Caregiver-perceived sleep outcomes in toddlers sleeping in cribs versus beds.

OBJECTIVE: Little is known about whether sleep space impacts toddler sleep outcomes. We examined the prevalence of crib-sleeping and its association with caregiver-reported sleep patterns and problems in a large sample of toddlers from Western countries.
METHODS: Participants were caregivers of 1983 toddlers ages 18.0-35.9 months (51.7% male; mean age 25.3 months) from Australia, Canada, New Zealand, the United Kingdom, and the United States sleeping in a crib or bed in a separate room from caregivers. Caregiver-reported sleep patterns and problems were collected via a free, publicly available child sleep smartphone application.
RESULTS: Across countries/regions, rates of crib-sleeping decreased linearly with age, with 63.4% of toddlers ages 18.0-23.9 months, 34.3% of toddlers ages 24.0-29.9 months, and 12.6% of toddlers ages 30.0-35.9 months sleeping in a crib. Across age groups and countries, crib sleeping was significantly associated with an earlier bedtime, shorter sleep onset latency, fewer night awakenings, longer stretches of time asleep, increased nighttime sleep duration, and decreased bedtime resistance and sleep problems. The duration of night awakenings did not significantly differ by sleep space.
CONCLUSION: Sleeping in a crib instead of a bed is associated with enhanced caregiver-reported sleep quantity and quality for toddlers in Western countries. Consistent with practice recommendations, deferring the crib-to-bed transition until age 3 years may benefit toddlers' sleep in Western contexts. Additional research is needed to identify the impact of sleep space on child sleep in other countries/regions.