Exploratory study of bedtime resistance in toddlers.

The aims of this study were to examine the prevalence and nature of bedtime resistance in toddlers, determine associations between bedtime resistance and sleep parameters, and explore relationships with sleep-related environmental and parenting behaviors. 318 mothers of toddlers (12-36 mos; M = 23.1 mos), including 162 younger toddlers (12-23 mos) and 156 older toddlers (24-36 mos), completed the Brief Infant Sleep Questionnaire-Revised (BISQ-R), including questions about bedtime resistance. Overall, 61.3% endorsed bedtime resistance (BR), with no differences in prevalence between younger and older toddlers. Younger toddlers were more likely to cry/tantrum and older toddlers were more likely to engage in a breadth of resistant behaviors. Toddlers with BR had later bedtimes, took twice as long to fall asleep, had decreased sleep consolidation, and shorter nighttime and 24 h sleep duration. In addition, toddlers with reported BR were less likely to fall asleep independently. Finally, mothers were more likely to perceive their BR toddler's sleep to be a problem (54.4% vs. 19.5%).

conclusionOver 60% of mothers report that their toddler resists in some way at bedtime. Although there are no differences in the prevalence of bedtime resistance between younger and older toddlers, the behavioral topography of this resistance differed, consistent with language and motoric development. BR is also associated with poorer sleep outcomes and decreased independent sleep. These findings indicate assessment and intervention strategies for bedtime resistance need to be integrated, as well as consideration of the impact of these issues on sleep outcomes and potentially family well-being. WHAT IS KNOWN: • Anecdotally, bedtime resistance is a common complaint for parents of toddlers. WHAT IS NEW: • Prevalence of bedtime resistance in the current sample was over 60%, and was associated with poorer sleep outcomes and decreased independent sleep. • Behavioral topography of resistance differed across age groups, with younger toddlers more likely to cry/tantrum and older toddlers more likely to engage in a breadth of resistant behaviors.