Study finds gaps in infant sleep guidelines across Canadian provinces

Thousands of licensed child care centers across Canada may not be providing children with adequate, healthy sleep due to inconsistent sleep policies.

A new UBC study led by pediatric sleep expert and emeritus professor of nursing Dr. Wendy Hall finds that sleep policies in licensed child care settings vary widely across provinces and territories in Canada, often leaving centers without clear guidance on how to meet children’s sleep needs. dream.

We found significant differences in sleep policies across provinces and territories. For example, the British Columbia regulations lack specific recommendations for general or daily sleep programming, instead focusing on maintaining a safe sleep environment through factors such as location, equipment safety, and prohibited activities.”

Dr. Wendy Hall, pediatric sleep expert and professor emeritus of nursing

Alberta regulations do not specify sleep programs or facilities, but do specify the number of staff required. In the Atlantic provinces, regulations vary regarding programming that includes rest or sleep time during the day. Ontario’s regulations specify the amount of sleep per day, designated sleep space and equipment based on age, sleep personnel, location and monitoring, and prohibited activities. Quebec regulations do not specify general or daily sleep programs, sleep/rest personnel, sleep positioning, or sleep monitoring. There are instruction manuals available to help licensees interpret the regulations, but many manuals are many years out of date.

Dr. Hall noted that nearly three-quarters of children in Canada are in institutional care—56 percent are in some form of child care, and another 26 percent are on waiting lists. “The lack of consistent guidelines creates confusion regarding the amount and duration of sleep/rest periods for children, especially in different age groups. Although sleep is critical for development, many centers prioritize only one rest period per day, which may not be appropriate for infants. ‘ needs or may exceed the needs of three- to four-year-old children.”

The definition of “infant” also varies between provinces – the age range can vary from 12 to 24 months – which affects sleeping space and equipment recommendations, as well as children’s development.

The study also notes that there are also equity issues. Children from lower socioeconomic backgrounds, who may stay up longer at night, may particularly benefit from access to nap time, but there are no consistent child care provisions for this in Canada.

To ensure children get quality, adequate sleep and rest, Dr. Hall recommends looking at Canada’s 24-hour traffic rules as a good starting point early in life. These recommendations include children’s physical activity, sedentary time and sleep, recommending naps for infants and children under two years of age, and sleep options for children aged three to four years.

Child care centers should also emphasize safe sleep practices by monitoring children while they sleep to ensure their safety. Only British Columbia and Ontario regulations emphasize sleep positioning.

“It is important to understand that each province or territory sets its own child care guidelines, which makes it difficult to create a consistent national approach,” Dr Hall added. Many governments already struggle to provide adequate child care and staff, making it difficult to improve sleep practices. However, organizations such as the Canadian Sleep Society and the Canadian Child Care Federation could advocate for improved sleep practices. Sleep should also be a key part of early childhood teacher training.

Parents can monitor their child’s sleep patterns, talk with child care providers about their children’s needs, and review sleep recommendations. For example, the American Academy of Sleep Medicine guidelines are useful in the context of 24-hour recommendations but do not separate daytime sleep from nighttime sleep. The Canadian 24-hour movement guidelines provide specific recommendations for napping within the broader context of sleep.