Impact of Sleep Extension and Restriction on Children's Emotional Lability and Impulsivity

Objective: To examine the impact of moderate sleep extension and restriction on child behavior in school.

Methods: We conducted a randomized parallel group study to determine the impact of an experimental sleep extension (addition of 1 hour of sleep relative to baseline habitual sleep duration on weekdays) and experimental sleep restriction (elimination of 1 hour of sleep relative to baseline habitual sleep duration on weekdays) on child behavior in school. The primary outcome measures were scores on the Conners' Global Index Scale, as determined by teachers blinded to sleep status of the participants. A sample of 34 typically developing children aged 7 to 11 years with no reported sleep problems and no behavioral, medical, or academic issues participated in the study.

Results: Our main findings were that (1) a cumulative extension of sleep duration of 27.36 minutes was associated with detectable improvement in Conners' Global Index-derived emotional lability and restless-impulsive behavior scores of children in school and a significant reduction in reported daytime sleepiness; and (2) a cumulative restriction of sleep of 54.04 minutes was associated with detectable deterioration on such measures.

Conclusions: A modest extension in sleep duration was associated with significant improvement in alertness and emotional regulation, whereas a modest sleep restriction had opposite effects.