SLEEP PRACTICES AND SLEEP PROBLEMS IN U. S. AND JAPAN

Most U.S. pediatricians advise parents to sleep apart from their children, primarily to promote early autonomy and avoid sleep problems. In order to understand the relationship between sleep practices and sleep problems, two highly industrialized countries with contrasting approaches to sleep management were compared. Mothers of healthy 6- to 48-month-old children were interviewed in the U.S. and Japan. The 42 U.S. and 44 Japanese children averaged two years of age and all had been breast fed, had two-parent families and had college-educated mothers. In certain aspects of sleep management, i.e., maintaining a regular time for bed and a bedtime routine, making a firm response to bedtime struggles or night waking, and co-sleeping for part of some nights, no U.S.-Japan differences were found. However, other differences were marked (p values <0.001). Only one U.S. child's bed was in the parents' bedroom in contrast to 64% in Japan. Seventeen per cent in the U.S. had adult company and body contact when falling asleep vs. 68% in Japan. Only one U.S. child regularly slept all night with parents vs. 48% in Japan. Contrary to pediatric prediction of increased sleep problems with co-sleeping, there were no differences in night waking between the two cultures (p=0.70), and there were fewer bedtime conflicts in the Japanese group (p<0.05). These results indicate that co-sleeping is not necessarily associated with sleep disturbances and that parental presence at bedtime may minimize conflict.