeping problems, the reference values reported in this article can be valuable tools in various clinical settings to define clinically significant deviances in the sleep development and to identify individuals benefitting from counselling and clinical interventions.
Original languageEnglish
Pages (from-to)145-154
Number of pages10
JournalSleep Medicine
Early online date20 Jan 2020
Publication statusPublished - May 2020


  • development
  • infants
  • normal sleep
  • sleep
  • sleep duration
  • sleep quality


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