Introduction: Culture and Sleep in Children

Abstract

At some fundamental level, sleep-related behaviors and sleep problems in children represent a complex interpolation of biological, psychologic/developmental/environmental, and social influences, the relative contributions of which are oftentimes difficult, if not impossible, to separate out. Biological determinants of sleep, including sleep homeostatic mechanisms and chronobiological principles,1,2 and the ways in which culture and biology interact both play a major role in the establishment of sleep patterns.3,4 In addition, children are also active participants in shaping sleep practices through such individual characteristics as temperament and social relatedness5 as well as an emerging understanding of their own individual cultures.6 As an inherently biopsychosocial phenomenon, sleep is embedded in its sociocultural context and thus is impacted on by such variables as cultural beliefs about the perceived function and meaning of sleep, cultural norms for sleep practices, and social interactions, networks, and relationships, to name a few. The biology of sleep architecture and regulation notwithstanding, there is unlikely to be one universally applicable “right way” (or time or place) to sleep. Ultimately, cross-cultural comparisons among societies of different political, economic, ideological, and historical backgrounds are invaluable in providing the opportunity to better understand the neurobiology and chronobiology of sleep itself, as well as to delineate the respective roles of culture and biology on sleep behavior and its interpretation.7 Sleep disorders and sleep practices in children are uniquely suited to serve as the focus for an examination of the interplay between the biological and the sociocultural, because so many of the variables that affect sleep problems, patterns, and practices are highly culturally based. Furthermore, because sleep problems are almost universally present in childhood and have negative health and well-being effects common to all children, the impact of sleep problems on children and families transcends all cultures. … Address correspondence to Judith A. Owens, MD, MPH, Department of Pediatrics, Potter Building, Suite 200, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903. E-mail: owensleep{at}aol.com