It’s a simple problem that drives some parents crazy: How do I get my pre-schooler to sleep? Now an innovative study by
University of Auckland research fellow Samantha Marsh is pointing to some easy tips that seem to work.
Parents of children aged between 2 and 4 years old were taught simple techniques for improving their connections with
their kids – from songs to imaginative playtime to establishing routines like a pre-bedtime bath. The results of the
three-month study have just been published in PLOS One, a peer-reviewed, open access journal. The research pointed to improvements in sleep and eating – both key factors
driving New Zealand’s epidemic of childhood obesity.
“A lot of pre-schoolers have sleep issues and parents really struggle with them, so it’s exciting to see something that
helps,” said Marsh, herself the mother of two young children with a busy schedule. “The best thing is that parents
really liked the programme.”
The ‘3 Pillars Study’ was focused on three things – sleep, family meals, and play. Twenty-seven Auckland parents
attended a half-day workshop of parenting advice and received support via a website, while another 27 were in a control
group. The quality of the children’s sleep was assessed by their parents, based on factors including how easily the
child fell asleep, night-time awakenings, and length of sleep, and the focus was purely on sleep at night, rather than
naps during the daytime.
Marsh, who works at the National Institute for Health Innovation in the School of Population Health at the Faculty of
Medical and Health Sciences, says the study is unique in that rather than focusing on bodyweight or specific energy
balance-related behaviours, the emphasis was on strengthening the parent-child connection. Creating a strong, positive
relationship was prioritised over short-term outcomes, such as getting a child to eat.
The aim was to avoid parents fixating on short-term goals, which can result in practices that increase obesity risk in
the long term – such as bribing children to eat healthy food. Instead, creating a supportive emotional environment
around meals, sleep, and play was promoted as the ideal context for children to develop healthy behaviours. Parents were
encouraged to switch focus from outcomes – “eat your vegetables!” -- to processes, such as fostering a happy family
dinner-time.
Scientists know that lack of sleep affects hormones related to appetite and metabolism and is a strong predictor of
obesity. The exact role that sleep plays in obesity may be difficult to unwind, since a child with healthy sleep
patterns may live in a household that also values good nutrition and exercise – and who knows which is having the
biggest effect?
Early childhood is a critical period for the development of obesity. Children who are overweight at 5 years of age are
four times more likely to develop obesity between the ages of 5-14 years compared to children with a healthy weight.
Obesity in early childhood is strongly associated with increased rates of premature death in later life and obesity
seems to worsen the effects of Covid-19.
Recent research from the Growing up in New Zealand study points specifically to sleep as promoting resilience to obesity
in vulnerable New Zealand children. Results from the pilot study are preliminary, and more research is warranted to
establish the long-term effectiveness of this relationship-based approach in children from different cultures and family
contexts, according to Marsh.
Ultimately, any programme aimed at promoting health-related behaviours in New Zealand families must be appropriate and
meet the specific needs of those families who need it most, she said.