Changing the type of DVDs, videos and TV shows that preschoolers watch during the day may help them sleep better at night.
A program that encouraged parents of kids ages 3 to 5 to replace age-inappropriate media content with more suitable programming found "long-lasting, significant reductions in sleep problems," says Michelle Garrison of Seattle Children's Research Institute, lead author of the study in Monday's Pediatrics.
Researchers made no attempt to change the amount of TV viewed or the time of day it was watched. "We know that media is already playing a large role in the lives of many families," says Garrison. "We felt that just by changing the content, we could have an impact on the health and development of these kids," she says. "That was borne out in results."
Preschoolers with sleep problems improved in both sleep and daytime tiredness over the course of the 12-month study, she says, and children who didn't initially have sleep problems were less likely to develop them.
Insufficient and disrupted sleep has been associated with obesity, behavior problems and poor school performance, researchers say.
"There are so many immediate and long-term effects from sleep loss at this age that it's really worth taking those extra steps to try and get sleep on a good track," says Garrison, who is also an acting assistant professor at the University of Washington in the department of health services.
Nearly 600 families of preschool-age children in the Seattle area participated in the study. They kept sleep diaries and received home visits, follow-up telephone calls, and monthly mailings from case managers. Half of the families received an intervention focused on healthy media use. The other half served as a comparison group and received an intervention focused on healthy eating.
Researchers assessed the sleep habits of all of the children, including how long it took them to fall asleep, night wakings, nightmares, difficulty waking and daytime tiredness.
Families receiving the media intervention were encouraged not only to replace TV and video programming, but also to view TV with their children as much as possible and discuss the content with their kids to help them "process what they're seeing and learn more from what they're seeing," says Garrison.
Monthly mailings included a program guide tailored to the families' available channels with recommended TV shows and schedules and a newsletter with tips and reinforcement.
For preschoolers, inappropriate content has less to do with violent or R-rated movies and more to do with cartoons "aimed at slightly older children," such as SpongeBob SquarePants and Scooby-Doo, says Garrison. "These are fun shows I would totally sit down and watch with an 8- or 9-year-old, but for a 3- or 4-year-old, it's too much and too overwhelming."
"The fact that Bugs Bunny can be too violent for a 3-year-old is not something that always clicks with some families," she adds. "Yes, they may know that (a preschooler) shouldn't watch the latest Transformers movie, but they may not necessarily make that same association with cartoons that have the more funny violence or the superhero violence, because some of the content is marketed toward preschool-age children."
Age-appropriate fare cited includes Sesame Street, Dora the Explorer and Curious George.
Previous studies have found an association between increased media use and sleep disturbances in young kids.
Findings "reinforce the notion that we need to be vigilant with the content we're exposing our children to," says Dennis Rosen, associate medical director of the Center for Pediatric Sleep Disorders at Boston Children's Hospital. "At this age, they are affected by what they watch."
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