8 Developmental Cultural Ecology of Sleep Carol M Worthman
Introduction
The scientific community long has viewed sleep as a basic biological function a behavior as natural necessary and universal as eating Accordingly sleep has been studied like other such functions where setshytings and social conditions are treated as moderating factors that influshyence exposure to sleep constraints or disrupters such as discomfort and noise worries or work demands Culture has been disregarded altoshy
gether Only recently has it become clear that sleep like eating is heavily conditioned by culture and that a great deal might be learned about the bases of sleep and sleep disorders through the study of cultural factors
This chapter builds on that insight and explores the role of culture in sleep practices perceptions and problems
The discussion necessarily remains exploratory because the crossshycultural ethnographic and empirical evidence base remains thin Such a curious omission ofthe most prevalent human behavior from anthroposhylogical and ethological inquiry stems partly from a view of behavior as
produced by a conscious agent and ofsleep itself as absent of meaning and cultural constructions except in dreams Thus we find reciprocal gaps in the literature that of culture in sleep science and that ofsleep in
cross-cultural research Together the paucity of data plus the emerging recognition of cultures possible significance offer an exciting opportushynity for sleep science for which conceptual frameworks and hypotheses
168 Sleep and Development
are needed to map the field of inquiry and inform systematic research
that will fill a real lacuna in current understandings of sleep
The present discussion aims to help bridge that gap from a developshy
mental perspective using the approaches of biocultural anthropology
Commencing with a consideration of adaptive-evolutionary constraints
that have shaped the place of sleep in human development this chapter
outlines a bioecocultural model that provides a framework for integrashy
tion ofculture into the study ofhuman developmentThis model inspired
a study of the comparative developmental ecology of sleep that is then
summarized in terms of initial insights into cultural patterns and variashy
tion in the physical ecology of sleep and the recognition of sleep as a form of social behavior The suggestive findings from this cross-cultural
survey are followed by results from an empirical investigation of the role
of culture in shaping sleep across the life course in a specific society
namely Egypt Study results showed that cultural factors powerfiilly
structured sleep accounting for much of the variance in sleep across the
life courseThis example engages a number ofissues regarding the impact
of culture change and globalization (schooling media family and resishy
dential patterns nutrition) on sleep schedules and consequently on funcshy
tioning and healtb The emerging global literature on these topics is
briefly surveyed
A concluding section deploys psychological anthropology to conshy
sider the role ofcultural models in how sleep is conceptualized and how
such models inform behavior and perception with particular regard to
parental behavior Building on a cultural consensus analysis from our
study ofparenting and development ofchild self-regulation in American
families I delineate two key dimensions in an American cultural model
ofsleep along with the resultant scripts for sleep and parenting practices
Then based on our comparative work contrasting elements in nonshy
Western cultural models ofsleep and their attendant scripts are proposed
A central insight from this perspective is that sleep is embedded in a moral framework that powerfully shapes not only behavior but also evalshy
uations ofsleep as appropriate or disordered Thus the cultural construcshy
tion ofsleep across the life course can also be understood as a project that
directly concerns crucial intangibles such as personhood morality and social relations as well as the urgent practical ones ofhealth subsistence
and survival
De-
Adaptive and Evolutionary Back
The lingeringly mysterious adaptive fa
scope of this chapter (see Worthman 2
tive constraints on human sleep patten
comparative study and raises four poi
range of environments using an array tions to flourish under widely diver
sociality and culture are obligatory to
and integral to development and func
ture shapes human ecology Children a become competent by living in socia
through culture Fourth and related
mental design anticipates reliable inr
ments ofrearing for assembling comp
nervous system (Worthman 2003) Tl Design implications for sleep ir
the daily activities necessary for sum
leable to the range of ecological and inhabit Indeed humans manifest pro
schedules and tolerating sleep restricti culturally prescribed sleep practices r
lenges presented by specific environ
analysis of selected non-Western cul
afternoon napping is not related to h
to the presence of malaria and oth (Barone 2000) Then in line with
sleep should commonly occur in soci
sion of group life Co-sleeping has b
instance all reports in an ethnograph identifIed infants as sleeping in the s
Paxson 1971) Finally dependence ( ing conditions suggests that onto~
shaped by sleeping practices The dt
is regularities in patterning and COl
an important factor in the develoJ
regulation
iuiry and inform systematic research
t understandings of sleep help bridge that gap from a developshy
roaches of biocultural anthropology
1 of adaptive-evolutionary constraints
) in human development this chapter
lat provides a framework for integrashy
nan developmentThis model inspired
pmental ecology of sleep that is then
ights into cultural patterns and variashy
eep and the recognition of sleep as a
estive findings from this cross-cultural
1 an empirical investigation of the role
gt the life course in a specific society
wed that cultural factors powerfully uch of the variance in sleep across the
number ofissues regarding the impact
on (schooling media family and resishy
p schedules and consequently on funcshy
19 global literature on these topics is
S psychological anthropology to conshy
1 how sleep is conceptualized and how
l perception with particular regard to
L cultural consensus analysis from our
~nt ofchild self-regulation in American
ensions in an American cultural model
cripts for sleep and parenting practices
e work contrasting elements in nonshy
and their attendant scripts are proposed
pective is that sleep is embedded in a
shapes not only behavior but also evalshy
disordered Thus the cultural construcshy
can also be understood as a project that
bles such as personhood morality and
ent practical ones ofhealth subsistence
Developmental Cultural Ecology of Sleep 169
Adaptive and Evolutionary Background
The lingeringly mysterious adaptive foundations of sleep lie outside the
scope of this chapter (see Worthman 2008) but a consideration of adapshy
tive constraints on human sleep patterns must be a starting point for any
comparative study and raises four points First humans inhabit a huge
range of environments using an array of cultural and biological adaptashy
tions to flourish under widely diverse ecological conditions Second
sociality and culture are obligatory to humans indispensable for survival
and integral to development and function Third and consequently culshy
ture shapes human ecology Childreg are provisioned learn language and
become competent by living in social groups structured and operating
through culture Fourth and related to cultural dependence developshy
mental design anticipates reliable inputs from the expectable environshy
ments of rearing for assembling complex features such as the immune or
nervous system (Worthman 2003) Thus culture gets under the skin
Design implications for sleep include that it must be fitted into
the daily activities necessary for survival and consequently must be malshy
leable to the range ofecological and cultural circumstances that humans
inhabit Indeed humans manifest prodigious capacity for adjusting sleep
schedules and tolerating sleep restriction (Worthman 2008) Furthermore
culturally prescribed sleep practices may themselves meet adaptive chalshy
lenges presented by specific environments For example cross-cultural
analysis of selected non-Western cultures has found that the practice of
afternoon napping is not related to hot climates or agricultural labor but
to the presence of malaria and other parasitic and infectious diseases
(Barone 2000) Then in line with most of humans primate relatives
sleep should commonly occur in social groups for safety and as an extenshy
sion of group life Co-sleeping has been widespread across societies For
instance all reports in an ethnographic sample of173 traditional societies
identified infants as sleeping in the same bed or room as others (Barry amp
Paxson 1971) Finally dependence of development on input from rearshy
ing conditions suggests that ontogeny of sleep regulation would be
shaped by sleeping practices The developmental ecology of sleep-that
is regularities in patterning and conditions of sleep-may therefore be
an important factor in the development of the systems related to its
regulation
bull 1
170 Sleep and Development
The Ecobiocultural Perspective on Human Development
The primary role of culture in shaping rearing environments has
prompted the claim that of all the thing one could do to influence the
development ofan infant the most important would be to decide where
on earth-in what human community-that infant is going to grow up
(Weisner 1996 p 276)A developmental-ecological framework builds on both adaptationist and cultural ecological perspectives and provides a
powerful basis for a fresh approach to sleep The ecobiocultural approach
integrates the pervasive influence of culture on living conditions and
experience with the environmental expectancy of the developing child
(reviewed in Worthman in press) Cultural beliefs values and cognitiveshy
affective orientations directly inform behaviors practices physical conshy
ditions materials and setting that members of the culture produce to
yield the patterned matrix of human ecology The actual conditions
under which children grow up or the developmental niche thereby are
society-specific products of culturally grounded views and practices for
the care and rearing of the young (Super amp Harkness 1986)
The developmental niche ofany society must also work with human
variation and incorporate elasticity responsive to the individual child
Cultural goals and values built in to the niche (eg parent assessments
and responses) engage with the childs endogenous or constitutional
conditions including temperament epigenetics and genetics physical or
functional features capacities and health to both drive and respond to
herhis perceived developmental states and needs toward culturally
desired results Outcomes such as state regulation physical function
and health and cultural competence are formed in this cultured space
Systems that regulate sleep as well as those influenced by sleep patterns
count among these outcomes and thus can be viewed as products of the
developmental niche Such logic argues for the possibly constitutive role
ofculture in sleep behavior and regulation and provides a general frameshy
work for linking distal cultural factors to more proximal accounts such
as Sadeh and Anders transactional model ofinfant sleep problems (Sadeh
amp Anders 1993) Method010gically it follows that ethnography should
play a key role in the study of human development and sleep
The bioecocultural model supports research design by operationalshy
izing culture and its actions in development in terrns of observable
phenomena including the behavior~
ditions that constitute the context
model represents a powerful tool f(
cultures in relation to human develo
ground patterns ofsleep behavior ar
the development not only of sleep
life--emotional social and produc
partThe next section describes a g
sleep and the unexpected insights y
cross-cultural ethnographic study
A Comparative Ecology of SI
The gap between paradigms for lal
and how it is practiced around th(
initial study over a decade ago to
anthropology (Worthman 1999)middot It and variation in sleep behavior
scarcely begun at that time (Reima
Souza Medeiros amp Almirao 1998 r 2000) Although direct comparativ(
were scant the physical and social
in ethnographic and historical acc
1993) Thus we used the ecobiocu
descriptive framework for characte
sleep in diverse societies in rnicroe
ing conditions (eg where when
macro ecological cultural demogra
sleep behavior at any age and phys left column) The framework was 1
inventories from colleagues havir
Bailey Fredrik Barth Magdalena and John Wood) concerning ten
tence strategy and geographic loc
Paraguay to horticulturalists in J Pakistan and Kenya and agricult
middot
ve on Human Development
1 shaping rearing envirorunents has bullthings one could do to influence the It important would be to decide where
lnity-that infant is going to grow up
nental-ecological framework builds on
Cological perspectives and provides a
b to sleepThe ecobiocultural approach e of culture on living conditions and
Ital expectancy of the developing child
I Cultural beliefs values and cognitiveshy
orm behaviors practices physical conshyIat members of the culture produce to
human ecology The actual conditions
or the developmental niche thereby are urally grounded views and practices for
19 (Super amp Harkness 1986) f any society must also work with hu~an icity responsive to the individual child in to the niche (eg parent assessments
tIe childs endogenous or constitutional
lent epigenetics and genetics physical or and health to both drive and respond to
ntal states and needs toward culturally h as state regulation physical function
etence are formed in this cultured space well as those influenced by sleep patterns
and thus can be viewed as products of the
ic argues for the possibly constitutive role
d regulation and provides a general frameshy
ral factors to more proximal accounts such
onal model of infant sleep problems (Sadeh
gically it follows that ethnography should
fhuman development and sleep d supports research design by operationalshy
s in development in terms of observable
Developmental Cultural Ecology ofSleep 171
p~~nomena including the behaviors perceptions relationships and conshydinons that constitute the context of rearing Thus an ecobiocultural
model represents a powerful tool for systematic study of sleep in other
cultures in relation to human development It draws attention to on-theshy
ground patterns ofsleep behavior and exp~rience as important factors in
t~e develo~ment not only ofsleep itself but also of the other aspects of life-emononal social and productive--of which it forms an integral
part The next section describes a general framework for the ecology of
sleep and the unexpected insights yielded from its use in an exploratory
cross-cultural ethnographic study
A Comparative Ecology of Sleep
The gap between paradigms for laboratory-based investigation of sleep
and how it is practiced around the world formed the impetus for our
initial study over a decade ago to begin filling this gap from the side of
anthropology (Worthman 1999) Investigation of cross-cultural patterns
and variation in sleep behavior and corresponding physiology had
scarcely begun at that time (Reimao Souza amp Gaudioso 1999 Reimao
Souza Medeiros amp Almirao 1998 reviewed in McKenna 1996 McKenna
2000) Although direct comparative empirical reports on sleep behavior
were scant the physical and social ecology of sleep was more accessible
in ethnographic and historical accounts (Ekirch 2005 McKenna et al
1993) T~us we used the ecobiocultural model to formulate an a priori
descn~nv~ framework for characterizing the developmental ecology of
~leep m ~~erse societies in rnicroecological terms that determine sleepshymg condinons (eg where when how and with whom) along with
macroecological cultural demographic and climatic factors that pattern
sleep behavior at any age and physical or social condition (see Table 81
~eft colu~)The framework was used to elicit structured ethnographic mventones from colleagues having society-specific expertise (Robert
Bailey Fredrik Barth Magdalena Hurtado Bruce Knauft Mel Kanner
and John Wood) concerning ten traditional cultures ranging in subsisshy
tence strategy and geographic location from foragers in Botswana and
Paraguay to horticulturalists in New Guinea and Zaire pastoralists in
Pakistan and Kenya and agriculturalists in Bali This analysis revealed
TABLE 81 Sleep ecology and settings elements and contrasts
Elements of sleep
ecology
Microecology
Proximate physical ecology
Bedding
Presence of fire Sleeping place or
structure
Proximate social ecology
Sleeping arrangements Separation ofsleepshy
wake states Biotic macro- and
micro-ecology Domestic animals
Parasites and nighttime pests
Macropredators
(animal human) Macroecology Labor demands Social activity
Ritual practices BeliefS about sleep and
dreaming Status (social status class
gender)
Life history lifespan processes
Ecology climate
Demography and
settlement patterns
Characteristics of nonshy Western sleep settings Western globalizing
historic
Security
risk from pathogens present absent predators elements enemies
Sensory stimulation sleeping arrangements
co-sleeping body contact thermal properties
use offire noise light
odors bedding
sleep surfaces and
bedding Variability of sensory
properties regulation ofthermal
conditions
disturbance (noise movement light)
moderate-high extensive
extensive heatcold yes
dynamic dimldark present minimal rough
variable
human active
episodic erratic
low-minimal
solitary limited
limited stable no
silent darkdim minimal elaborate smooth padded
stable
climate-control
absentIminiroal
areas ofcommonality along with di
microecology under which people
effects ofsocial cultural and physic
on sleep patterns (Worthman amp M
Unexpectedly the comparativ(
tics of contemporary sleep ecology
Across this small non-Western sam]
itary sleep rare bedtimes fluid and
fire present conditions dim or da
animals and little or no acoustic ar
tiollSAs such sleep settings offered
including security and comfort thr
in time and space and little climate
eties by contrast appear to have r
properties including solitary or lov
bedtimes and wake times with cor
fuse bedding absence of fire darb as physical boundaries to sleep spac
modernized sleep conditions tl
challenging include habitual soli
infancy onward a lie down and d
vals with few brief sleep-wake tr
physical and social cues in sleep set
distinctively modernized habits
dens on the development of sleepshy
contribute to contemporary sleeF
another hypothesis might propose
sustained sensory loads straining sl
mentation and requiring more dis
sitated robust sleep-wake regulatio
Our cross-cultural survey als mental niche for sleep that were co
from prevailing Western practice
rooming In line with the crossshy
1971) virtually all infants and mo
were provided with sleeping parI
sleep was an exception rather tha
ents and contraSts Western Inonshyglobalizing
historic
Western I
IS present absent
ments
don moderate-high low-minimal
ents extensive solitary llimited
extensive limited
heatcold stable
yes no
dynamic silent
dimldark darkdim
present minimal
minimal elaborate
rough smooth padded
lnsory variable stable
mal human active climate-control
e episodic erratic absent minimal
light)
Developmental Cultural Ecology ofSleep 173
areas ofcommonality along with diversity in the proximal conditions or
microecology under which people sleep and documented the pervasive effects ofsocial cultural and physical ecological factors or macroecology
on sleep patterns (Worthman amp Melby 2002)
Unexpectedly the comparative evidence flagged some characterisshy
tics of contemporary sleep ecology and practices as unusual (Table 81)
Across this small non-Western sample sleep settings were social and solshyitary sleep rare bedtimes fluid and napping common bedding minimal
fire present conditions dim or dark and relatively noisy with people
animals and little or no acoustic and physical barrier to ambient condishy
tions As such sleep settings offered riC and dynamic sensory properties
including security and comfort through social setting fuzzy boundaries
in time and space and little climate controL Postmodern industrial socishyeties by contrast appear to have relatively impoverished stable sensory
properties including solitary or low-contact sleep conditions scheduled
bedtimes and wake times with consolidated sleep padded bed and proshy
fuse bedding absence of fire darkness silence and high acoustic as well
as physical boundaries to sleep spaces Features ofthese much more static modernized sleep conditions that may make sleep regulation more
challenging include habitual solitary sleep or limited cosleep from
infancy onward a lie down and die model of sleep in restricted intershy
vals with few brief sleep-wake transitions and sensory deprivation of physical and social cues in sleep settingsAn untested question is whether
distinctively modernized habits and settings place high sustained burshy
dens on the development ofsleep-wake regulation systems and in turn contribute to contemporary sleep problems and disorders Conversely
another hypothesis might propose that traditional settings placed high sustained sensory loads straining sleep maintenance fostering sleep fragshy
mentation and requiring more distributed and variable sleep that necesshy
sitated robust sleep-wake regulation
Our cross-cultural survey also identified features of the developshymental niche for sleep that were common across the sample but distinctive
from prevailing Western practices First is extensive co-sleeping andshy
rooming In line with the cross-cultural evidence (Barry amp Paxson
1971) virtually all infants and most children in our sample normatively
were provided with sleeping partners from birth onward and solitary sleep was an exception rather than a rule Second as with adults fixed
174 Sleep and Development
bedtimes were absent for children daily routines were common but also
highly flexible As with adults sleep commonly occurred as needed
interspersed with ongoing quotidian affairs Thus for example young
children listen observe and may doze during family food preparation
and gossip or during evening parlays or rituals Third and related to the
absence of fixed bedtimes and the ability to accommodate individual
sleep needs around the clock we found no strong sense ofspecific stageshy
graded developmental needs for sleep Most societies surveyed regarded sleep not as a wholly distinct state but as a range of attentional states
situated along a spectrum graduated from here-and-now engagement
through somnolence to lightsleepto profound awaynessDevelopmental
goals commonly concerned socialization for appropriate sleep intensity
along an attentional spectrum for physical or spiritual safety in sleep
Fourth was the common importance of normative and moral frameshy
works that structure sleep For instance concerns for spiritual safety
mandated co-sleeping and socialization for light sleep in some societies including the Papua New Guinean Gebusi and Zairian LeseThese four
features of the developmental niche for sleep reflect cultural influences
grounded in shared models and schemas concerning sleep that will be
discussed in later sections of this chapter
Cultural Patterning of Sleep across the Life Course An Egyptian Case Study
Our initial cross-cultural analysis intrigued the sleep science community
Genni amp OConnor 200S and elicited cogent questions about generalizshy
ability to contemporary urban populations Our survey too had revealed
a need for studies ofsleep in the context ofeveryday activities and social
settings Consequendy we undertook a household-based study among
Egyptian families living at two sites Cairo or a densely setded agrarian
village Egypt holds one of the longest continuous records for urbanized
stratified cosmopolitan livilg has moderate to very high population densities and maintains the historic circum-Mediterranean tradition of
co-sleeping and bimodal sleep Study data included one week of conshytinuous activity records by all household members details of each sleep
event sleep history since birth and eth
(Worthman amp Brown 2007)
Qualitative evidence from intern
a strong customary preference for c as expectable protective comforting
tionships and family life (Worthman reported routine co-sleeping and brea
by co-sleeping in early childhood 1 co-sleeping or co-rooming through n as through adulthood All reported
and most endorsed its virtues even Customary practices of providing sle(
are constrained by rules of sexual prol reliably doing so for adolescents and
lished patterns of co-sleeping and co disrupted during adolescence and um was no age_and_gender-appropriate s1
Family activity records revealed tl of sleep per day but followed a patte
napping and habitual co-sleeping (We norms for sleep and sleeping arrang
pattern and amount across the life c(
hood of co-sleeping and relationship
gender of the sleeper Specifically ke night sleep arousals and total sleep) all ally moderated factors most particula
age and gender Family relationships flt most nighttime sleep events and a
involved co-sleeping Furthermore fe
itary without roommate or bed parm ner appeared to be more regular corr but not co-rooming was associated
night sleep shorter less variable lengl turbance represented by reported aro
Co-sleeping may qualify as the I
shared by partners of all ages and ge
ily routines were common but also p commonly occurred as needed
n affairs Thus for example young
lze during family food preparation or rituals Third and related to the
ability to accommodate individual
nd no strong sense of specific stageshy
p Most societies surveyed regarded but as a range of attentional states
i from here-and-now engagement
rofoundawaynessDevelopmental
~tion for appropriate sleep intensity
physical or spiritual safety in sleep
ce of normative and moral frameshy
tance concerns for spiritual safety ion for light sleep in some societies Gebusi and Zairian LeseThese four
for sleep reflect cultural influences
lemas concerning sleep that will be
lpter
cross the Life Course
rigued the sleep science community
ed cogent questions about generalizshytlations Our survey too had revealed
ltext of everyday activities and social
ok a household-based study among s Cairo or a densely settled agrarian
est continuous records for urbanized moderate to very high population
c circum-Mediterranean tradition of
dy data included one week of conshy
ehold members details of each sleep
Developmental Cultural Ecology of Sleep 17S
event sleep history since birth and ethnographic interviews about sleep (Worthman amp Brown 2007)
Qualitative evidence from interviews and sleep histories endorsed
a strong customary preference for co-sle~ing which was regarded as expectable protective comforting and integral to foundational relashy
tionships and family life (Worthman amp Brown 2007) All participants
reported routine co-sleeping and breastfeeding during infancy followed by co-sleeping in early childhood The great majority also reported
co-sleeping or co-rooming through middle and late childhood as well
as through adulthood All reported napping routinely earlier in life and most endorsed its virtues even if they rarely napped later on
Customary practices of providing sleep partners for persons of all ages
are constrained by rules ofsexual propriety that reduce the feasibility of
reliably doing so for adolescents and single young adults Hence estabshy
lished patterns of co-sleeping and co-rooming were most likely to be
disrupted during adolescence and unmarried young adulthood if there
was no age-and-gender-appropriate sleeping partner available
Family activity records revealed that participants averaged 84 hours of sleep per day but followed a pattern of bimodal sleep with daytime
napping and habitual co-sleeping (Worthman amp Brown 2007) Cultural
norms for sleep and sleeping arrangements strongly determined sleep pattern and amount across the life course such that age gender likelishy
hood of co-sleeping and relationship to co-sleeper varied with age and gender of the sleeper Specifically key features of sleep behavior (onset
night sleep arousals and total sleep) all were strongly predicted by culturshy
ally moderated factors most particularly bed-sharing habits followed by age and gender Family relationships formed the context for sleep Hence most nighttime sleep events and a near majority of afternoon naps
involved co-sleeping Furthermore few sleep events (one-fifth) were solshy
itary without roommate or bed partner In this setting sleep with a partshy
ner appeared to be more regular compact and undisturbed co-sleeping but not co-rooming was associated with earlier less variable onset of
night sleep shorter less variable length of nighttime sleep less sleep disshy
turbance represented by reported arousals and less total sleep per day Co-sleeping may qualify as the most intimate behavior that can be
shared by parmers of all ages and genders While sharing their sleeping
I76 Sleep and Development
hours co-sleepers in close body contact share space air warmth and
time (a third of the day) during a vital chronobiological period Such
shared experience creates a context for mutual regulation that also shapes
the developmental course of systems regulating arousal and affect
(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy
mental preclinical work Hofer (1978) early proposed that relationships
act as regulators that inform development and shape adult function
Subsequent research has borne out this prediction and revolutionized
understandings of the roles of early environment and epigenetics in the
process of development Work among rodents in particular has detailed
the impact of expectable environments of rearing and functioning parshy
ticularly maternal behavior and early postnatal conditions on organizashy
tion of arousal and affect regulation among many other systems (Szyf
McGowan amp Meaney 2008 Weaver 2007) Different developmental
periods thus present particular opportunities and vulnerabilities to conshy
textual cues that drive regulation of systems closely involved in sleep
(McKenna 2000)
In line with such views data from our family study in Egypt indicate
that co-sleeping habits directly influenced sleep budgets and sleep qualshy
ity and that interruption of these habits in adolescence and young adultshy
hood was associated with increased likelihood of sleep dysregulation and
disruption in males and females respectively But the data do not address
the logical questions of whether and how sleeping arrangements and
co-sleeping in particular influence the development ofsystems that regshy
ulate sleep and arousal (Thoman 2006) These compelling issues remain
open to empirical investigation inemerging comparative research on
sleep
Culture and Sleep Recent Directions
Research on sleep and human development in different settings is
expanding in two directionsone being documentation of sleep patterns
and related outcomes in increasing numbers of non-Western settings
another being the emergence ofcomparative cross-national cross-cultural
research The former is particularly valuable for drawing attention to
divergent as well as shared issues across contexts that vary by wealth and
Develo)
technology as well as other cultural factor
needed to characterize relationships of sle
niche to the formation of sleep-wake pat1
Culture Culture Change and Child Sleej
Globalization and the forces of rapid soc
developmental niche in many ways Thes
ules for new forms o(labor introductio
gies altered setdement patterns (particu
and shifts in family and household struc
tions likely has profound effects on sl
research on these concerns remains an
lifestyle furthermore impose different (
tion regulation that raise the stakes for
ing changes in the developmental niche
systems including sleep A major factor driving contempor
and activity is formal education By 20
schooling had progressed to the point
children and 78 of secondary sch
(Watkins 2008)This phenomenon has
(see also Wolfson and Richards chapt
mental factors that pose challenges for
must be present and alert during th(
school start times determine wake tim
will impair school performance For e
fIfth-grade Israeli students compared
to less sleep and greater daytime slee
concentrating regardless of hours slel
Schooling also makes children sede
linked to reduced sleep time and
Cameron Biddle Marshall amp Gorel
turbance in a multiethnic study ofAl
Chan amp Meininger 2002) School
families whose ability to meet tho
parent education and workloads 1
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
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Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
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Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
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young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
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Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
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Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
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EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
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Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
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for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
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lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
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UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
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WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
168 Sleep and Development
are needed to map the field of inquiry and inform systematic research
that will fill a real lacuna in current understandings of sleep
The present discussion aims to help bridge that gap from a developshy
mental perspective using the approaches of biocultural anthropology
Commencing with a consideration of adaptive-evolutionary constraints
that have shaped the place of sleep in human development this chapter
outlines a bioecocultural model that provides a framework for integrashy
tion ofculture into the study ofhuman developmentThis model inspired
a study of the comparative developmental ecology of sleep that is then
summarized in terms of initial insights into cultural patterns and variashy
tion in the physical ecology of sleep and the recognition of sleep as a form of social behavior The suggestive findings from this cross-cultural
survey are followed by results from an empirical investigation of the role
of culture in shaping sleep across the life course in a specific society
namely Egypt Study results showed that cultural factors powerfiilly
structured sleep accounting for much of the variance in sleep across the
life courseThis example engages a number ofissues regarding the impact
of culture change and globalization (schooling media family and resishy
dential patterns nutrition) on sleep schedules and consequently on funcshy
tioning and healtb The emerging global literature on these topics is
briefly surveyed
A concluding section deploys psychological anthropology to conshy
sider the role ofcultural models in how sleep is conceptualized and how
such models inform behavior and perception with particular regard to
parental behavior Building on a cultural consensus analysis from our
study ofparenting and development ofchild self-regulation in American
families I delineate two key dimensions in an American cultural model
ofsleep along with the resultant scripts for sleep and parenting practices
Then based on our comparative work contrasting elements in nonshy
Western cultural models ofsleep and their attendant scripts are proposed
A central insight from this perspective is that sleep is embedded in a moral framework that powerfully shapes not only behavior but also evalshy
uations ofsleep as appropriate or disordered Thus the cultural construcshy
tion ofsleep across the life course can also be understood as a project that
directly concerns crucial intangibles such as personhood morality and social relations as well as the urgent practical ones ofhealth subsistence
and survival
De-
Adaptive and Evolutionary Back
The lingeringly mysterious adaptive fa
scope of this chapter (see Worthman 2
tive constraints on human sleep patten
comparative study and raises four poi
range of environments using an array tions to flourish under widely diver
sociality and culture are obligatory to
and integral to development and func
ture shapes human ecology Children a become competent by living in socia
through culture Fourth and related
mental design anticipates reliable inr
ments ofrearing for assembling comp
nervous system (Worthman 2003) Tl Design implications for sleep ir
the daily activities necessary for sum
leable to the range of ecological and inhabit Indeed humans manifest pro
schedules and tolerating sleep restricti culturally prescribed sleep practices r
lenges presented by specific environ
analysis of selected non-Western cul
afternoon napping is not related to h
to the presence of malaria and oth (Barone 2000) Then in line with
sleep should commonly occur in soci
sion of group life Co-sleeping has b
instance all reports in an ethnograph identifIed infants as sleeping in the s
Paxson 1971) Finally dependence ( ing conditions suggests that onto~
shaped by sleeping practices The dt
is regularities in patterning and COl
an important factor in the develoJ
regulation
iuiry and inform systematic research
t understandings of sleep help bridge that gap from a developshy
roaches of biocultural anthropology
1 of adaptive-evolutionary constraints
) in human development this chapter
lat provides a framework for integrashy
nan developmentThis model inspired
pmental ecology of sleep that is then
ights into cultural patterns and variashy
eep and the recognition of sleep as a
estive findings from this cross-cultural
1 an empirical investigation of the role
gt the life course in a specific society
wed that cultural factors powerfully uch of the variance in sleep across the
number ofissues regarding the impact
on (schooling media family and resishy
p schedules and consequently on funcshy
19 global literature on these topics is
S psychological anthropology to conshy
1 how sleep is conceptualized and how
l perception with particular regard to
L cultural consensus analysis from our
~nt ofchild self-regulation in American
ensions in an American cultural model
cripts for sleep and parenting practices
e work contrasting elements in nonshy
and their attendant scripts are proposed
pective is that sleep is embedded in a
shapes not only behavior but also evalshy
disordered Thus the cultural construcshy
can also be understood as a project that
bles such as personhood morality and
ent practical ones ofhealth subsistence
Developmental Cultural Ecology of Sleep 169
Adaptive and Evolutionary Background
The lingeringly mysterious adaptive foundations of sleep lie outside the
scope of this chapter (see Worthman 2008) but a consideration of adapshy
tive constraints on human sleep patterns must be a starting point for any
comparative study and raises four points First humans inhabit a huge
range of environments using an array of cultural and biological adaptashy
tions to flourish under widely diverse ecological conditions Second
sociality and culture are obligatory to humans indispensable for survival
and integral to development and function Third and consequently culshy
ture shapes human ecology Childreg are provisioned learn language and
become competent by living in social groups structured and operating
through culture Fourth and related to cultural dependence developshy
mental design anticipates reliable inputs from the expectable environshy
ments of rearing for assembling complex features such as the immune or
nervous system (Worthman 2003) Thus culture gets under the skin
Design implications for sleep include that it must be fitted into
the daily activities necessary for survival and consequently must be malshy
leable to the range ofecological and cultural circumstances that humans
inhabit Indeed humans manifest prodigious capacity for adjusting sleep
schedules and tolerating sleep restriction (Worthman 2008) Furthermore
culturally prescribed sleep practices may themselves meet adaptive chalshy
lenges presented by specific environments For example cross-cultural
analysis of selected non-Western cultures has found that the practice of
afternoon napping is not related to hot climates or agricultural labor but
to the presence of malaria and other parasitic and infectious diseases
(Barone 2000) Then in line with most of humans primate relatives
sleep should commonly occur in social groups for safety and as an extenshy
sion of group life Co-sleeping has been widespread across societies For
instance all reports in an ethnographic sample of173 traditional societies
identified infants as sleeping in the same bed or room as others (Barry amp
Paxson 1971) Finally dependence of development on input from rearshy
ing conditions suggests that ontogeny of sleep regulation would be
shaped by sleeping practices The developmental ecology of sleep-that
is regularities in patterning and conditions of sleep-may therefore be
an important factor in the development of the systems related to its
regulation
bull 1
170 Sleep and Development
The Ecobiocultural Perspective on Human Development
The primary role of culture in shaping rearing environments has
prompted the claim that of all the thing one could do to influence the
development ofan infant the most important would be to decide where
on earth-in what human community-that infant is going to grow up
(Weisner 1996 p 276)A developmental-ecological framework builds on both adaptationist and cultural ecological perspectives and provides a
powerful basis for a fresh approach to sleep The ecobiocultural approach
integrates the pervasive influence of culture on living conditions and
experience with the environmental expectancy of the developing child
(reviewed in Worthman in press) Cultural beliefs values and cognitiveshy
affective orientations directly inform behaviors practices physical conshy
ditions materials and setting that members of the culture produce to
yield the patterned matrix of human ecology The actual conditions
under which children grow up or the developmental niche thereby are
society-specific products of culturally grounded views and practices for
the care and rearing of the young (Super amp Harkness 1986)
The developmental niche ofany society must also work with human
variation and incorporate elasticity responsive to the individual child
Cultural goals and values built in to the niche (eg parent assessments
and responses) engage with the childs endogenous or constitutional
conditions including temperament epigenetics and genetics physical or
functional features capacities and health to both drive and respond to
herhis perceived developmental states and needs toward culturally
desired results Outcomes such as state regulation physical function
and health and cultural competence are formed in this cultured space
Systems that regulate sleep as well as those influenced by sleep patterns
count among these outcomes and thus can be viewed as products of the
developmental niche Such logic argues for the possibly constitutive role
ofculture in sleep behavior and regulation and provides a general frameshy
work for linking distal cultural factors to more proximal accounts such
as Sadeh and Anders transactional model ofinfant sleep problems (Sadeh
amp Anders 1993) Method010gically it follows that ethnography should
play a key role in the study of human development and sleep
The bioecocultural model supports research design by operationalshy
izing culture and its actions in development in terrns of observable
phenomena including the behavior~
ditions that constitute the context
model represents a powerful tool f(
cultures in relation to human develo
ground patterns ofsleep behavior ar
the development not only of sleep
life--emotional social and produc
partThe next section describes a g
sleep and the unexpected insights y
cross-cultural ethnographic study
A Comparative Ecology of SI
The gap between paradigms for lal
and how it is practiced around th(
initial study over a decade ago to
anthropology (Worthman 1999)middot It and variation in sleep behavior
scarcely begun at that time (Reima
Souza Medeiros amp Almirao 1998 r 2000) Although direct comparativ(
were scant the physical and social
in ethnographic and historical acc
1993) Thus we used the ecobiocu
descriptive framework for characte
sleep in diverse societies in rnicroe
ing conditions (eg where when
macro ecological cultural demogra
sleep behavior at any age and phys left column) The framework was 1
inventories from colleagues havir
Bailey Fredrik Barth Magdalena and John Wood) concerning ten
tence strategy and geographic loc
Paraguay to horticulturalists in J Pakistan and Kenya and agricult
middot
ve on Human Development
1 shaping rearing envirorunents has bullthings one could do to influence the It important would be to decide where
lnity-that infant is going to grow up
nental-ecological framework builds on
Cological perspectives and provides a
b to sleepThe ecobiocultural approach e of culture on living conditions and
Ital expectancy of the developing child
I Cultural beliefs values and cognitiveshy
orm behaviors practices physical conshyIat members of the culture produce to
human ecology The actual conditions
or the developmental niche thereby are urally grounded views and practices for
19 (Super amp Harkness 1986) f any society must also work with hu~an icity responsive to the individual child in to the niche (eg parent assessments
tIe childs endogenous or constitutional
lent epigenetics and genetics physical or and health to both drive and respond to
ntal states and needs toward culturally h as state regulation physical function
etence are formed in this cultured space well as those influenced by sleep patterns
and thus can be viewed as products of the
ic argues for the possibly constitutive role
d regulation and provides a general frameshy
ral factors to more proximal accounts such
onal model of infant sleep problems (Sadeh
gically it follows that ethnography should
fhuman development and sleep d supports research design by operationalshy
s in development in terms of observable
Developmental Cultural Ecology ofSleep 171
p~~nomena including the behaviors perceptions relationships and conshydinons that constitute the context of rearing Thus an ecobiocultural
model represents a powerful tool for systematic study of sleep in other
cultures in relation to human development It draws attention to on-theshy
ground patterns ofsleep behavior and exp~rience as important factors in
t~e develo~ment not only ofsleep itself but also of the other aspects of life-emononal social and productive--of which it forms an integral
part The next section describes a general framework for the ecology of
sleep and the unexpected insights yielded from its use in an exploratory
cross-cultural ethnographic study
A Comparative Ecology of Sleep
The gap between paradigms for laboratory-based investigation of sleep
and how it is practiced around the world formed the impetus for our
initial study over a decade ago to begin filling this gap from the side of
anthropology (Worthman 1999) Investigation of cross-cultural patterns
and variation in sleep behavior and corresponding physiology had
scarcely begun at that time (Reimao Souza amp Gaudioso 1999 Reimao
Souza Medeiros amp Almirao 1998 reviewed in McKenna 1996 McKenna
2000) Although direct comparative empirical reports on sleep behavior
were scant the physical and social ecology of sleep was more accessible
in ethnographic and historical accounts (Ekirch 2005 McKenna et al
1993) T~us we used the ecobiocultural model to formulate an a priori
descn~nv~ framework for characterizing the developmental ecology of
~leep m ~~erse societies in rnicroecological terms that determine sleepshymg condinons (eg where when how and with whom) along with
macroecological cultural demographic and climatic factors that pattern
sleep behavior at any age and physical or social condition (see Table 81
~eft colu~)The framework was used to elicit structured ethnographic mventones from colleagues having society-specific expertise (Robert
Bailey Fredrik Barth Magdalena Hurtado Bruce Knauft Mel Kanner
and John Wood) concerning ten traditional cultures ranging in subsisshy
tence strategy and geographic location from foragers in Botswana and
Paraguay to horticulturalists in New Guinea and Zaire pastoralists in
Pakistan and Kenya and agriculturalists in Bali This analysis revealed
TABLE 81 Sleep ecology and settings elements and contrasts
Elements of sleep
ecology
Microecology
Proximate physical ecology
Bedding
Presence of fire Sleeping place or
structure
Proximate social ecology
Sleeping arrangements Separation ofsleepshy
wake states Biotic macro- and
micro-ecology Domestic animals
Parasites and nighttime pests
Macropredators
(animal human) Macroecology Labor demands Social activity
Ritual practices BeliefS about sleep and
dreaming Status (social status class
gender)
Life history lifespan processes
Ecology climate
Demography and
settlement patterns
Characteristics of nonshy Western sleep settings Western globalizing
historic
Security
risk from pathogens present absent predators elements enemies
Sensory stimulation sleeping arrangements
co-sleeping body contact thermal properties
use offire noise light
odors bedding
sleep surfaces and
bedding Variability of sensory
properties regulation ofthermal
conditions
disturbance (noise movement light)
moderate-high extensive
extensive heatcold yes
dynamic dimldark present minimal rough
variable
human active
episodic erratic
low-minimal
solitary limited
limited stable no
silent darkdim minimal elaborate smooth padded
stable
climate-control
absentIminiroal
areas ofcommonality along with di
microecology under which people
effects ofsocial cultural and physic
on sleep patterns (Worthman amp M
Unexpectedly the comparativ(
tics of contemporary sleep ecology
Across this small non-Western sam]
itary sleep rare bedtimes fluid and
fire present conditions dim or da
animals and little or no acoustic ar
tiollSAs such sleep settings offered
including security and comfort thr
in time and space and little climate
eties by contrast appear to have r
properties including solitary or lov
bedtimes and wake times with cor
fuse bedding absence of fire darb as physical boundaries to sleep spac
modernized sleep conditions tl
challenging include habitual soli
infancy onward a lie down and d
vals with few brief sleep-wake tr
physical and social cues in sleep set
distinctively modernized habits
dens on the development of sleepshy
contribute to contemporary sleeF
another hypothesis might propose
sustained sensory loads straining sl
mentation and requiring more dis
sitated robust sleep-wake regulatio
Our cross-cultural survey als mental niche for sleep that were co
from prevailing Western practice
rooming In line with the crossshy
1971) virtually all infants and mo
were provided with sleeping parI
sleep was an exception rather tha
ents and contraSts Western Inonshyglobalizing
historic
Western I
IS present absent
ments
don moderate-high low-minimal
ents extensive solitary llimited
extensive limited
heatcold stable
yes no
dynamic silent
dimldark darkdim
present minimal
minimal elaborate
rough smooth padded
lnsory variable stable
mal human active climate-control
e episodic erratic absent minimal
light)
Developmental Cultural Ecology ofSleep 173
areas ofcommonality along with diversity in the proximal conditions or
microecology under which people sleep and documented the pervasive effects ofsocial cultural and physical ecological factors or macroecology
on sleep patterns (Worthman amp Melby 2002)
Unexpectedly the comparative evidence flagged some characterisshy
tics of contemporary sleep ecology and practices as unusual (Table 81)
Across this small non-Western sample sleep settings were social and solshyitary sleep rare bedtimes fluid and napping common bedding minimal
fire present conditions dim or dark and relatively noisy with people
animals and little or no acoustic and physical barrier to ambient condishy
tions As such sleep settings offered riC and dynamic sensory properties
including security and comfort through social setting fuzzy boundaries
in time and space and little climate controL Postmodern industrial socishyeties by contrast appear to have relatively impoverished stable sensory
properties including solitary or low-contact sleep conditions scheduled
bedtimes and wake times with consolidated sleep padded bed and proshy
fuse bedding absence of fire darkness silence and high acoustic as well
as physical boundaries to sleep spaces Features ofthese much more static modernized sleep conditions that may make sleep regulation more
challenging include habitual solitary sleep or limited cosleep from
infancy onward a lie down and die model of sleep in restricted intershy
vals with few brief sleep-wake transitions and sensory deprivation of physical and social cues in sleep settingsAn untested question is whether
distinctively modernized habits and settings place high sustained burshy
dens on the development ofsleep-wake regulation systems and in turn contribute to contemporary sleep problems and disorders Conversely
another hypothesis might propose that traditional settings placed high sustained sensory loads straining sleep maintenance fostering sleep fragshy
mentation and requiring more distributed and variable sleep that necesshy
sitated robust sleep-wake regulation
Our cross-cultural survey also identified features of the developshymental niche for sleep that were common across the sample but distinctive
from prevailing Western practices First is extensive co-sleeping andshy
rooming In line with the cross-cultural evidence (Barry amp Paxson
1971) virtually all infants and most children in our sample normatively
were provided with sleeping partners from birth onward and solitary sleep was an exception rather than a rule Second as with adults fixed
174 Sleep and Development
bedtimes were absent for children daily routines were common but also
highly flexible As with adults sleep commonly occurred as needed
interspersed with ongoing quotidian affairs Thus for example young
children listen observe and may doze during family food preparation
and gossip or during evening parlays or rituals Third and related to the
absence of fixed bedtimes and the ability to accommodate individual
sleep needs around the clock we found no strong sense ofspecific stageshy
graded developmental needs for sleep Most societies surveyed regarded sleep not as a wholly distinct state but as a range of attentional states
situated along a spectrum graduated from here-and-now engagement
through somnolence to lightsleepto profound awaynessDevelopmental
goals commonly concerned socialization for appropriate sleep intensity
along an attentional spectrum for physical or spiritual safety in sleep
Fourth was the common importance of normative and moral frameshy
works that structure sleep For instance concerns for spiritual safety
mandated co-sleeping and socialization for light sleep in some societies including the Papua New Guinean Gebusi and Zairian LeseThese four
features of the developmental niche for sleep reflect cultural influences
grounded in shared models and schemas concerning sleep that will be
discussed in later sections of this chapter
Cultural Patterning of Sleep across the Life Course An Egyptian Case Study
Our initial cross-cultural analysis intrigued the sleep science community
Genni amp OConnor 200S and elicited cogent questions about generalizshy
ability to contemporary urban populations Our survey too had revealed
a need for studies ofsleep in the context ofeveryday activities and social
settings Consequendy we undertook a household-based study among
Egyptian families living at two sites Cairo or a densely setded agrarian
village Egypt holds one of the longest continuous records for urbanized
stratified cosmopolitan livilg has moderate to very high population densities and maintains the historic circum-Mediterranean tradition of
co-sleeping and bimodal sleep Study data included one week of conshytinuous activity records by all household members details of each sleep
event sleep history since birth and eth
(Worthman amp Brown 2007)
Qualitative evidence from intern
a strong customary preference for c as expectable protective comforting
tionships and family life (Worthman reported routine co-sleeping and brea
by co-sleeping in early childhood 1 co-sleeping or co-rooming through n as through adulthood All reported
and most endorsed its virtues even Customary practices of providing sle(
are constrained by rules of sexual prol reliably doing so for adolescents and
lished patterns of co-sleeping and co disrupted during adolescence and um was no age_and_gender-appropriate s1
Family activity records revealed tl of sleep per day but followed a patte
napping and habitual co-sleeping (We norms for sleep and sleeping arrang
pattern and amount across the life c(
hood of co-sleeping and relationship
gender of the sleeper Specifically ke night sleep arousals and total sleep) all ally moderated factors most particula
age and gender Family relationships flt most nighttime sleep events and a
involved co-sleeping Furthermore fe
itary without roommate or bed parm ner appeared to be more regular corr but not co-rooming was associated
night sleep shorter less variable lengl turbance represented by reported aro
Co-sleeping may qualify as the I
shared by partners of all ages and ge
ily routines were common but also p commonly occurred as needed
n affairs Thus for example young
lze during family food preparation or rituals Third and related to the
ability to accommodate individual
nd no strong sense of specific stageshy
p Most societies surveyed regarded but as a range of attentional states
i from here-and-now engagement
rofoundawaynessDevelopmental
~tion for appropriate sleep intensity
physical or spiritual safety in sleep
ce of normative and moral frameshy
tance concerns for spiritual safety ion for light sleep in some societies Gebusi and Zairian LeseThese four
for sleep reflect cultural influences
lemas concerning sleep that will be
lpter
cross the Life Course
rigued the sleep science community
ed cogent questions about generalizshytlations Our survey too had revealed
ltext of everyday activities and social
ok a household-based study among s Cairo or a densely settled agrarian
est continuous records for urbanized moderate to very high population
c circum-Mediterranean tradition of
dy data included one week of conshy
ehold members details of each sleep
Developmental Cultural Ecology of Sleep 17S
event sleep history since birth and ethnographic interviews about sleep (Worthman amp Brown 2007)
Qualitative evidence from interviews and sleep histories endorsed
a strong customary preference for co-sle~ing which was regarded as expectable protective comforting and integral to foundational relashy
tionships and family life (Worthman amp Brown 2007) All participants
reported routine co-sleeping and breastfeeding during infancy followed by co-sleeping in early childhood The great majority also reported
co-sleeping or co-rooming through middle and late childhood as well
as through adulthood All reported napping routinely earlier in life and most endorsed its virtues even if they rarely napped later on
Customary practices of providing sleep partners for persons of all ages
are constrained by rules ofsexual propriety that reduce the feasibility of
reliably doing so for adolescents and single young adults Hence estabshy
lished patterns of co-sleeping and co-rooming were most likely to be
disrupted during adolescence and unmarried young adulthood if there
was no age-and-gender-appropriate sleeping partner available
Family activity records revealed that participants averaged 84 hours of sleep per day but followed a pattern of bimodal sleep with daytime
napping and habitual co-sleeping (Worthman amp Brown 2007) Cultural
norms for sleep and sleeping arrangements strongly determined sleep pattern and amount across the life course such that age gender likelishy
hood of co-sleeping and relationship to co-sleeper varied with age and gender of the sleeper Specifically key features of sleep behavior (onset
night sleep arousals and total sleep) all were strongly predicted by culturshy
ally moderated factors most particularly bed-sharing habits followed by age and gender Family relationships formed the context for sleep Hence most nighttime sleep events and a near majority of afternoon naps
involved co-sleeping Furthermore few sleep events (one-fifth) were solshy
itary without roommate or bed partner In this setting sleep with a partshy
ner appeared to be more regular compact and undisturbed co-sleeping but not co-rooming was associated with earlier less variable onset of
night sleep shorter less variable length of nighttime sleep less sleep disshy
turbance represented by reported arousals and less total sleep per day Co-sleeping may qualify as the most intimate behavior that can be
shared by parmers of all ages and genders While sharing their sleeping
I76 Sleep and Development
hours co-sleepers in close body contact share space air warmth and
time (a third of the day) during a vital chronobiological period Such
shared experience creates a context for mutual regulation that also shapes
the developmental course of systems regulating arousal and affect
(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy
mental preclinical work Hofer (1978) early proposed that relationships
act as regulators that inform development and shape adult function
Subsequent research has borne out this prediction and revolutionized
understandings of the roles of early environment and epigenetics in the
process of development Work among rodents in particular has detailed
the impact of expectable environments of rearing and functioning parshy
ticularly maternal behavior and early postnatal conditions on organizashy
tion of arousal and affect regulation among many other systems (Szyf
McGowan amp Meaney 2008 Weaver 2007) Different developmental
periods thus present particular opportunities and vulnerabilities to conshy
textual cues that drive regulation of systems closely involved in sleep
(McKenna 2000)
In line with such views data from our family study in Egypt indicate
that co-sleeping habits directly influenced sleep budgets and sleep qualshy
ity and that interruption of these habits in adolescence and young adultshy
hood was associated with increased likelihood of sleep dysregulation and
disruption in males and females respectively But the data do not address
the logical questions of whether and how sleeping arrangements and
co-sleeping in particular influence the development ofsystems that regshy
ulate sleep and arousal (Thoman 2006) These compelling issues remain
open to empirical investigation inemerging comparative research on
sleep
Culture and Sleep Recent Directions
Research on sleep and human development in different settings is
expanding in two directionsone being documentation of sleep patterns
and related outcomes in increasing numbers of non-Western settings
another being the emergence ofcomparative cross-national cross-cultural
research The former is particularly valuable for drawing attention to
divergent as well as shared issues across contexts that vary by wealth and
Develo)
technology as well as other cultural factor
needed to characterize relationships of sle
niche to the formation of sleep-wake pat1
Culture Culture Change and Child Sleej
Globalization and the forces of rapid soc
developmental niche in many ways Thes
ules for new forms o(labor introductio
gies altered setdement patterns (particu
and shifts in family and household struc
tions likely has profound effects on sl
research on these concerns remains an
lifestyle furthermore impose different (
tion regulation that raise the stakes for
ing changes in the developmental niche
systems including sleep A major factor driving contempor
and activity is formal education By 20
schooling had progressed to the point
children and 78 of secondary sch
(Watkins 2008)This phenomenon has
(see also Wolfson and Richards chapt
mental factors that pose challenges for
must be present and alert during th(
school start times determine wake tim
will impair school performance For e
fIfth-grade Israeli students compared
to less sleep and greater daytime slee
concentrating regardless of hours slel
Schooling also makes children sede
linked to reduced sleep time and
Cameron Biddle Marshall amp Gorel
turbance in a multiethnic study ofAl
Chan amp Meininger 2002) School
families whose ability to meet tho
parent education and workloads 1
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
iuiry and inform systematic research
t understandings of sleep help bridge that gap from a developshy
roaches of biocultural anthropology
1 of adaptive-evolutionary constraints
) in human development this chapter
lat provides a framework for integrashy
nan developmentThis model inspired
pmental ecology of sleep that is then
ights into cultural patterns and variashy
eep and the recognition of sleep as a
estive findings from this cross-cultural
1 an empirical investigation of the role
gt the life course in a specific society
wed that cultural factors powerfully uch of the variance in sleep across the
number ofissues regarding the impact
on (schooling media family and resishy
p schedules and consequently on funcshy
19 global literature on these topics is
S psychological anthropology to conshy
1 how sleep is conceptualized and how
l perception with particular regard to
L cultural consensus analysis from our
~nt ofchild self-regulation in American
ensions in an American cultural model
cripts for sleep and parenting practices
e work contrasting elements in nonshy
and their attendant scripts are proposed
pective is that sleep is embedded in a
shapes not only behavior but also evalshy
disordered Thus the cultural construcshy
can also be understood as a project that
bles such as personhood morality and
ent practical ones ofhealth subsistence
Developmental Cultural Ecology of Sleep 169
Adaptive and Evolutionary Background
The lingeringly mysterious adaptive foundations of sleep lie outside the
scope of this chapter (see Worthman 2008) but a consideration of adapshy
tive constraints on human sleep patterns must be a starting point for any
comparative study and raises four points First humans inhabit a huge
range of environments using an array of cultural and biological adaptashy
tions to flourish under widely diverse ecological conditions Second
sociality and culture are obligatory to humans indispensable for survival
and integral to development and function Third and consequently culshy
ture shapes human ecology Childreg are provisioned learn language and
become competent by living in social groups structured and operating
through culture Fourth and related to cultural dependence developshy
mental design anticipates reliable inputs from the expectable environshy
ments of rearing for assembling complex features such as the immune or
nervous system (Worthman 2003) Thus culture gets under the skin
Design implications for sleep include that it must be fitted into
the daily activities necessary for survival and consequently must be malshy
leable to the range ofecological and cultural circumstances that humans
inhabit Indeed humans manifest prodigious capacity for adjusting sleep
schedules and tolerating sleep restriction (Worthman 2008) Furthermore
culturally prescribed sleep practices may themselves meet adaptive chalshy
lenges presented by specific environments For example cross-cultural
analysis of selected non-Western cultures has found that the practice of
afternoon napping is not related to hot climates or agricultural labor but
to the presence of malaria and other parasitic and infectious diseases
(Barone 2000) Then in line with most of humans primate relatives
sleep should commonly occur in social groups for safety and as an extenshy
sion of group life Co-sleeping has been widespread across societies For
instance all reports in an ethnographic sample of173 traditional societies
identified infants as sleeping in the same bed or room as others (Barry amp
Paxson 1971) Finally dependence of development on input from rearshy
ing conditions suggests that ontogeny of sleep regulation would be
shaped by sleeping practices The developmental ecology of sleep-that
is regularities in patterning and conditions of sleep-may therefore be
an important factor in the development of the systems related to its
regulation
bull 1
170 Sleep and Development
The Ecobiocultural Perspective on Human Development
The primary role of culture in shaping rearing environments has
prompted the claim that of all the thing one could do to influence the
development ofan infant the most important would be to decide where
on earth-in what human community-that infant is going to grow up
(Weisner 1996 p 276)A developmental-ecological framework builds on both adaptationist and cultural ecological perspectives and provides a
powerful basis for a fresh approach to sleep The ecobiocultural approach
integrates the pervasive influence of culture on living conditions and
experience with the environmental expectancy of the developing child
(reviewed in Worthman in press) Cultural beliefs values and cognitiveshy
affective orientations directly inform behaviors practices physical conshy
ditions materials and setting that members of the culture produce to
yield the patterned matrix of human ecology The actual conditions
under which children grow up or the developmental niche thereby are
society-specific products of culturally grounded views and practices for
the care and rearing of the young (Super amp Harkness 1986)
The developmental niche ofany society must also work with human
variation and incorporate elasticity responsive to the individual child
Cultural goals and values built in to the niche (eg parent assessments
and responses) engage with the childs endogenous or constitutional
conditions including temperament epigenetics and genetics physical or
functional features capacities and health to both drive and respond to
herhis perceived developmental states and needs toward culturally
desired results Outcomes such as state regulation physical function
and health and cultural competence are formed in this cultured space
Systems that regulate sleep as well as those influenced by sleep patterns
count among these outcomes and thus can be viewed as products of the
developmental niche Such logic argues for the possibly constitutive role
ofculture in sleep behavior and regulation and provides a general frameshy
work for linking distal cultural factors to more proximal accounts such
as Sadeh and Anders transactional model ofinfant sleep problems (Sadeh
amp Anders 1993) Method010gically it follows that ethnography should
play a key role in the study of human development and sleep
The bioecocultural model supports research design by operationalshy
izing culture and its actions in development in terrns of observable
phenomena including the behavior~
ditions that constitute the context
model represents a powerful tool f(
cultures in relation to human develo
ground patterns ofsleep behavior ar
the development not only of sleep
life--emotional social and produc
partThe next section describes a g
sleep and the unexpected insights y
cross-cultural ethnographic study
A Comparative Ecology of SI
The gap between paradigms for lal
and how it is practiced around th(
initial study over a decade ago to
anthropology (Worthman 1999)middot It and variation in sleep behavior
scarcely begun at that time (Reima
Souza Medeiros amp Almirao 1998 r 2000) Although direct comparativ(
were scant the physical and social
in ethnographic and historical acc
1993) Thus we used the ecobiocu
descriptive framework for characte
sleep in diverse societies in rnicroe
ing conditions (eg where when
macro ecological cultural demogra
sleep behavior at any age and phys left column) The framework was 1
inventories from colleagues havir
Bailey Fredrik Barth Magdalena and John Wood) concerning ten
tence strategy and geographic loc
Paraguay to horticulturalists in J Pakistan and Kenya and agricult
middot
ve on Human Development
1 shaping rearing envirorunents has bullthings one could do to influence the It important would be to decide where
lnity-that infant is going to grow up
nental-ecological framework builds on
Cological perspectives and provides a
b to sleepThe ecobiocultural approach e of culture on living conditions and
Ital expectancy of the developing child
I Cultural beliefs values and cognitiveshy
orm behaviors practices physical conshyIat members of the culture produce to
human ecology The actual conditions
or the developmental niche thereby are urally grounded views and practices for
19 (Super amp Harkness 1986) f any society must also work with hu~an icity responsive to the individual child in to the niche (eg parent assessments
tIe childs endogenous or constitutional
lent epigenetics and genetics physical or and health to both drive and respond to
ntal states and needs toward culturally h as state regulation physical function
etence are formed in this cultured space well as those influenced by sleep patterns
and thus can be viewed as products of the
ic argues for the possibly constitutive role
d regulation and provides a general frameshy
ral factors to more proximal accounts such
onal model of infant sleep problems (Sadeh
gically it follows that ethnography should
fhuman development and sleep d supports research design by operationalshy
s in development in terms of observable
Developmental Cultural Ecology ofSleep 171
p~~nomena including the behaviors perceptions relationships and conshydinons that constitute the context of rearing Thus an ecobiocultural
model represents a powerful tool for systematic study of sleep in other
cultures in relation to human development It draws attention to on-theshy
ground patterns ofsleep behavior and exp~rience as important factors in
t~e develo~ment not only ofsleep itself but also of the other aspects of life-emononal social and productive--of which it forms an integral
part The next section describes a general framework for the ecology of
sleep and the unexpected insights yielded from its use in an exploratory
cross-cultural ethnographic study
A Comparative Ecology of Sleep
The gap between paradigms for laboratory-based investigation of sleep
and how it is practiced around the world formed the impetus for our
initial study over a decade ago to begin filling this gap from the side of
anthropology (Worthman 1999) Investigation of cross-cultural patterns
and variation in sleep behavior and corresponding physiology had
scarcely begun at that time (Reimao Souza amp Gaudioso 1999 Reimao
Souza Medeiros amp Almirao 1998 reviewed in McKenna 1996 McKenna
2000) Although direct comparative empirical reports on sleep behavior
were scant the physical and social ecology of sleep was more accessible
in ethnographic and historical accounts (Ekirch 2005 McKenna et al
1993) T~us we used the ecobiocultural model to formulate an a priori
descn~nv~ framework for characterizing the developmental ecology of
~leep m ~~erse societies in rnicroecological terms that determine sleepshymg condinons (eg where when how and with whom) along with
macroecological cultural demographic and climatic factors that pattern
sleep behavior at any age and physical or social condition (see Table 81
~eft colu~)The framework was used to elicit structured ethnographic mventones from colleagues having society-specific expertise (Robert
Bailey Fredrik Barth Magdalena Hurtado Bruce Knauft Mel Kanner
and John Wood) concerning ten traditional cultures ranging in subsisshy
tence strategy and geographic location from foragers in Botswana and
Paraguay to horticulturalists in New Guinea and Zaire pastoralists in
Pakistan and Kenya and agriculturalists in Bali This analysis revealed
TABLE 81 Sleep ecology and settings elements and contrasts
Elements of sleep
ecology
Microecology
Proximate physical ecology
Bedding
Presence of fire Sleeping place or
structure
Proximate social ecology
Sleeping arrangements Separation ofsleepshy
wake states Biotic macro- and
micro-ecology Domestic animals
Parasites and nighttime pests
Macropredators
(animal human) Macroecology Labor demands Social activity
Ritual practices BeliefS about sleep and
dreaming Status (social status class
gender)
Life history lifespan processes
Ecology climate
Demography and
settlement patterns
Characteristics of nonshy Western sleep settings Western globalizing
historic
Security
risk from pathogens present absent predators elements enemies
Sensory stimulation sleeping arrangements
co-sleeping body contact thermal properties
use offire noise light
odors bedding
sleep surfaces and
bedding Variability of sensory
properties regulation ofthermal
conditions
disturbance (noise movement light)
moderate-high extensive
extensive heatcold yes
dynamic dimldark present minimal rough
variable
human active
episodic erratic
low-minimal
solitary limited
limited stable no
silent darkdim minimal elaborate smooth padded
stable
climate-control
absentIminiroal
areas ofcommonality along with di
microecology under which people
effects ofsocial cultural and physic
on sleep patterns (Worthman amp M
Unexpectedly the comparativ(
tics of contemporary sleep ecology
Across this small non-Western sam]
itary sleep rare bedtimes fluid and
fire present conditions dim or da
animals and little or no acoustic ar
tiollSAs such sleep settings offered
including security and comfort thr
in time and space and little climate
eties by contrast appear to have r
properties including solitary or lov
bedtimes and wake times with cor
fuse bedding absence of fire darb as physical boundaries to sleep spac
modernized sleep conditions tl
challenging include habitual soli
infancy onward a lie down and d
vals with few brief sleep-wake tr
physical and social cues in sleep set
distinctively modernized habits
dens on the development of sleepshy
contribute to contemporary sleeF
another hypothesis might propose
sustained sensory loads straining sl
mentation and requiring more dis
sitated robust sleep-wake regulatio
Our cross-cultural survey als mental niche for sleep that were co
from prevailing Western practice
rooming In line with the crossshy
1971) virtually all infants and mo
were provided with sleeping parI
sleep was an exception rather tha
ents and contraSts Western Inonshyglobalizing
historic
Western I
IS present absent
ments
don moderate-high low-minimal
ents extensive solitary llimited
extensive limited
heatcold stable
yes no
dynamic silent
dimldark darkdim
present minimal
minimal elaborate
rough smooth padded
lnsory variable stable
mal human active climate-control
e episodic erratic absent minimal
light)
Developmental Cultural Ecology ofSleep 173
areas ofcommonality along with diversity in the proximal conditions or
microecology under which people sleep and documented the pervasive effects ofsocial cultural and physical ecological factors or macroecology
on sleep patterns (Worthman amp Melby 2002)
Unexpectedly the comparative evidence flagged some characterisshy
tics of contemporary sleep ecology and practices as unusual (Table 81)
Across this small non-Western sample sleep settings were social and solshyitary sleep rare bedtimes fluid and napping common bedding minimal
fire present conditions dim or dark and relatively noisy with people
animals and little or no acoustic and physical barrier to ambient condishy
tions As such sleep settings offered riC and dynamic sensory properties
including security and comfort through social setting fuzzy boundaries
in time and space and little climate controL Postmodern industrial socishyeties by contrast appear to have relatively impoverished stable sensory
properties including solitary or low-contact sleep conditions scheduled
bedtimes and wake times with consolidated sleep padded bed and proshy
fuse bedding absence of fire darkness silence and high acoustic as well
as physical boundaries to sleep spaces Features ofthese much more static modernized sleep conditions that may make sleep regulation more
challenging include habitual solitary sleep or limited cosleep from
infancy onward a lie down and die model of sleep in restricted intershy
vals with few brief sleep-wake transitions and sensory deprivation of physical and social cues in sleep settingsAn untested question is whether
distinctively modernized habits and settings place high sustained burshy
dens on the development ofsleep-wake regulation systems and in turn contribute to contemporary sleep problems and disorders Conversely
another hypothesis might propose that traditional settings placed high sustained sensory loads straining sleep maintenance fostering sleep fragshy
mentation and requiring more distributed and variable sleep that necesshy
sitated robust sleep-wake regulation
Our cross-cultural survey also identified features of the developshymental niche for sleep that were common across the sample but distinctive
from prevailing Western practices First is extensive co-sleeping andshy
rooming In line with the cross-cultural evidence (Barry amp Paxson
1971) virtually all infants and most children in our sample normatively
were provided with sleeping partners from birth onward and solitary sleep was an exception rather than a rule Second as with adults fixed
174 Sleep and Development
bedtimes were absent for children daily routines were common but also
highly flexible As with adults sleep commonly occurred as needed
interspersed with ongoing quotidian affairs Thus for example young
children listen observe and may doze during family food preparation
and gossip or during evening parlays or rituals Third and related to the
absence of fixed bedtimes and the ability to accommodate individual
sleep needs around the clock we found no strong sense ofspecific stageshy
graded developmental needs for sleep Most societies surveyed regarded sleep not as a wholly distinct state but as a range of attentional states
situated along a spectrum graduated from here-and-now engagement
through somnolence to lightsleepto profound awaynessDevelopmental
goals commonly concerned socialization for appropriate sleep intensity
along an attentional spectrum for physical or spiritual safety in sleep
Fourth was the common importance of normative and moral frameshy
works that structure sleep For instance concerns for spiritual safety
mandated co-sleeping and socialization for light sleep in some societies including the Papua New Guinean Gebusi and Zairian LeseThese four
features of the developmental niche for sleep reflect cultural influences
grounded in shared models and schemas concerning sleep that will be
discussed in later sections of this chapter
Cultural Patterning of Sleep across the Life Course An Egyptian Case Study
Our initial cross-cultural analysis intrigued the sleep science community
Genni amp OConnor 200S and elicited cogent questions about generalizshy
ability to contemporary urban populations Our survey too had revealed
a need for studies ofsleep in the context ofeveryday activities and social
settings Consequendy we undertook a household-based study among
Egyptian families living at two sites Cairo or a densely setded agrarian
village Egypt holds one of the longest continuous records for urbanized
stratified cosmopolitan livilg has moderate to very high population densities and maintains the historic circum-Mediterranean tradition of
co-sleeping and bimodal sleep Study data included one week of conshytinuous activity records by all household members details of each sleep
event sleep history since birth and eth
(Worthman amp Brown 2007)
Qualitative evidence from intern
a strong customary preference for c as expectable protective comforting
tionships and family life (Worthman reported routine co-sleeping and brea
by co-sleeping in early childhood 1 co-sleeping or co-rooming through n as through adulthood All reported
and most endorsed its virtues even Customary practices of providing sle(
are constrained by rules of sexual prol reliably doing so for adolescents and
lished patterns of co-sleeping and co disrupted during adolescence and um was no age_and_gender-appropriate s1
Family activity records revealed tl of sleep per day but followed a patte
napping and habitual co-sleeping (We norms for sleep and sleeping arrang
pattern and amount across the life c(
hood of co-sleeping and relationship
gender of the sleeper Specifically ke night sleep arousals and total sleep) all ally moderated factors most particula
age and gender Family relationships flt most nighttime sleep events and a
involved co-sleeping Furthermore fe
itary without roommate or bed parm ner appeared to be more regular corr but not co-rooming was associated
night sleep shorter less variable lengl turbance represented by reported aro
Co-sleeping may qualify as the I
shared by partners of all ages and ge
ily routines were common but also p commonly occurred as needed
n affairs Thus for example young
lze during family food preparation or rituals Third and related to the
ability to accommodate individual
nd no strong sense of specific stageshy
p Most societies surveyed regarded but as a range of attentional states
i from here-and-now engagement
rofoundawaynessDevelopmental
~tion for appropriate sleep intensity
physical or spiritual safety in sleep
ce of normative and moral frameshy
tance concerns for spiritual safety ion for light sleep in some societies Gebusi and Zairian LeseThese four
for sleep reflect cultural influences
lemas concerning sleep that will be
lpter
cross the Life Course
rigued the sleep science community
ed cogent questions about generalizshytlations Our survey too had revealed
ltext of everyday activities and social
ok a household-based study among s Cairo or a densely settled agrarian
est continuous records for urbanized moderate to very high population
c circum-Mediterranean tradition of
dy data included one week of conshy
ehold members details of each sleep
Developmental Cultural Ecology of Sleep 17S
event sleep history since birth and ethnographic interviews about sleep (Worthman amp Brown 2007)
Qualitative evidence from interviews and sleep histories endorsed
a strong customary preference for co-sle~ing which was regarded as expectable protective comforting and integral to foundational relashy
tionships and family life (Worthman amp Brown 2007) All participants
reported routine co-sleeping and breastfeeding during infancy followed by co-sleeping in early childhood The great majority also reported
co-sleeping or co-rooming through middle and late childhood as well
as through adulthood All reported napping routinely earlier in life and most endorsed its virtues even if they rarely napped later on
Customary practices of providing sleep partners for persons of all ages
are constrained by rules ofsexual propriety that reduce the feasibility of
reliably doing so for adolescents and single young adults Hence estabshy
lished patterns of co-sleeping and co-rooming were most likely to be
disrupted during adolescence and unmarried young adulthood if there
was no age-and-gender-appropriate sleeping partner available
Family activity records revealed that participants averaged 84 hours of sleep per day but followed a pattern of bimodal sleep with daytime
napping and habitual co-sleeping (Worthman amp Brown 2007) Cultural
norms for sleep and sleeping arrangements strongly determined sleep pattern and amount across the life course such that age gender likelishy
hood of co-sleeping and relationship to co-sleeper varied with age and gender of the sleeper Specifically key features of sleep behavior (onset
night sleep arousals and total sleep) all were strongly predicted by culturshy
ally moderated factors most particularly bed-sharing habits followed by age and gender Family relationships formed the context for sleep Hence most nighttime sleep events and a near majority of afternoon naps
involved co-sleeping Furthermore few sleep events (one-fifth) were solshy
itary without roommate or bed partner In this setting sleep with a partshy
ner appeared to be more regular compact and undisturbed co-sleeping but not co-rooming was associated with earlier less variable onset of
night sleep shorter less variable length of nighttime sleep less sleep disshy
turbance represented by reported arousals and less total sleep per day Co-sleeping may qualify as the most intimate behavior that can be
shared by parmers of all ages and genders While sharing their sleeping
I76 Sleep and Development
hours co-sleepers in close body contact share space air warmth and
time (a third of the day) during a vital chronobiological period Such
shared experience creates a context for mutual regulation that also shapes
the developmental course of systems regulating arousal and affect
(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy
mental preclinical work Hofer (1978) early proposed that relationships
act as regulators that inform development and shape adult function
Subsequent research has borne out this prediction and revolutionized
understandings of the roles of early environment and epigenetics in the
process of development Work among rodents in particular has detailed
the impact of expectable environments of rearing and functioning parshy
ticularly maternal behavior and early postnatal conditions on organizashy
tion of arousal and affect regulation among many other systems (Szyf
McGowan amp Meaney 2008 Weaver 2007) Different developmental
periods thus present particular opportunities and vulnerabilities to conshy
textual cues that drive regulation of systems closely involved in sleep
(McKenna 2000)
In line with such views data from our family study in Egypt indicate
that co-sleeping habits directly influenced sleep budgets and sleep qualshy
ity and that interruption of these habits in adolescence and young adultshy
hood was associated with increased likelihood of sleep dysregulation and
disruption in males and females respectively But the data do not address
the logical questions of whether and how sleeping arrangements and
co-sleeping in particular influence the development ofsystems that regshy
ulate sleep and arousal (Thoman 2006) These compelling issues remain
open to empirical investigation inemerging comparative research on
sleep
Culture and Sleep Recent Directions
Research on sleep and human development in different settings is
expanding in two directionsone being documentation of sleep patterns
and related outcomes in increasing numbers of non-Western settings
another being the emergence ofcomparative cross-national cross-cultural
research The former is particularly valuable for drawing attention to
divergent as well as shared issues across contexts that vary by wealth and
Develo)
technology as well as other cultural factor
needed to characterize relationships of sle
niche to the formation of sleep-wake pat1
Culture Culture Change and Child Sleej
Globalization and the forces of rapid soc
developmental niche in many ways Thes
ules for new forms o(labor introductio
gies altered setdement patterns (particu
and shifts in family and household struc
tions likely has profound effects on sl
research on these concerns remains an
lifestyle furthermore impose different (
tion regulation that raise the stakes for
ing changes in the developmental niche
systems including sleep A major factor driving contempor
and activity is formal education By 20
schooling had progressed to the point
children and 78 of secondary sch
(Watkins 2008)This phenomenon has
(see also Wolfson and Richards chapt
mental factors that pose challenges for
must be present and alert during th(
school start times determine wake tim
will impair school performance For e
fIfth-grade Israeli students compared
to less sleep and greater daytime slee
concentrating regardless of hours slel
Schooling also makes children sede
linked to reduced sleep time and
Cameron Biddle Marshall amp Gorel
turbance in a multiethnic study ofAl
Chan amp Meininger 2002) School
families whose ability to meet tho
parent education and workloads 1
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
bull 1
170 Sleep and Development
The Ecobiocultural Perspective on Human Development
The primary role of culture in shaping rearing environments has
prompted the claim that of all the thing one could do to influence the
development ofan infant the most important would be to decide where
on earth-in what human community-that infant is going to grow up
(Weisner 1996 p 276)A developmental-ecological framework builds on both adaptationist and cultural ecological perspectives and provides a
powerful basis for a fresh approach to sleep The ecobiocultural approach
integrates the pervasive influence of culture on living conditions and
experience with the environmental expectancy of the developing child
(reviewed in Worthman in press) Cultural beliefs values and cognitiveshy
affective orientations directly inform behaviors practices physical conshy
ditions materials and setting that members of the culture produce to
yield the patterned matrix of human ecology The actual conditions
under which children grow up or the developmental niche thereby are
society-specific products of culturally grounded views and practices for
the care and rearing of the young (Super amp Harkness 1986)
The developmental niche ofany society must also work with human
variation and incorporate elasticity responsive to the individual child
Cultural goals and values built in to the niche (eg parent assessments
and responses) engage with the childs endogenous or constitutional
conditions including temperament epigenetics and genetics physical or
functional features capacities and health to both drive and respond to
herhis perceived developmental states and needs toward culturally
desired results Outcomes such as state regulation physical function
and health and cultural competence are formed in this cultured space
Systems that regulate sleep as well as those influenced by sleep patterns
count among these outcomes and thus can be viewed as products of the
developmental niche Such logic argues for the possibly constitutive role
ofculture in sleep behavior and regulation and provides a general frameshy
work for linking distal cultural factors to more proximal accounts such
as Sadeh and Anders transactional model ofinfant sleep problems (Sadeh
amp Anders 1993) Method010gically it follows that ethnography should
play a key role in the study of human development and sleep
The bioecocultural model supports research design by operationalshy
izing culture and its actions in development in terrns of observable
phenomena including the behavior~
ditions that constitute the context
model represents a powerful tool f(
cultures in relation to human develo
ground patterns ofsleep behavior ar
the development not only of sleep
life--emotional social and produc
partThe next section describes a g
sleep and the unexpected insights y
cross-cultural ethnographic study
A Comparative Ecology of SI
The gap between paradigms for lal
and how it is practiced around th(
initial study over a decade ago to
anthropology (Worthman 1999)middot It and variation in sleep behavior
scarcely begun at that time (Reima
Souza Medeiros amp Almirao 1998 r 2000) Although direct comparativ(
were scant the physical and social
in ethnographic and historical acc
1993) Thus we used the ecobiocu
descriptive framework for characte
sleep in diverse societies in rnicroe
ing conditions (eg where when
macro ecological cultural demogra
sleep behavior at any age and phys left column) The framework was 1
inventories from colleagues havir
Bailey Fredrik Barth Magdalena and John Wood) concerning ten
tence strategy and geographic loc
Paraguay to horticulturalists in J Pakistan and Kenya and agricult
middot
ve on Human Development
1 shaping rearing envirorunents has bullthings one could do to influence the It important would be to decide where
lnity-that infant is going to grow up
nental-ecological framework builds on
Cological perspectives and provides a
b to sleepThe ecobiocultural approach e of culture on living conditions and
Ital expectancy of the developing child
I Cultural beliefs values and cognitiveshy
orm behaviors practices physical conshyIat members of the culture produce to
human ecology The actual conditions
or the developmental niche thereby are urally grounded views and practices for
19 (Super amp Harkness 1986) f any society must also work with hu~an icity responsive to the individual child in to the niche (eg parent assessments
tIe childs endogenous or constitutional
lent epigenetics and genetics physical or and health to both drive and respond to
ntal states and needs toward culturally h as state regulation physical function
etence are formed in this cultured space well as those influenced by sleep patterns
and thus can be viewed as products of the
ic argues for the possibly constitutive role
d regulation and provides a general frameshy
ral factors to more proximal accounts such
onal model of infant sleep problems (Sadeh
gically it follows that ethnography should
fhuman development and sleep d supports research design by operationalshy
s in development in terms of observable
Developmental Cultural Ecology ofSleep 171
p~~nomena including the behaviors perceptions relationships and conshydinons that constitute the context of rearing Thus an ecobiocultural
model represents a powerful tool for systematic study of sleep in other
cultures in relation to human development It draws attention to on-theshy
ground patterns ofsleep behavior and exp~rience as important factors in
t~e develo~ment not only ofsleep itself but also of the other aspects of life-emononal social and productive--of which it forms an integral
part The next section describes a general framework for the ecology of
sleep and the unexpected insights yielded from its use in an exploratory
cross-cultural ethnographic study
A Comparative Ecology of Sleep
The gap between paradigms for laboratory-based investigation of sleep
and how it is practiced around the world formed the impetus for our
initial study over a decade ago to begin filling this gap from the side of
anthropology (Worthman 1999) Investigation of cross-cultural patterns
and variation in sleep behavior and corresponding physiology had
scarcely begun at that time (Reimao Souza amp Gaudioso 1999 Reimao
Souza Medeiros amp Almirao 1998 reviewed in McKenna 1996 McKenna
2000) Although direct comparative empirical reports on sleep behavior
were scant the physical and social ecology of sleep was more accessible
in ethnographic and historical accounts (Ekirch 2005 McKenna et al
1993) T~us we used the ecobiocultural model to formulate an a priori
descn~nv~ framework for characterizing the developmental ecology of
~leep m ~~erse societies in rnicroecological terms that determine sleepshymg condinons (eg where when how and with whom) along with
macroecological cultural demographic and climatic factors that pattern
sleep behavior at any age and physical or social condition (see Table 81
~eft colu~)The framework was used to elicit structured ethnographic mventones from colleagues having society-specific expertise (Robert
Bailey Fredrik Barth Magdalena Hurtado Bruce Knauft Mel Kanner
and John Wood) concerning ten traditional cultures ranging in subsisshy
tence strategy and geographic location from foragers in Botswana and
Paraguay to horticulturalists in New Guinea and Zaire pastoralists in
Pakistan and Kenya and agriculturalists in Bali This analysis revealed
TABLE 81 Sleep ecology and settings elements and contrasts
Elements of sleep
ecology
Microecology
Proximate physical ecology
Bedding
Presence of fire Sleeping place or
structure
Proximate social ecology
Sleeping arrangements Separation ofsleepshy
wake states Biotic macro- and
micro-ecology Domestic animals
Parasites and nighttime pests
Macropredators
(animal human) Macroecology Labor demands Social activity
Ritual practices BeliefS about sleep and
dreaming Status (social status class
gender)
Life history lifespan processes
Ecology climate
Demography and
settlement patterns
Characteristics of nonshy Western sleep settings Western globalizing
historic
Security
risk from pathogens present absent predators elements enemies
Sensory stimulation sleeping arrangements
co-sleeping body contact thermal properties
use offire noise light
odors bedding
sleep surfaces and
bedding Variability of sensory
properties regulation ofthermal
conditions
disturbance (noise movement light)
moderate-high extensive
extensive heatcold yes
dynamic dimldark present minimal rough
variable
human active
episodic erratic
low-minimal
solitary limited
limited stable no
silent darkdim minimal elaborate smooth padded
stable
climate-control
absentIminiroal
areas ofcommonality along with di
microecology under which people
effects ofsocial cultural and physic
on sleep patterns (Worthman amp M
Unexpectedly the comparativ(
tics of contemporary sleep ecology
Across this small non-Western sam]
itary sleep rare bedtimes fluid and
fire present conditions dim or da
animals and little or no acoustic ar
tiollSAs such sleep settings offered
including security and comfort thr
in time and space and little climate
eties by contrast appear to have r
properties including solitary or lov
bedtimes and wake times with cor
fuse bedding absence of fire darb as physical boundaries to sleep spac
modernized sleep conditions tl
challenging include habitual soli
infancy onward a lie down and d
vals with few brief sleep-wake tr
physical and social cues in sleep set
distinctively modernized habits
dens on the development of sleepshy
contribute to contemporary sleeF
another hypothesis might propose
sustained sensory loads straining sl
mentation and requiring more dis
sitated robust sleep-wake regulatio
Our cross-cultural survey als mental niche for sleep that were co
from prevailing Western practice
rooming In line with the crossshy
1971) virtually all infants and mo
were provided with sleeping parI
sleep was an exception rather tha
ents and contraSts Western Inonshyglobalizing
historic
Western I
IS present absent
ments
don moderate-high low-minimal
ents extensive solitary llimited
extensive limited
heatcold stable
yes no
dynamic silent
dimldark darkdim
present minimal
minimal elaborate
rough smooth padded
lnsory variable stable
mal human active climate-control
e episodic erratic absent minimal
light)
Developmental Cultural Ecology ofSleep 173
areas ofcommonality along with diversity in the proximal conditions or
microecology under which people sleep and documented the pervasive effects ofsocial cultural and physical ecological factors or macroecology
on sleep patterns (Worthman amp Melby 2002)
Unexpectedly the comparative evidence flagged some characterisshy
tics of contemporary sleep ecology and practices as unusual (Table 81)
Across this small non-Western sample sleep settings were social and solshyitary sleep rare bedtimes fluid and napping common bedding minimal
fire present conditions dim or dark and relatively noisy with people
animals and little or no acoustic and physical barrier to ambient condishy
tions As such sleep settings offered riC and dynamic sensory properties
including security and comfort through social setting fuzzy boundaries
in time and space and little climate controL Postmodern industrial socishyeties by contrast appear to have relatively impoverished stable sensory
properties including solitary or low-contact sleep conditions scheduled
bedtimes and wake times with consolidated sleep padded bed and proshy
fuse bedding absence of fire darkness silence and high acoustic as well
as physical boundaries to sleep spaces Features ofthese much more static modernized sleep conditions that may make sleep regulation more
challenging include habitual solitary sleep or limited cosleep from
infancy onward a lie down and die model of sleep in restricted intershy
vals with few brief sleep-wake transitions and sensory deprivation of physical and social cues in sleep settingsAn untested question is whether
distinctively modernized habits and settings place high sustained burshy
dens on the development ofsleep-wake regulation systems and in turn contribute to contemporary sleep problems and disorders Conversely
another hypothesis might propose that traditional settings placed high sustained sensory loads straining sleep maintenance fostering sleep fragshy
mentation and requiring more distributed and variable sleep that necesshy
sitated robust sleep-wake regulation
Our cross-cultural survey also identified features of the developshymental niche for sleep that were common across the sample but distinctive
from prevailing Western practices First is extensive co-sleeping andshy
rooming In line with the cross-cultural evidence (Barry amp Paxson
1971) virtually all infants and most children in our sample normatively
were provided with sleeping partners from birth onward and solitary sleep was an exception rather than a rule Second as with adults fixed
174 Sleep and Development
bedtimes were absent for children daily routines were common but also
highly flexible As with adults sleep commonly occurred as needed
interspersed with ongoing quotidian affairs Thus for example young
children listen observe and may doze during family food preparation
and gossip or during evening parlays or rituals Third and related to the
absence of fixed bedtimes and the ability to accommodate individual
sleep needs around the clock we found no strong sense ofspecific stageshy
graded developmental needs for sleep Most societies surveyed regarded sleep not as a wholly distinct state but as a range of attentional states
situated along a spectrum graduated from here-and-now engagement
through somnolence to lightsleepto profound awaynessDevelopmental
goals commonly concerned socialization for appropriate sleep intensity
along an attentional spectrum for physical or spiritual safety in sleep
Fourth was the common importance of normative and moral frameshy
works that structure sleep For instance concerns for spiritual safety
mandated co-sleeping and socialization for light sleep in some societies including the Papua New Guinean Gebusi and Zairian LeseThese four
features of the developmental niche for sleep reflect cultural influences
grounded in shared models and schemas concerning sleep that will be
discussed in later sections of this chapter
Cultural Patterning of Sleep across the Life Course An Egyptian Case Study
Our initial cross-cultural analysis intrigued the sleep science community
Genni amp OConnor 200S and elicited cogent questions about generalizshy
ability to contemporary urban populations Our survey too had revealed
a need for studies ofsleep in the context ofeveryday activities and social
settings Consequendy we undertook a household-based study among
Egyptian families living at two sites Cairo or a densely setded agrarian
village Egypt holds one of the longest continuous records for urbanized
stratified cosmopolitan livilg has moderate to very high population densities and maintains the historic circum-Mediterranean tradition of
co-sleeping and bimodal sleep Study data included one week of conshytinuous activity records by all household members details of each sleep
event sleep history since birth and eth
(Worthman amp Brown 2007)
Qualitative evidence from intern
a strong customary preference for c as expectable protective comforting
tionships and family life (Worthman reported routine co-sleeping and brea
by co-sleeping in early childhood 1 co-sleeping or co-rooming through n as through adulthood All reported
and most endorsed its virtues even Customary practices of providing sle(
are constrained by rules of sexual prol reliably doing so for adolescents and
lished patterns of co-sleeping and co disrupted during adolescence and um was no age_and_gender-appropriate s1
Family activity records revealed tl of sleep per day but followed a patte
napping and habitual co-sleeping (We norms for sleep and sleeping arrang
pattern and amount across the life c(
hood of co-sleeping and relationship
gender of the sleeper Specifically ke night sleep arousals and total sleep) all ally moderated factors most particula
age and gender Family relationships flt most nighttime sleep events and a
involved co-sleeping Furthermore fe
itary without roommate or bed parm ner appeared to be more regular corr but not co-rooming was associated
night sleep shorter less variable lengl turbance represented by reported aro
Co-sleeping may qualify as the I
shared by partners of all ages and ge
ily routines were common but also p commonly occurred as needed
n affairs Thus for example young
lze during family food preparation or rituals Third and related to the
ability to accommodate individual
nd no strong sense of specific stageshy
p Most societies surveyed regarded but as a range of attentional states
i from here-and-now engagement
rofoundawaynessDevelopmental
~tion for appropriate sleep intensity
physical or spiritual safety in sleep
ce of normative and moral frameshy
tance concerns for spiritual safety ion for light sleep in some societies Gebusi and Zairian LeseThese four
for sleep reflect cultural influences
lemas concerning sleep that will be
lpter
cross the Life Course
rigued the sleep science community
ed cogent questions about generalizshytlations Our survey too had revealed
ltext of everyday activities and social
ok a household-based study among s Cairo or a densely settled agrarian
est continuous records for urbanized moderate to very high population
c circum-Mediterranean tradition of
dy data included one week of conshy
ehold members details of each sleep
Developmental Cultural Ecology of Sleep 17S
event sleep history since birth and ethnographic interviews about sleep (Worthman amp Brown 2007)
Qualitative evidence from interviews and sleep histories endorsed
a strong customary preference for co-sle~ing which was regarded as expectable protective comforting and integral to foundational relashy
tionships and family life (Worthman amp Brown 2007) All participants
reported routine co-sleeping and breastfeeding during infancy followed by co-sleeping in early childhood The great majority also reported
co-sleeping or co-rooming through middle and late childhood as well
as through adulthood All reported napping routinely earlier in life and most endorsed its virtues even if they rarely napped later on
Customary practices of providing sleep partners for persons of all ages
are constrained by rules ofsexual propriety that reduce the feasibility of
reliably doing so for adolescents and single young adults Hence estabshy
lished patterns of co-sleeping and co-rooming were most likely to be
disrupted during adolescence and unmarried young adulthood if there
was no age-and-gender-appropriate sleeping partner available
Family activity records revealed that participants averaged 84 hours of sleep per day but followed a pattern of bimodal sleep with daytime
napping and habitual co-sleeping (Worthman amp Brown 2007) Cultural
norms for sleep and sleeping arrangements strongly determined sleep pattern and amount across the life course such that age gender likelishy
hood of co-sleeping and relationship to co-sleeper varied with age and gender of the sleeper Specifically key features of sleep behavior (onset
night sleep arousals and total sleep) all were strongly predicted by culturshy
ally moderated factors most particularly bed-sharing habits followed by age and gender Family relationships formed the context for sleep Hence most nighttime sleep events and a near majority of afternoon naps
involved co-sleeping Furthermore few sleep events (one-fifth) were solshy
itary without roommate or bed partner In this setting sleep with a partshy
ner appeared to be more regular compact and undisturbed co-sleeping but not co-rooming was associated with earlier less variable onset of
night sleep shorter less variable length of nighttime sleep less sleep disshy
turbance represented by reported arousals and less total sleep per day Co-sleeping may qualify as the most intimate behavior that can be
shared by parmers of all ages and genders While sharing their sleeping
I76 Sleep and Development
hours co-sleepers in close body contact share space air warmth and
time (a third of the day) during a vital chronobiological period Such
shared experience creates a context for mutual regulation that also shapes
the developmental course of systems regulating arousal and affect
(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy
mental preclinical work Hofer (1978) early proposed that relationships
act as regulators that inform development and shape adult function
Subsequent research has borne out this prediction and revolutionized
understandings of the roles of early environment and epigenetics in the
process of development Work among rodents in particular has detailed
the impact of expectable environments of rearing and functioning parshy
ticularly maternal behavior and early postnatal conditions on organizashy
tion of arousal and affect regulation among many other systems (Szyf
McGowan amp Meaney 2008 Weaver 2007) Different developmental
periods thus present particular opportunities and vulnerabilities to conshy
textual cues that drive regulation of systems closely involved in sleep
(McKenna 2000)
In line with such views data from our family study in Egypt indicate
that co-sleeping habits directly influenced sleep budgets and sleep qualshy
ity and that interruption of these habits in adolescence and young adultshy
hood was associated with increased likelihood of sleep dysregulation and
disruption in males and females respectively But the data do not address
the logical questions of whether and how sleeping arrangements and
co-sleeping in particular influence the development ofsystems that regshy
ulate sleep and arousal (Thoman 2006) These compelling issues remain
open to empirical investigation inemerging comparative research on
sleep
Culture and Sleep Recent Directions
Research on sleep and human development in different settings is
expanding in two directionsone being documentation of sleep patterns
and related outcomes in increasing numbers of non-Western settings
another being the emergence ofcomparative cross-national cross-cultural
research The former is particularly valuable for drawing attention to
divergent as well as shared issues across contexts that vary by wealth and
Develo)
technology as well as other cultural factor
needed to characterize relationships of sle
niche to the formation of sleep-wake pat1
Culture Culture Change and Child Sleej
Globalization and the forces of rapid soc
developmental niche in many ways Thes
ules for new forms o(labor introductio
gies altered setdement patterns (particu
and shifts in family and household struc
tions likely has profound effects on sl
research on these concerns remains an
lifestyle furthermore impose different (
tion regulation that raise the stakes for
ing changes in the developmental niche
systems including sleep A major factor driving contempor
and activity is formal education By 20
schooling had progressed to the point
children and 78 of secondary sch
(Watkins 2008)This phenomenon has
(see also Wolfson and Richards chapt
mental factors that pose challenges for
must be present and alert during th(
school start times determine wake tim
will impair school performance For e
fIfth-grade Israeli students compared
to less sleep and greater daytime slee
concentrating regardless of hours slel
Schooling also makes children sede
linked to reduced sleep time and
Cameron Biddle Marshall amp Gorel
turbance in a multiethnic study ofAl
Chan amp Meininger 2002) School
families whose ability to meet tho
parent education and workloads 1
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
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Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
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Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
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EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
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for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
middot
ve on Human Development
1 shaping rearing envirorunents has bullthings one could do to influence the It important would be to decide where
lnity-that infant is going to grow up
nental-ecological framework builds on
Cological perspectives and provides a
b to sleepThe ecobiocultural approach e of culture on living conditions and
Ital expectancy of the developing child
I Cultural beliefs values and cognitiveshy
orm behaviors practices physical conshyIat members of the culture produce to
human ecology The actual conditions
or the developmental niche thereby are urally grounded views and practices for
19 (Super amp Harkness 1986) f any society must also work with hu~an icity responsive to the individual child in to the niche (eg parent assessments
tIe childs endogenous or constitutional
lent epigenetics and genetics physical or and health to both drive and respond to
ntal states and needs toward culturally h as state regulation physical function
etence are formed in this cultured space well as those influenced by sleep patterns
and thus can be viewed as products of the
ic argues for the possibly constitutive role
d regulation and provides a general frameshy
ral factors to more proximal accounts such
onal model of infant sleep problems (Sadeh
gically it follows that ethnography should
fhuman development and sleep d supports research design by operationalshy
s in development in terms of observable
Developmental Cultural Ecology ofSleep 171
p~~nomena including the behaviors perceptions relationships and conshydinons that constitute the context of rearing Thus an ecobiocultural
model represents a powerful tool for systematic study of sleep in other
cultures in relation to human development It draws attention to on-theshy
ground patterns ofsleep behavior and exp~rience as important factors in
t~e develo~ment not only ofsleep itself but also of the other aspects of life-emononal social and productive--of which it forms an integral
part The next section describes a general framework for the ecology of
sleep and the unexpected insights yielded from its use in an exploratory
cross-cultural ethnographic study
A Comparative Ecology of Sleep
The gap between paradigms for laboratory-based investigation of sleep
and how it is practiced around the world formed the impetus for our
initial study over a decade ago to begin filling this gap from the side of
anthropology (Worthman 1999) Investigation of cross-cultural patterns
and variation in sleep behavior and corresponding physiology had
scarcely begun at that time (Reimao Souza amp Gaudioso 1999 Reimao
Souza Medeiros amp Almirao 1998 reviewed in McKenna 1996 McKenna
2000) Although direct comparative empirical reports on sleep behavior
were scant the physical and social ecology of sleep was more accessible
in ethnographic and historical accounts (Ekirch 2005 McKenna et al
1993) T~us we used the ecobiocultural model to formulate an a priori
descn~nv~ framework for characterizing the developmental ecology of
~leep m ~~erse societies in rnicroecological terms that determine sleepshymg condinons (eg where when how and with whom) along with
macroecological cultural demographic and climatic factors that pattern
sleep behavior at any age and physical or social condition (see Table 81
~eft colu~)The framework was used to elicit structured ethnographic mventones from colleagues having society-specific expertise (Robert
Bailey Fredrik Barth Magdalena Hurtado Bruce Knauft Mel Kanner
and John Wood) concerning ten traditional cultures ranging in subsisshy
tence strategy and geographic location from foragers in Botswana and
Paraguay to horticulturalists in New Guinea and Zaire pastoralists in
Pakistan and Kenya and agriculturalists in Bali This analysis revealed
TABLE 81 Sleep ecology and settings elements and contrasts
Elements of sleep
ecology
Microecology
Proximate physical ecology
Bedding
Presence of fire Sleeping place or
structure
Proximate social ecology
Sleeping arrangements Separation ofsleepshy
wake states Biotic macro- and
micro-ecology Domestic animals
Parasites and nighttime pests
Macropredators
(animal human) Macroecology Labor demands Social activity
Ritual practices BeliefS about sleep and
dreaming Status (social status class
gender)
Life history lifespan processes
Ecology climate
Demography and
settlement patterns
Characteristics of nonshy Western sleep settings Western globalizing
historic
Security
risk from pathogens present absent predators elements enemies
Sensory stimulation sleeping arrangements
co-sleeping body contact thermal properties
use offire noise light
odors bedding
sleep surfaces and
bedding Variability of sensory
properties regulation ofthermal
conditions
disturbance (noise movement light)
moderate-high extensive
extensive heatcold yes
dynamic dimldark present minimal rough
variable
human active
episodic erratic
low-minimal
solitary limited
limited stable no
silent darkdim minimal elaborate smooth padded
stable
climate-control
absentIminiroal
areas ofcommonality along with di
microecology under which people
effects ofsocial cultural and physic
on sleep patterns (Worthman amp M
Unexpectedly the comparativ(
tics of contemporary sleep ecology
Across this small non-Western sam]
itary sleep rare bedtimes fluid and
fire present conditions dim or da
animals and little or no acoustic ar
tiollSAs such sleep settings offered
including security and comfort thr
in time and space and little climate
eties by contrast appear to have r
properties including solitary or lov
bedtimes and wake times with cor
fuse bedding absence of fire darb as physical boundaries to sleep spac
modernized sleep conditions tl
challenging include habitual soli
infancy onward a lie down and d
vals with few brief sleep-wake tr
physical and social cues in sleep set
distinctively modernized habits
dens on the development of sleepshy
contribute to contemporary sleeF
another hypothesis might propose
sustained sensory loads straining sl
mentation and requiring more dis
sitated robust sleep-wake regulatio
Our cross-cultural survey als mental niche for sleep that were co
from prevailing Western practice
rooming In line with the crossshy
1971) virtually all infants and mo
were provided with sleeping parI
sleep was an exception rather tha
ents and contraSts Western Inonshyglobalizing
historic
Western I
IS present absent
ments
don moderate-high low-minimal
ents extensive solitary llimited
extensive limited
heatcold stable
yes no
dynamic silent
dimldark darkdim
present minimal
minimal elaborate
rough smooth padded
lnsory variable stable
mal human active climate-control
e episodic erratic absent minimal
light)
Developmental Cultural Ecology ofSleep 173
areas ofcommonality along with diversity in the proximal conditions or
microecology under which people sleep and documented the pervasive effects ofsocial cultural and physical ecological factors or macroecology
on sleep patterns (Worthman amp Melby 2002)
Unexpectedly the comparative evidence flagged some characterisshy
tics of contemporary sleep ecology and practices as unusual (Table 81)
Across this small non-Western sample sleep settings were social and solshyitary sleep rare bedtimes fluid and napping common bedding minimal
fire present conditions dim or dark and relatively noisy with people
animals and little or no acoustic and physical barrier to ambient condishy
tions As such sleep settings offered riC and dynamic sensory properties
including security and comfort through social setting fuzzy boundaries
in time and space and little climate controL Postmodern industrial socishyeties by contrast appear to have relatively impoverished stable sensory
properties including solitary or low-contact sleep conditions scheduled
bedtimes and wake times with consolidated sleep padded bed and proshy
fuse bedding absence of fire darkness silence and high acoustic as well
as physical boundaries to sleep spaces Features ofthese much more static modernized sleep conditions that may make sleep regulation more
challenging include habitual solitary sleep or limited cosleep from
infancy onward a lie down and die model of sleep in restricted intershy
vals with few brief sleep-wake transitions and sensory deprivation of physical and social cues in sleep settingsAn untested question is whether
distinctively modernized habits and settings place high sustained burshy
dens on the development ofsleep-wake regulation systems and in turn contribute to contemporary sleep problems and disorders Conversely
another hypothesis might propose that traditional settings placed high sustained sensory loads straining sleep maintenance fostering sleep fragshy
mentation and requiring more distributed and variable sleep that necesshy
sitated robust sleep-wake regulation
Our cross-cultural survey also identified features of the developshymental niche for sleep that were common across the sample but distinctive
from prevailing Western practices First is extensive co-sleeping andshy
rooming In line with the cross-cultural evidence (Barry amp Paxson
1971) virtually all infants and most children in our sample normatively
were provided with sleeping partners from birth onward and solitary sleep was an exception rather than a rule Second as with adults fixed
174 Sleep and Development
bedtimes were absent for children daily routines were common but also
highly flexible As with adults sleep commonly occurred as needed
interspersed with ongoing quotidian affairs Thus for example young
children listen observe and may doze during family food preparation
and gossip or during evening parlays or rituals Third and related to the
absence of fixed bedtimes and the ability to accommodate individual
sleep needs around the clock we found no strong sense ofspecific stageshy
graded developmental needs for sleep Most societies surveyed regarded sleep not as a wholly distinct state but as a range of attentional states
situated along a spectrum graduated from here-and-now engagement
through somnolence to lightsleepto profound awaynessDevelopmental
goals commonly concerned socialization for appropriate sleep intensity
along an attentional spectrum for physical or spiritual safety in sleep
Fourth was the common importance of normative and moral frameshy
works that structure sleep For instance concerns for spiritual safety
mandated co-sleeping and socialization for light sleep in some societies including the Papua New Guinean Gebusi and Zairian LeseThese four
features of the developmental niche for sleep reflect cultural influences
grounded in shared models and schemas concerning sleep that will be
discussed in later sections of this chapter
Cultural Patterning of Sleep across the Life Course An Egyptian Case Study
Our initial cross-cultural analysis intrigued the sleep science community
Genni amp OConnor 200S and elicited cogent questions about generalizshy
ability to contemporary urban populations Our survey too had revealed
a need for studies ofsleep in the context ofeveryday activities and social
settings Consequendy we undertook a household-based study among
Egyptian families living at two sites Cairo or a densely setded agrarian
village Egypt holds one of the longest continuous records for urbanized
stratified cosmopolitan livilg has moderate to very high population densities and maintains the historic circum-Mediterranean tradition of
co-sleeping and bimodal sleep Study data included one week of conshytinuous activity records by all household members details of each sleep
event sleep history since birth and eth
(Worthman amp Brown 2007)
Qualitative evidence from intern
a strong customary preference for c as expectable protective comforting
tionships and family life (Worthman reported routine co-sleeping and brea
by co-sleeping in early childhood 1 co-sleeping or co-rooming through n as through adulthood All reported
and most endorsed its virtues even Customary practices of providing sle(
are constrained by rules of sexual prol reliably doing so for adolescents and
lished patterns of co-sleeping and co disrupted during adolescence and um was no age_and_gender-appropriate s1
Family activity records revealed tl of sleep per day but followed a patte
napping and habitual co-sleeping (We norms for sleep and sleeping arrang
pattern and amount across the life c(
hood of co-sleeping and relationship
gender of the sleeper Specifically ke night sleep arousals and total sleep) all ally moderated factors most particula
age and gender Family relationships flt most nighttime sleep events and a
involved co-sleeping Furthermore fe
itary without roommate or bed parm ner appeared to be more regular corr but not co-rooming was associated
night sleep shorter less variable lengl turbance represented by reported aro
Co-sleeping may qualify as the I
shared by partners of all ages and ge
ily routines were common but also p commonly occurred as needed
n affairs Thus for example young
lze during family food preparation or rituals Third and related to the
ability to accommodate individual
nd no strong sense of specific stageshy
p Most societies surveyed regarded but as a range of attentional states
i from here-and-now engagement
rofoundawaynessDevelopmental
~tion for appropriate sleep intensity
physical or spiritual safety in sleep
ce of normative and moral frameshy
tance concerns for spiritual safety ion for light sleep in some societies Gebusi and Zairian LeseThese four
for sleep reflect cultural influences
lemas concerning sleep that will be
lpter
cross the Life Course
rigued the sleep science community
ed cogent questions about generalizshytlations Our survey too had revealed
ltext of everyday activities and social
ok a household-based study among s Cairo or a densely settled agrarian
est continuous records for urbanized moderate to very high population
c circum-Mediterranean tradition of
dy data included one week of conshy
ehold members details of each sleep
Developmental Cultural Ecology of Sleep 17S
event sleep history since birth and ethnographic interviews about sleep (Worthman amp Brown 2007)
Qualitative evidence from interviews and sleep histories endorsed
a strong customary preference for co-sle~ing which was regarded as expectable protective comforting and integral to foundational relashy
tionships and family life (Worthman amp Brown 2007) All participants
reported routine co-sleeping and breastfeeding during infancy followed by co-sleeping in early childhood The great majority also reported
co-sleeping or co-rooming through middle and late childhood as well
as through adulthood All reported napping routinely earlier in life and most endorsed its virtues even if they rarely napped later on
Customary practices of providing sleep partners for persons of all ages
are constrained by rules ofsexual propriety that reduce the feasibility of
reliably doing so for adolescents and single young adults Hence estabshy
lished patterns of co-sleeping and co-rooming were most likely to be
disrupted during adolescence and unmarried young adulthood if there
was no age-and-gender-appropriate sleeping partner available
Family activity records revealed that participants averaged 84 hours of sleep per day but followed a pattern of bimodal sleep with daytime
napping and habitual co-sleeping (Worthman amp Brown 2007) Cultural
norms for sleep and sleeping arrangements strongly determined sleep pattern and amount across the life course such that age gender likelishy
hood of co-sleeping and relationship to co-sleeper varied with age and gender of the sleeper Specifically key features of sleep behavior (onset
night sleep arousals and total sleep) all were strongly predicted by culturshy
ally moderated factors most particularly bed-sharing habits followed by age and gender Family relationships formed the context for sleep Hence most nighttime sleep events and a near majority of afternoon naps
involved co-sleeping Furthermore few sleep events (one-fifth) were solshy
itary without roommate or bed partner In this setting sleep with a partshy
ner appeared to be more regular compact and undisturbed co-sleeping but not co-rooming was associated with earlier less variable onset of
night sleep shorter less variable length of nighttime sleep less sleep disshy
turbance represented by reported arousals and less total sleep per day Co-sleeping may qualify as the most intimate behavior that can be
shared by parmers of all ages and genders While sharing their sleeping
I76 Sleep and Development
hours co-sleepers in close body contact share space air warmth and
time (a third of the day) during a vital chronobiological period Such
shared experience creates a context for mutual regulation that also shapes
the developmental course of systems regulating arousal and affect
(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy
mental preclinical work Hofer (1978) early proposed that relationships
act as regulators that inform development and shape adult function
Subsequent research has borne out this prediction and revolutionized
understandings of the roles of early environment and epigenetics in the
process of development Work among rodents in particular has detailed
the impact of expectable environments of rearing and functioning parshy
ticularly maternal behavior and early postnatal conditions on organizashy
tion of arousal and affect regulation among many other systems (Szyf
McGowan amp Meaney 2008 Weaver 2007) Different developmental
periods thus present particular opportunities and vulnerabilities to conshy
textual cues that drive regulation of systems closely involved in sleep
(McKenna 2000)
In line with such views data from our family study in Egypt indicate
that co-sleeping habits directly influenced sleep budgets and sleep qualshy
ity and that interruption of these habits in adolescence and young adultshy
hood was associated with increased likelihood of sleep dysregulation and
disruption in males and females respectively But the data do not address
the logical questions of whether and how sleeping arrangements and
co-sleeping in particular influence the development ofsystems that regshy
ulate sleep and arousal (Thoman 2006) These compelling issues remain
open to empirical investigation inemerging comparative research on
sleep
Culture and Sleep Recent Directions
Research on sleep and human development in different settings is
expanding in two directionsone being documentation of sleep patterns
and related outcomes in increasing numbers of non-Western settings
another being the emergence ofcomparative cross-national cross-cultural
research The former is particularly valuable for drawing attention to
divergent as well as shared issues across contexts that vary by wealth and
Develo)
technology as well as other cultural factor
needed to characterize relationships of sle
niche to the formation of sleep-wake pat1
Culture Culture Change and Child Sleej
Globalization and the forces of rapid soc
developmental niche in many ways Thes
ules for new forms o(labor introductio
gies altered setdement patterns (particu
and shifts in family and household struc
tions likely has profound effects on sl
research on these concerns remains an
lifestyle furthermore impose different (
tion regulation that raise the stakes for
ing changes in the developmental niche
systems including sleep A major factor driving contempor
and activity is formal education By 20
schooling had progressed to the point
children and 78 of secondary sch
(Watkins 2008)This phenomenon has
(see also Wolfson and Richards chapt
mental factors that pose challenges for
must be present and alert during th(
school start times determine wake tim
will impair school performance For e
fIfth-grade Israeli students compared
to less sleep and greater daytime slee
concentrating regardless of hours slel
Schooling also makes children sede
linked to reduced sleep time and
Cameron Biddle Marshall amp Gorel
turbance in a multiethnic study ofAl
Chan amp Meininger 2002) School
families whose ability to meet tho
parent education and workloads 1
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
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Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
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Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
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Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
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Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
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child development and parenting Put
led to sleep can prove important for
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ative study ofsleep in human developshy
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lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
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Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
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Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
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Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
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Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
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1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
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lT Hamp Goh DYT (in press) Crossshy
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R Marshall S] amp GorelyT (2004)
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meier M (2002) Rethinking individushy
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-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
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doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
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Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
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Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
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DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
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9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
TABLE 81 Sleep ecology and settings elements and contrasts
Elements of sleep
ecology
Microecology
Proximate physical ecology
Bedding
Presence of fire Sleeping place or
structure
Proximate social ecology
Sleeping arrangements Separation ofsleepshy
wake states Biotic macro- and
micro-ecology Domestic animals
Parasites and nighttime pests
Macropredators
(animal human) Macroecology Labor demands Social activity
Ritual practices BeliefS about sleep and
dreaming Status (social status class
gender)
Life history lifespan processes
Ecology climate
Demography and
settlement patterns
Characteristics of nonshy Western sleep settings Western globalizing
historic
Security
risk from pathogens present absent predators elements enemies
Sensory stimulation sleeping arrangements
co-sleeping body contact thermal properties
use offire noise light
odors bedding
sleep surfaces and
bedding Variability of sensory
properties regulation ofthermal
conditions
disturbance (noise movement light)
moderate-high extensive
extensive heatcold yes
dynamic dimldark present minimal rough
variable
human active
episodic erratic
low-minimal
solitary limited
limited stable no
silent darkdim minimal elaborate smooth padded
stable
climate-control
absentIminiroal
areas ofcommonality along with di
microecology under which people
effects ofsocial cultural and physic
on sleep patterns (Worthman amp M
Unexpectedly the comparativ(
tics of contemporary sleep ecology
Across this small non-Western sam]
itary sleep rare bedtimes fluid and
fire present conditions dim or da
animals and little or no acoustic ar
tiollSAs such sleep settings offered
including security and comfort thr
in time and space and little climate
eties by contrast appear to have r
properties including solitary or lov
bedtimes and wake times with cor
fuse bedding absence of fire darb as physical boundaries to sleep spac
modernized sleep conditions tl
challenging include habitual soli
infancy onward a lie down and d
vals with few brief sleep-wake tr
physical and social cues in sleep set
distinctively modernized habits
dens on the development of sleepshy
contribute to contemporary sleeF
another hypothesis might propose
sustained sensory loads straining sl
mentation and requiring more dis
sitated robust sleep-wake regulatio
Our cross-cultural survey als mental niche for sleep that were co
from prevailing Western practice
rooming In line with the crossshy
1971) virtually all infants and mo
were provided with sleeping parI
sleep was an exception rather tha
ents and contraSts Western Inonshyglobalizing
historic
Western I
IS present absent
ments
don moderate-high low-minimal
ents extensive solitary llimited
extensive limited
heatcold stable
yes no
dynamic silent
dimldark darkdim
present minimal
minimal elaborate
rough smooth padded
lnsory variable stable
mal human active climate-control
e episodic erratic absent minimal
light)
Developmental Cultural Ecology ofSleep 173
areas ofcommonality along with diversity in the proximal conditions or
microecology under which people sleep and documented the pervasive effects ofsocial cultural and physical ecological factors or macroecology
on sleep patterns (Worthman amp Melby 2002)
Unexpectedly the comparative evidence flagged some characterisshy
tics of contemporary sleep ecology and practices as unusual (Table 81)
Across this small non-Western sample sleep settings were social and solshyitary sleep rare bedtimes fluid and napping common bedding minimal
fire present conditions dim or dark and relatively noisy with people
animals and little or no acoustic and physical barrier to ambient condishy
tions As such sleep settings offered riC and dynamic sensory properties
including security and comfort through social setting fuzzy boundaries
in time and space and little climate controL Postmodern industrial socishyeties by contrast appear to have relatively impoverished stable sensory
properties including solitary or low-contact sleep conditions scheduled
bedtimes and wake times with consolidated sleep padded bed and proshy
fuse bedding absence of fire darkness silence and high acoustic as well
as physical boundaries to sleep spaces Features ofthese much more static modernized sleep conditions that may make sleep regulation more
challenging include habitual solitary sleep or limited cosleep from
infancy onward a lie down and die model of sleep in restricted intershy
vals with few brief sleep-wake transitions and sensory deprivation of physical and social cues in sleep settingsAn untested question is whether
distinctively modernized habits and settings place high sustained burshy
dens on the development ofsleep-wake regulation systems and in turn contribute to contemporary sleep problems and disorders Conversely
another hypothesis might propose that traditional settings placed high sustained sensory loads straining sleep maintenance fostering sleep fragshy
mentation and requiring more distributed and variable sleep that necesshy
sitated robust sleep-wake regulation
Our cross-cultural survey also identified features of the developshymental niche for sleep that were common across the sample but distinctive
from prevailing Western practices First is extensive co-sleeping andshy
rooming In line with the cross-cultural evidence (Barry amp Paxson
1971) virtually all infants and most children in our sample normatively
were provided with sleeping partners from birth onward and solitary sleep was an exception rather than a rule Second as with adults fixed
174 Sleep and Development
bedtimes were absent for children daily routines were common but also
highly flexible As with adults sleep commonly occurred as needed
interspersed with ongoing quotidian affairs Thus for example young
children listen observe and may doze during family food preparation
and gossip or during evening parlays or rituals Third and related to the
absence of fixed bedtimes and the ability to accommodate individual
sleep needs around the clock we found no strong sense ofspecific stageshy
graded developmental needs for sleep Most societies surveyed regarded sleep not as a wholly distinct state but as a range of attentional states
situated along a spectrum graduated from here-and-now engagement
through somnolence to lightsleepto profound awaynessDevelopmental
goals commonly concerned socialization for appropriate sleep intensity
along an attentional spectrum for physical or spiritual safety in sleep
Fourth was the common importance of normative and moral frameshy
works that structure sleep For instance concerns for spiritual safety
mandated co-sleeping and socialization for light sleep in some societies including the Papua New Guinean Gebusi and Zairian LeseThese four
features of the developmental niche for sleep reflect cultural influences
grounded in shared models and schemas concerning sleep that will be
discussed in later sections of this chapter
Cultural Patterning of Sleep across the Life Course An Egyptian Case Study
Our initial cross-cultural analysis intrigued the sleep science community
Genni amp OConnor 200S and elicited cogent questions about generalizshy
ability to contemporary urban populations Our survey too had revealed
a need for studies ofsleep in the context ofeveryday activities and social
settings Consequendy we undertook a household-based study among
Egyptian families living at two sites Cairo or a densely setded agrarian
village Egypt holds one of the longest continuous records for urbanized
stratified cosmopolitan livilg has moderate to very high population densities and maintains the historic circum-Mediterranean tradition of
co-sleeping and bimodal sleep Study data included one week of conshytinuous activity records by all household members details of each sleep
event sleep history since birth and eth
(Worthman amp Brown 2007)
Qualitative evidence from intern
a strong customary preference for c as expectable protective comforting
tionships and family life (Worthman reported routine co-sleeping and brea
by co-sleeping in early childhood 1 co-sleeping or co-rooming through n as through adulthood All reported
and most endorsed its virtues even Customary practices of providing sle(
are constrained by rules of sexual prol reliably doing so for adolescents and
lished patterns of co-sleeping and co disrupted during adolescence and um was no age_and_gender-appropriate s1
Family activity records revealed tl of sleep per day but followed a patte
napping and habitual co-sleeping (We norms for sleep and sleeping arrang
pattern and amount across the life c(
hood of co-sleeping and relationship
gender of the sleeper Specifically ke night sleep arousals and total sleep) all ally moderated factors most particula
age and gender Family relationships flt most nighttime sleep events and a
involved co-sleeping Furthermore fe
itary without roommate or bed parm ner appeared to be more regular corr but not co-rooming was associated
night sleep shorter less variable lengl turbance represented by reported aro
Co-sleeping may qualify as the I
shared by partners of all ages and ge
ily routines were common but also p commonly occurred as needed
n affairs Thus for example young
lze during family food preparation or rituals Third and related to the
ability to accommodate individual
nd no strong sense of specific stageshy
p Most societies surveyed regarded but as a range of attentional states
i from here-and-now engagement
rofoundawaynessDevelopmental
~tion for appropriate sleep intensity
physical or spiritual safety in sleep
ce of normative and moral frameshy
tance concerns for spiritual safety ion for light sleep in some societies Gebusi and Zairian LeseThese four
for sleep reflect cultural influences
lemas concerning sleep that will be
lpter
cross the Life Course
rigued the sleep science community
ed cogent questions about generalizshytlations Our survey too had revealed
ltext of everyday activities and social
ok a household-based study among s Cairo or a densely settled agrarian
est continuous records for urbanized moderate to very high population
c circum-Mediterranean tradition of
dy data included one week of conshy
ehold members details of each sleep
Developmental Cultural Ecology of Sleep 17S
event sleep history since birth and ethnographic interviews about sleep (Worthman amp Brown 2007)
Qualitative evidence from interviews and sleep histories endorsed
a strong customary preference for co-sle~ing which was regarded as expectable protective comforting and integral to foundational relashy
tionships and family life (Worthman amp Brown 2007) All participants
reported routine co-sleeping and breastfeeding during infancy followed by co-sleeping in early childhood The great majority also reported
co-sleeping or co-rooming through middle and late childhood as well
as through adulthood All reported napping routinely earlier in life and most endorsed its virtues even if they rarely napped later on
Customary practices of providing sleep partners for persons of all ages
are constrained by rules ofsexual propriety that reduce the feasibility of
reliably doing so for adolescents and single young adults Hence estabshy
lished patterns of co-sleeping and co-rooming were most likely to be
disrupted during adolescence and unmarried young adulthood if there
was no age-and-gender-appropriate sleeping partner available
Family activity records revealed that participants averaged 84 hours of sleep per day but followed a pattern of bimodal sleep with daytime
napping and habitual co-sleeping (Worthman amp Brown 2007) Cultural
norms for sleep and sleeping arrangements strongly determined sleep pattern and amount across the life course such that age gender likelishy
hood of co-sleeping and relationship to co-sleeper varied with age and gender of the sleeper Specifically key features of sleep behavior (onset
night sleep arousals and total sleep) all were strongly predicted by culturshy
ally moderated factors most particularly bed-sharing habits followed by age and gender Family relationships formed the context for sleep Hence most nighttime sleep events and a near majority of afternoon naps
involved co-sleeping Furthermore few sleep events (one-fifth) were solshy
itary without roommate or bed partner In this setting sleep with a partshy
ner appeared to be more regular compact and undisturbed co-sleeping but not co-rooming was associated with earlier less variable onset of
night sleep shorter less variable length of nighttime sleep less sleep disshy
turbance represented by reported arousals and less total sleep per day Co-sleeping may qualify as the most intimate behavior that can be
shared by parmers of all ages and genders While sharing their sleeping
I76 Sleep and Development
hours co-sleepers in close body contact share space air warmth and
time (a third of the day) during a vital chronobiological period Such
shared experience creates a context for mutual regulation that also shapes
the developmental course of systems regulating arousal and affect
(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy
mental preclinical work Hofer (1978) early proposed that relationships
act as regulators that inform development and shape adult function
Subsequent research has borne out this prediction and revolutionized
understandings of the roles of early environment and epigenetics in the
process of development Work among rodents in particular has detailed
the impact of expectable environments of rearing and functioning parshy
ticularly maternal behavior and early postnatal conditions on organizashy
tion of arousal and affect regulation among many other systems (Szyf
McGowan amp Meaney 2008 Weaver 2007) Different developmental
periods thus present particular opportunities and vulnerabilities to conshy
textual cues that drive regulation of systems closely involved in sleep
(McKenna 2000)
In line with such views data from our family study in Egypt indicate
that co-sleeping habits directly influenced sleep budgets and sleep qualshy
ity and that interruption of these habits in adolescence and young adultshy
hood was associated with increased likelihood of sleep dysregulation and
disruption in males and females respectively But the data do not address
the logical questions of whether and how sleeping arrangements and
co-sleeping in particular influence the development ofsystems that regshy
ulate sleep and arousal (Thoman 2006) These compelling issues remain
open to empirical investigation inemerging comparative research on
sleep
Culture and Sleep Recent Directions
Research on sleep and human development in different settings is
expanding in two directionsone being documentation of sleep patterns
and related outcomes in increasing numbers of non-Western settings
another being the emergence ofcomparative cross-national cross-cultural
research The former is particularly valuable for drawing attention to
divergent as well as shared issues across contexts that vary by wealth and
Develo)
technology as well as other cultural factor
needed to characterize relationships of sle
niche to the formation of sleep-wake pat1
Culture Culture Change and Child Sleej
Globalization and the forces of rapid soc
developmental niche in many ways Thes
ules for new forms o(labor introductio
gies altered setdement patterns (particu
and shifts in family and household struc
tions likely has profound effects on sl
research on these concerns remains an
lifestyle furthermore impose different (
tion regulation that raise the stakes for
ing changes in the developmental niche
systems including sleep A major factor driving contempor
and activity is formal education By 20
schooling had progressed to the point
children and 78 of secondary sch
(Watkins 2008)This phenomenon has
(see also Wolfson and Richards chapt
mental factors that pose challenges for
must be present and alert during th(
school start times determine wake tim
will impair school performance For e
fIfth-grade Israeli students compared
to less sleep and greater daytime slee
concentrating regardless of hours slel
Schooling also makes children sede
linked to reduced sleep time and
Cameron Biddle Marshall amp Gorel
turbance in a multiethnic study ofAl
Chan amp Meininger 2002) School
families whose ability to meet tho
parent education and workloads 1
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
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Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
ents and contraSts Western Inonshyglobalizing
historic
Western I
IS present absent
ments
don moderate-high low-minimal
ents extensive solitary llimited
extensive limited
heatcold stable
yes no
dynamic silent
dimldark darkdim
present minimal
minimal elaborate
rough smooth padded
lnsory variable stable
mal human active climate-control
e episodic erratic absent minimal
light)
Developmental Cultural Ecology ofSleep 173
areas ofcommonality along with diversity in the proximal conditions or
microecology under which people sleep and documented the pervasive effects ofsocial cultural and physical ecological factors or macroecology
on sleep patterns (Worthman amp Melby 2002)
Unexpectedly the comparative evidence flagged some characterisshy
tics of contemporary sleep ecology and practices as unusual (Table 81)
Across this small non-Western sample sleep settings were social and solshyitary sleep rare bedtimes fluid and napping common bedding minimal
fire present conditions dim or dark and relatively noisy with people
animals and little or no acoustic and physical barrier to ambient condishy
tions As such sleep settings offered riC and dynamic sensory properties
including security and comfort through social setting fuzzy boundaries
in time and space and little climate controL Postmodern industrial socishyeties by contrast appear to have relatively impoverished stable sensory
properties including solitary or low-contact sleep conditions scheduled
bedtimes and wake times with consolidated sleep padded bed and proshy
fuse bedding absence of fire darkness silence and high acoustic as well
as physical boundaries to sleep spaces Features ofthese much more static modernized sleep conditions that may make sleep regulation more
challenging include habitual solitary sleep or limited cosleep from
infancy onward a lie down and die model of sleep in restricted intershy
vals with few brief sleep-wake transitions and sensory deprivation of physical and social cues in sleep settingsAn untested question is whether
distinctively modernized habits and settings place high sustained burshy
dens on the development ofsleep-wake regulation systems and in turn contribute to contemporary sleep problems and disorders Conversely
another hypothesis might propose that traditional settings placed high sustained sensory loads straining sleep maintenance fostering sleep fragshy
mentation and requiring more distributed and variable sleep that necesshy
sitated robust sleep-wake regulation
Our cross-cultural survey also identified features of the developshymental niche for sleep that were common across the sample but distinctive
from prevailing Western practices First is extensive co-sleeping andshy
rooming In line with the cross-cultural evidence (Barry amp Paxson
1971) virtually all infants and most children in our sample normatively
were provided with sleeping partners from birth onward and solitary sleep was an exception rather than a rule Second as with adults fixed
174 Sleep and Development
bedtimes were absent for children daily routines were common but also
highly flexible As with adults sleep commonly occurred as needed
interspersed with ongoing quotidian affairs Thus for example young
children listen observe and may doze during family food preparation
and gossip or during evening parlays or rituals Third and related to the
absence of fixed bedtimes and the ability to accommodate individual
sleep needs around the clock we found no strong sense ofspecific stageshy
graded developmental needs for sleep Most societies surveyed regarded sleep not as a wholly distinct state but as a range of attentional states
situated along a spectrum graduated from here-and-now engagement
through somnolence to lightsleepto profound awaynessDevelopmental
goals commonly concerned socialization for appropriate sleep intensity
along an attentional spectrum for physical or spiritual safety in sleep
Fourth was the common importance of normative and moral frameshy
works that structure sleep For instance concerns for spiritual safety
mandated co-sleeping and socialization for light sleep in some societies including the Papua New Guinean Gebusi and Zairian LeseThese four
features of the developmental niche for sleep reflect cultural influences
grounded in shared models and schemas concerning sleep that will be
discussed in later sections of this chapter
Cultural Patterning of Sleep across the Life Course An Egyptian Case Study
Our initial cross-cultural analysis intrigued the sleep science community
Genni amp OConnor 200S and elicited cogent questions about generalizshy
ability to contemporary urban populations Our survey too had revealed
a need for studies ofsleep in the context ofeveryday activities and social
settings Consequendy we undertook a household-based study among
Egyptian families living at two sites Cairo or a densely setded agrarian
village Egypt holds one of the longest continuous records for urbanized
stratified cosmopolitan livilg has moderate to very high population densities and maintains the historic circum-Mediterranean tradition of
co-sleeping and bimodal sleep Study data included one week of conshytinuous activity records by all household members details of each sleep
event sleep history since birth and eth
(Worthman amp Brown 2007)
Qualitative evidence from intern
a strong customary preference for c as expectable protective comforting
tionships and family life (Worthman reported routine co-sleeping and brea
by co-sleeping in early childhood 1 co-sleeping or co-rooming through n as through adulthood All reported
and most endorsed its virtues even Customary practices of providing sle(
are constrained by rules of sexual prol reliably doing so for adolescents and
lished patterns of co-sleeping and co disrupted during adolescence and um was no age_and_gender-appropriate s1
Family activity records revealed tl of sleep per day but followed a patte
napping and habitual co-sleeping (We norms for sleep and sleeping arrang
pattern and amount across the life c(
hood of co-sleeping and relationship
gender of the sleeper Specifically ke night sleep arousals and total sleep) all ally moderated factors most particula
age and gender Family relationships flt most nighttime sleep events and a
involved co-sleeping Furthermore fe
itary without roommate or bed parm ner appeared to be more regular corr but not co-rooming was associated
night sleep shorter less variable lengl turbance represented by reported aro
Co-sleeping may qualify as the I
shared by partners of all ages and ge
ily routines were common but also p commonly occurred as needed
n affairs Thus for example young
lze during family food preparation or rituals Third and related to the
ability to accommodate individual
nd no strong sense of specific stageshy
p Most societies surveyed regarded but as a range of attentional states
i from here-and-now engagement
rofoundawaynessDevelopmental
~tion for appropriate sleep intensity
physical or spiritual safety in sleep
ce of normative and moral frameshy
tance concerns for spiritual safety ion for light sleep in some societies Gebusi and Zairian LeseThese four
for sleep reflect cultural influences
lemas concerning sleep that will be
lpter
cross the Life Course
rigued the sleep science community
ed cogent questions about generalizshytlations Our survey too had revealed
ltext of everyday activities and social
ok a household-based study among s Cairo or a densely settled agrarian
est continuous records for urbanized moderate to very high population
c circum-Mediterranean tradition of
dy data included one week of conshy
ehold members details of each sleep
Developmental Cultural Ecology of Sleep 17S
event sleep history since birth and ethnographic interviews about sleep (Worthman amp Brown 2007)
Qualitative evidence from interviews and sleep histories endorsed
a strong customary preference for co-sle~ing which was regarded as expectable protective comforting and integral to foundational relashy
tionships and family life (Worthman amp Brown 2007) All participants
reported routine co-sleeping and breastfeeding during infancy followed by co-sleeping in early childhood The great majority also reported
co-sleeping or co-rooming through middle and late childhood as well
as through adulthood All reported napping routinely earlier in life and most endorsed its virtues even if they rarely napped later on
Customary practices of providing sleep partners for persons of all ages
are constrained by rules ofsexual propriety that reduce the feasibility of
reliably doing so for adolescents and single young adults Hence estabshy
lished patterns of co-sleeping and co-rooming were most likely to be
disrupted during adolescence and unmarried young adulthood if there
was no age-and-gender-appropriate sleeping partner available
Family activity records revealed that participants averaged 84 hours of sleep per day but followed a pattern of bimodal sleep with daytime
napping and habitual co-sleeping (Worthman amp Brown 2007) Cultural
norms for sleep and sleeping arrangements strongly determined sleep pattern and amount across the life course such that age gender likelishy
hood of co-sleeping and relationship to co-sleeper varied with age and gender of the sleeper Specifically key features of sleep behavior (onset
night sleep arousals and total sleep) all were strongly predicted by culturshy
ally moderated factors most particularly bed-sharing habits followed by age and gender Family relationships formed the context for sleep Hence most nighttime sleep events and a near majority of afternoon naps
involved co-sleeping Furthermore few sleep events (one-fifth) were solshy
itary without roommate or bed partner In this setting sleep with a partshy
ner appeared to be more regular compact and undisturbed co-sleeping but not co-rooming was associated with earlier less variable onset of
night sleep shorter less variable length of nighttime sleep less sleep disshy
turbance represented by reported arousals and less total sleep per day Co-sleeping may qualify as the most intimate behavior that can be
shared by parmers of all ages and genders While sharing their sleeping
I76 Sleep and Development
hours co-sleepers in close body contact share space air warmth and
time (a third of the day) during a vital chronobiological period Such
shared experience creates a context for mutual regulation that also shapes
the developmental course of systems regulating arousal and affect
(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy
mental preclinical work Hofer (1978) early proposed that relationships
act as regulators that inform development and shape adult function
Subsequent research has borne out this prediction and revolutionized
understandings of the roles of early environment and epigenetics in the
process of development Work among rodents in particular has detailed
the impact of expectable environments of rearing and functioning parshy
ticularly maternal behavior and early postnatal conditions on organizashy
tion of arousal and affect regulation among many other systems (Szyf
McGowan amp Meaney 2008 Weaver 2007) Different developmental
periods thus present particular opportunities and vulnerabilities to conshy
textual cues that drive regulation of systems closely involved in sleep
(McKenna 2000)
In line with such views data from our family study in Egypt indicate
that co-sleeping habits directly influenced sleep budgets and sleep qualshy
ity and that interruption of these habits in adolescence and young adultshy
hood was associated with increased likelihood of sleep dysregulation and
disruption in males and females respectively But the data do not address
the logical questions of whether and how sleeping arrangements and
co-sleeping in particular influence the development ofsystems that regshy
ulate sleep and arousal (Thoman 2006) These compelling issues remain
open to empirical investigation inemerging comparative research on
sleep
Culture and Sleep Recent Directions
Research on sleep and human development in different settings is
expanding in two directionsone being documentation of sleep patterns
and related outcomes in increasing numbers of non-Western settings
another being the emergence ofcomparative cross-national cross-cultural
research The former is particularly valuable for drawing attention to
divergent as well as shared issues across contexts that vary by wealth and
Develo)
technology as well as other cultural factor
needed to characterize relationships of sle
niche to the formation of sleep-wake pat1
Culture Culture Change and Child Sleej
Globalization and the forces of rapid soc
developmental niche in many ways Thes
ules for new forms o(labor introductio
gies altered setdement patterns (particu
and shifts in family and household struc
tions likely has profound effects on sl
research on these concerns remains an
lifestyle furthermore impose different (
tion regulation that raise the stakes for
ing changes in the developmental niche
systems including sleep A major factor driving contempor
and activity is formal education By 20
schooling had progressed to the point
children and 78 of secondary sch
(Watkins 2008)This phenomenon has
(see also Wolfson and Richards chapt
mental factors that pose challenges for
must be present and alert during th(
school start times determine wake tim
will impair school performance For e
fIfth-grade Israeli students compared
to less sleep and greater daytime slee
concentrating regardless of hours slel
Schooling also makes children sede
linked to reduced sleep time and
Cameron Biddle Marshall amp Gorel
turbance in a multiethnic study ofAl
Chan amp Meininger 2002) School
families whose ability to meet tho
parent education and workloads 1
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
174 Sleep and Development
bedtimes were absent for children daily routines were common but also
highly flexible As with adults sleep commonly occurred as needed
interspersed with ongoing quotidian affairs Thus for example young
children listen observe and may doze during family food preparation
and gossip or during evening parlays or rituals Third and related to the
absence of fixed bedtimes and the ability to accommodate individual
sleep needs around the clock we found no strong sense ofspecific stageshy
graded developmental needs for sleep Most societies surveyed regarded sleep not as a wholly distinct state but as a range of attentional states
situated along a spectrum graduated from here-and-now engagement
through somnolence to lightsleepto profound awaynessDevelopmental
goals commonly concerned socialization for appropriate sleep intensity
along an attentional spectrum for physical or spiritual safety in sleep
Fourth was the common importance of normative and moral frameshy
works that structure sleep For instance concerns for spiritual safety
mandated co-sleeping and socialization for light sleep in some societies including the Papua New Guinean Gebusi and Zairian LeseThese four
features of the developmental niche for sleep reflect cultural influences
grounded in shared models and schemas concerning sleep that will be
discussed in later sections of this chapter
Cultural Patterning of Sleep across the Life Course An Egyptian Case Study
Our initial cross-cultural analysis intrigued the sleep science community
Genni amp OConnor 200S and elicited cogent questions about generalizshy
ability to contemporary urban populations Our survey too had revealed
a need for studies ofsleep in the context ofeveryday activities and social
settings Consequendy we undertook a household-based study among
Egyptian families living at two sites Cairo or a densely setded agrarian
village Egypt holds one of the longest continuous records for urbanized
stratified cosmopolitan livilg has moderate to very high population densities and maintains the historic circum-Mediterranean tradition of
co-sleeping and bimodal sleep Study data included one week of conshytinuous activity records by all household members details of each sleep
event sleep history since birth and eth
(Worthman amp Brown 2007)
Qualitative evidence from intern
a strong customary preference for c as expectable protective comforting
tionships and family life (Worthman reported routine co-sleeping and brea
by co-sleeping in early childhood 1 co-sleeping or co-rooming through n as through adulthood All reported
and most endorsed its virtues even Customary practices of providing sle(
are constrained by rules of sexual prol reliably doing so for adolescents and
lished patterns of co-sleeping and co disrupted during adolescence and um was no age_and_gender-appropriate s1
Family activity records revealed tl of sleep per day but followed a patte
napping and habitual co-sleeping (We norms for sleep and sleeping arrang
pattern and amount across the life c(
hood of co-sleeping and relationship
gender of the sleeper Specifically ke night sleep arousals and total sleep) all ally moderated factors most particula
age and gender Family relationships flt most nighttime sleep events and a
involved co-sleeping Furthermore fe
itary without roommate or bed parm ner appeared to be more regular corr but not co-rooming was associated
night sleep shorter less variable lengl turbance represented by reported aro
Co-sleeping may qualify as the I
shared by partners of all ages and ge
ily routines were common but also p commonly occurred as needed
n affairs Thus for example young
lze during family food preparation or rituals Third and related to the
ability to accommodate individual
nd no strong sense of specific stageshy
p Most societies surveyed regarded but as a range of attentional states
i from here-and-now engagement
rofoundawaynessDevelopmental
~tion for appropriate sleep intensity
physical or spiritual safety in sleep
ce of normative and moral frameshy
tance concerns for spiritual safety ion for light sleep in some societies Gebusi and Zairian LeseThese four
for sleep reflect cultural influences
lemas concerning sleep that will be
lpter
cross the Life Course
rigued the sleep science community
ed cogent questions about generalizshytlations Our survey too had revealed
ltext of everyday activities and social
ok a household-based study among s Cairo or a densely settled agrarian
est continuous records for urbanized moderate to very high population
c circum-Mediterranean tradition of
dy data included one week of conshy
ehold members details of each sleep
Developmental Cultural Ecology of Sleep 17S
event sleep history since birth and ethnographic interviews about sleep (Worthman amp Brown 2007)
Qualitative evidence from interviews and sleep histories endorsed
a strong customary preference for co-sle~ing which was regarded as expectable protective comforting and integral to foundational relashy
tionships and family life (Worthman amp Brown 2007) All participants
reported routine co-sleeping and breastfeeding during infancy followed by co-sleeping in early childhood The great majority also reported
co-sleeping or co-rooming through middle and late childhood as well
as through adulthood All reported napping routinely earlier in life and most endorsed its virtues even if they rarely napped later on
Customary practices of providing sleep partners for persons of all ages
are constrained by rules ofsexual propriety that reduce the feasibility of
reliably doing so for adolescents and single young adults Hence estabshy
lished patterns of co-sleeping and co-rooming were most likely to be
disrupted during adolescence and unmarried young adulthood if there
was no age-and-gender-appropriate sleeping partner available
Family activity records revealed that participants averaged 84 hours of sleep per day but followed a pattern of bimodal sleep with daytime
napping and habitual co-sleeping (Worthman amp Brown 2007) Cultural
norms for sleep and sleeping arrangements strongly determined sleep pattern and amount across the life course such that age gender likelishy
hood of co-sleeping and relationship to co-sleeper varied with age and gender of the sleeper Specifically key features of sleep behavior (onset
night sleep arousals and total sleep) all were strongly predicted by culturshy
ally moderated factors most particularly bed-sharing habits followed by age and gender Family relationships formed the context for sleep Hence most nighttime sleep events and a near majority of afternoon naps
involved co-sleeping Furthermore few sleep events (one-fifth) were solshy
itary without roommate or bed partner In this setting sleep with a partshy
ner appeared to be more regular compact and undisturbed co-sleeping but not co-rooming was associated with earlier less variable onset of
night sleep shorter less variable length of nighttime sleep less sleep disshy
turbance represented by reported arousals and less total sleep per day Co-sleeping may qualify as the most intimate behavior that can be
shared by parmers of all ages and genders While sharing their sleeping
I76 Sleep and Development
hours co-sleepers in close body contact share space air warmth and
time (a third of the day) during a vital chronobiological period Such
shared experience creates a context for mutual regulation that also shapes
the developmental course of systems regulating arousal and affect
(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy
mental preclinical work Hofer (1978) early proposed that relationships
act as regulators that inform development and shape adult function
Subsequent research has borne out this prediction and revolutionized
understandings of the roles of early environment and epigenetics in the
process of development Work among rodents in particular has detailed
the impact of expectable environments of rearing and functioning parshy
ticularly maternal behavior and early postnatal conditions on organizashy
tion of arousal and affect regulation among many other systems (Szyf
McGowan amp Meaney 2008 Weaver 2007) Different developmental
periods thus present particular opportunities and vulnerabilities to conshy
textual cues that drive regulation of systems closely involved in sleep
(McKenna 2000)
In line with such views data from our family study in Egypt indicate
that co-sleeping habits directly influenced sleep budgets and sleep qualshy
ity and that interruption of these habits in adolescence and young adultshy
hood was associated with increased likelihood of sleep dysregulation and
disruption in males and females respectively But the data do not address
the logical questions of whether and how sleeping arrangements and
co-sleeping in particular influence the development ofsystems that regshy
ulate sleep and arousal (Thoman 2006) These compelling issues remain
open to empirical investigation inemerging comparative research on
sleep
Culture and Sleep Recent Directions
Research on sleep and human development in different settings is
expanding in two directionsone being documentation of sleep patterns
and related outcomes in increasing numbers of non-Western settings
another being the emergence ofcomparative cross-national cross-cultural
research The former is particularly valuable for drawing attention to
divergent as well as shared issues across contexts that vary by wealth and
Develo)
technology as well as other cultural factor
needed to characterize relationships of sle
niche to the formation of sleep-wake pat1
Culture Culture Change and Child Sleej
Globalization and the forces of rapid soc
developmental niche in many ways Thes
ules for new forms o(labor introductio
gies altered setdement patterns (particu
and shifts in family and household struc
tions likely has profound effects on sl
research on these concerns remains an
lifestyle furthermore impose different (
tion regulation that raise the stakes for
ing changes in the developmental niche
systems including sleep A major factor driving contempor
and activity is formal education By 20
schooling had progressed to the point
children and 78 of secondary sch
(Watkins 2008)This phenomenon has
(see also Wolfson and Richards chapt
mental factors that pose challenges for
must be present and alert during th(
school start times determine wake tim
will impair school performance For e
fIfth-grade Israeli students compared
to less sleep and greater daytime slee
concentrating regardless of hours slel
Schooling also makes children sede
linked to reduced sleep time and
Cameron Biddle Marshall amp Gorel
turbance in a multiethnic study ofAl
Chan amp Meininger 2002) School
families whose ability to meet tho
parent education and workloads 1
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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BaHammam A Bin Saeed A AI-Faris E amp Shaikh S (2006) Sleep duration and its correlates in a sample ofSaudi elementary school children Singapore Medicaljoumal 47875-881
BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23
Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
cardiovascular regulation at school ent
Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
ily routines were common but also p commonly occurred as needed
n affairs Thus for example young
lze during family food preparation or rituals Third and related to the
ability to accommodate individual
nd no strong sense of specific stageshy
p Most societies surveyed regarded but as a range of attentional states
i from here-and-now engagement
rofoundawaynessDevelopmental
~tion for appropriate sleep intensity
physical or spiritual safety in sleep
ce of normative and moral frameshy
tance concerns for spiritual safety ion for light sleep in some societies Gebusi and Zairian LeseThese four
for sleep reflect cultural influences
lemas concerning sleep that will be
lpter
cross the Life Course
rigued the sleep science community
ed cogent questions about generalizshytlations Our survey too had revealed
ltext of everyday activities and social
ok a household-based study among s Cairo or a densely settled agrarian
est continuous records for urbanized moderate to very high population
c circum-Mediterranean tradition of
dy data included one week of conshy
ehold members details of each sleep
Developmental Cultural Ecology of Sleep 17S
event sleep history since birth and ethnographic interviews about sleep (Worthman amp Brown 2007)
Qualitative evidence from interviews and sleep histories endorsed
a strong customary preference for co-sle~ing which was regarded as expectable protective comforting and integral to foundational relashy
tionships and family life (Worthman amp Brown 2007) All participants
reported routine co-sleeping and breastfeeding during infancy followed by co-sleeping in early childhood The great majority also reported
co-sleeping or co-rooming through middle and late childhood as well
as through adulthood All reported napping routinely earlier in life and most endorsed its virtues even if they rarely napped later on
Customary practices of providing sleep partners for persons of all ages
are constrained by rules ofsexual propriety that reduce the feasibility of
reliably doing so for adolescents and single young adults Hence estabshy
lished patterns of co-sleeping and co-rooming were most likely to be
disrupted during adolescence and unmarried young adulthood if there
was no age-and-gender-appropriate sleeping partner available
Family activity records revealed that participants averaged 84 hours of sleep per day but followed a pattern of bimodal sleep with daytime
napping and habitual co-sleeping (Worthman amp Brown 2007) Cultural
norms for sleep and sleeping arrangements strongly determined sleep pattern and amount across the life course such that age gender likelishy
hood of co-sleeping and relationship to co-sleeper varied with age and gender of the sleeper Specifically key features of sleep behavior (onset
night sleep arousals and total sleep) all were strongly predicted by culturshy
ally moderated factors most particularly bed-sharing habits followed by age and gender Family relationships formed the context for sleep Hence most nighttime sleep events and a near majority of afternoon naps
involved co-sleeping Furthermore few sleep events (one-fifth) were solshy
itary without roommate or bed partner In this setting sleep with a partshy
ner appeared to be more regular compact and undisturbed co-sleeping but not co-rooming was associated with earlier less variable onset of
night sleep shorter less variable length of nighttime sleep less sleep disshy
turbance represented by reported arousals and less total sleep per day Co-sleeping may qualify as the most intimate behavior that can be
shared by parmers of all ages and genders While sharing their sleeping
I76 Sleep and Development
hours co-sleepers in close body contact share space air warmth and
time (a third of the day) during a vital chronobiological period Such
shared experience creates a context for mutual regulation that also shapes
the developmental course of systems regulating arousal and affect
(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy
mental preclinical work Hofer (1978) early proposed that relationships
act as regulators that inform development and shape adult function
Subsequent research has borne out this prediction and revolutionized
understandings of the roles of early environment and epigenetics in the
process of development Work among rodents in particular has detailed
the impact of expectable environments of rearing and functioning parshy
ticularly maternal behavior and early postnatal conditions on organizashy
tion of arousal and affect regulation among many other systems (Szyf
McGowan amp Meaney 2008 Weaver 2007) Different developmental
periods thus present particular opportunities and vulnerabilities to conshy
textual cues that drive regulation of systems closely involved in sleep
(McKenna 2000)
In line with such views data from our family study in Egypt indicate
that co-sleeping habits directly influenced sleep budgets and sleep qualshy
ity and that interruption of these habits in adolescence and young adultshy
hood was associated with increased likelihood of sleep dysregulation and
disruption in males and females respectively But the data do not address
the logical questions of whether and how sleeping arrangements and
co-sleeping in particular influence the development ofsystems that regshy
ulate sleep and arousal (Thoman 2006) These compelling issues remain
open to empirical investigation inemerging comparative research on
sleep
Culture and Sleep Recent Directions
Research on sleep and human development in different settings is
expanding in two directionsone being documentation of sleep patterns
and related outcomes in increasing numbers of non-Western settings
another being the emergence ofcomparative cross-national cross-cultural
research The former is particularly valuable for drawing attention to
divergent as well as shared issues across contexts that vary by wealth and
Develo)
technology as well as other cultural factor
needed to characterize relationships of sle
niche to the formation of sleep-wake pat1
Culture Culture Change and Child Sleej
Globalization and the forces of rapid soc
developmental niche in many ways Thes
ules for new forms o(labor introductio
gies altered setdement patterns (particu
and shifts in family and household struc
tions likely has profound effects on sl
research on these concerns remains an
lifestyle furthermore impose different (
tion regulation that raise the stakes for
ing changes in the developmental niche
systems including sleep A major factor driving contempor
and activity is formal education By 20
schooling had progressed to the point
children and 78 of secondary sch
(Watkins 2008)This phenomenon has
(see also Wolfson and Richards chapt
mental factors that pose challenges for
must be present and alert during th(
school start times determine wake tim
will impair school performance For e
fIfth-grade Israeli students compared
to less sleep and greater daytime slee
concentrating regardless of hours slel
Schooling also makes children sede
linked to reduced sleep time and
Cameron Biddle Marshall amp Gorel
turbance in a multiethnic study ofAl
Chan amp Meininger 2002) School
families whose ability to meet tho
parent education and workloads 1
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23
Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
cardiovascular regulation at school ent
Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
I76 Sleep and Development
hours co-sleepers in close body contact share space air warmth and
time (a third of the day) during a vital chronobiological period Such
shared experience creates a context for mutual regulation that also shapes
the developmental course of systems regulating arousal and affect
(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy
mental preclinical work Hofer (1978) early proposed that relationships
act as regulators that inform development and shape adult function
Subsequent research has borne out this prediction and revolutionized
understandings of the roles of early environment and epigenetics in the
process of development Work among rodents in particular has detailed
the impact of expectable environments of rearing and functioning parshy
ticularly maternal behavior and early postnatal conditions on organizashy
tion of arousal and affect regulation among many other systems (Szyf
McGowan amp Meaney 2008 Weaver 2007) Different developmental
periods thus present particular opportunities and vulnerabilities to conshy
textual cues that drive regulation of systems closely involved in sleep
(McKenna 2000)
In line with such views data from our family study in Egypt indicate
that co-sleeping habits directly influenced sleep budgets and sleep qualshy
ity and that interruption of these habits in adolescence and young adultshy
hood was associated with increased likelihood of sleep dysregulation and
disruption in males and females respectively But the data do not address
the logical questions of whether and how sleeping arrangements and
co-sleeping in particular influence the development ofsystems that regshy
ulate sleep and arousal (Thoman 2006) These compelling issues remain
open to empirical investigation inemerging comparative research on
sleep
Culture and Sleep Recent Directions
Research on sleep and human development in different settings is
expanding in two directionsone being documentation of sleep patterns
and related outcomes in increasing numbers of non-Western settings
another being the emergence ofcomparative cross-national cross-cultural
research The former is particularly valuable for drawing attention to
divergent as well as shared issues across contexts that vary by wealth and
Develo)
technology as well as other cultural factor
needed to characterize relationships of sle
niche to the formation of sleep-wake pat1
Culture Culture Change and Child Sleej
Globalization and the forces of rapid soc
developmental niche in many ways Thes
ules for new forms o(labor introductio
gies altered setdement patterns (particu
and shifts in family and household struc
tions likely has profound effects on sl
research on these concerns remains an
lifestyle furthermore impose different (
tion regulation that raise the stakes for
ing changes in the developmental niche
systems including sleep A major factor driving contempor
and activity is formal education By 20
schooling had progressed to the point
children and 78 of secondary sch
(Watkins 2008)This phenomenon has
(see also Wolfson and Richards chapt
mental factors that pose challenges for
must be present and alert during th(
school start times determine wake tim
will impair school performance For e
fIfth-grade Israeli students compared
to less sleep and greater daytime slee
concentrating regardless of hours slel
Schooling also makes children sede
linked to reduced sleep time and
Cameron Biddle Marshall amp Gorel
turbance in a multiethnic study ofAl
Chan amp Meininger 2002) School
families whose ability to meet tho
parent education and workloads 1
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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BaHammam A Bin Saeed A AI-Faris E amp Shaikh S (2006) Sleep duration and its correlates in a sample ofSaudi elementary school children Singapore Medicaljoumal 47875-881
BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23
Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
cardiovascular regulation at school ent
Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
Developmental Cultural Ecology ofSleep 177
itact share space air warmth and
ital chronobiological period Such r mutual regulation that also shapes
ms regulating arousal and affect
linch 1990) Based on his experishy
~) early proposed that relationships
gtpment and shape adult function
this prediction and revolutionized
environment and epigenetics in the
g rodents in particular has detailed
nts of rearing and functioning parshy
r postnatal conditions on organizashy
i among many other systems (Szyf
ler 200 7) Different developmental
lrtunities and vulnerabilities to conshy
gtf systems closely involved in sleep
m our family study in Egypt indicate
lenced sleep budgets and sleep qualshy
ibits in adolescence and young adultshy
likelihood ofsleep dysregulation and
pectively But the data do not address
Uld how sleeping arrangements and
the development of systems that regshy
~006)These compelling issues remain 1 emerging comparative research on
irections
development in different settings IS
being documentation ofsleep patterns
ng numbers of non-Western settings
gtmparative cross-national cross-cultural
trly valuable for drawing attention to
across contexts that vary by wealth and
technology as well as other cultural factors such as lifestyleThe latter is
needed to characterize relationships ofsleep ecology and developmental
niche to the formation ofsleep-wake patterns and self regulation
Cultue Cultue Change and Child Sleep bull
Globalization and the forces of rapid social change are transforming the
developmental niche in many waysThese include changing daily schedshy
ules for new forms oflabor introduction of mass media and technoloshy
gies altered settlement patterns (particularly urbanization) and housing
and shifts in family and household structure Each of these transformashy
tions likely has profound effects on sleep ecology and behavior but
research on these concerns remains an urgent need These changes in
lifestyle furthermore impose different demands on attention and emoshy
tion regulation that raise the stakes for understanding how correspondshy
ing changes in the developmental niche influences development of these
systems including sleep
A major factor driving contemporary young peoples daily schedules
and activity is formal education By 2006 the global project of universal
schooling had progressed to the point that 88 ofprimary school-aged
children and 78 of secondary school-aged youth were in school
(Watkins 2008)This phenomenon has important consequences for sleep
(see also WolfSon and Richards chapter 12 in this volume for environshy
mental factors that pose challenges for young adolescents sleep) Children
must be present and alert during the school hours which means that
school start times determine wake times while factors that erode alertness
will impair school performance For example an early start (710 AM) for
fifth-grade Israeli students compared to the usual 800 AM was related
to less sleep and greater daytime sleepiness as well as increased difficulty
concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)
Schooling also makes children sedentary Daytime inactivity has been
linked to reduced sleep time and quality in British youth (Murdey
Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy
turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller
Chan amp Meininger 2002) Schooling places scheduling demands on
families whose ability to meet those demands vary by factors such as
parent education and workloads Thus for instance schoolchildren in
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
178 Sleep and Development
Riyadh Saudi Arabia with less educated mothers had later bedtimes and
less weekday sleep while those with working mothers had more total
sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy
tionship of physical activity with total sleep (padez Mourao Moreira amp
Rosado 2009)
These and other studies document the impact ofmedia use on chilshy
drens activity and sleep budgets Children who watch more television
sleep less than those who watch less Similarly the spread of computer
use among Brazilian adolescents has been related to sleep disruption and
daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same
phenomena in our Egypt study (Worthman amp Brown 2007) Such effects
promise to intensify as access to these media spreads worldwide The
attractions of media are not the only source of time load and schedule
disruption for young people In developing countries childrens domesshy
tic or paid labor is vital for household welfare and adds to the scheduling
burden ofschool Moreover school overcrowding in many regions may
prompt rotating morning and evening shifts that together with parent
labor schedules further complicate timetables and compromise youth
sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade
Louzada amp Nagai 2004) Accommodation of shifting sleep schedules
comes at a cost to neurobehavioral functioning in children for instance
Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but
showed large effects on response times and continuous performance
tasks (Sadeh et al 2003)
Combined these sleep studies also illuminate sources for the global
spread ofobesity not only in adults but increasingly in youth (Darntonshy
Hill Nishida amp James 2004) Reduced sleep has been linked firmly to
greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has
been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would
also need to consider schooling demands and media opportunities when
both may be valued by youth as means to build vital skills and social
networks
Develo
Even as obesity spreads malnutrition
affects brain development Nevertheless it
considered The scant evidence on develc
suggests disruption in malnourished infa
neurological development that can be re
bilitation (Shaaban Ei-Sayed NassarAsaa
developing countries who participate in
on top of schooling often are marginal study of nutrition activity and sleep testlaquo
gy-sparing role (Benefice Garnier amp Nc
workloads sleep duration in this sample (
than reported for Western counterparts
level during the day did not predict arne
ished Senegalese girls did sleep longer u
nourished peers Continuing expansiol nutrition enlarges the need for understal
on sleep and its regulation In sum viewed globally schedules
ofchildren increasingly are driven by th
school and influenced by media useTh
tion on sleep remains understudied an(
Cross-cultural Studies
A new generation of empirical crossshy
and aims to characterize sleep pract
development A parallel trend is the settings and behaviors in larger if r
within Western populations as well 1
for delineating actual normative con
characterizing their within-populat research with developmental study (
identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil
tion for sleep schedule duration difj
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
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Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
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off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
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DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
ed mothers had later bedtimes and
working mothers had more total
ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp
nt the impact ofmedia use on chilshyrildren who watch more television
i Similarly the spread of computer
been related to sleep disruption and
imao 2007) We observed the same thman amp Brown 2007) Such effects
lese media spreads worldwide The
ly source of time load and schedule
elopirlg countries childrens domesshy
ld welfare and adds to the scheduling
overcrowding in many regions may
ring shifts that together with parent
~ timetables and compromise youth
c 2004Teixeira Fischer de Andrade
nodation of shifting sleep schedules
functioning irl children for instance
d that children could adjust to small
le range of naturalistic variation but
times and continuous performance
i also illuminate sources for the global
s but increasirlgly in youth (Darntonshy
duced sleep has been linked firmly to n diverse populations (ChenBeydoun
I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling
eping longer to combat obesity would emands and media opportunities when
s means to build vital skills and social
Developmental Cultural Ecology ofSleep 179
Even as obesity spreads malnutrition still afRicts many and directly
affects brain development Nevertheless its relationship to sleep is rarely
considered The scant evidence on development of sleep-wake patterns
suggests disruption in malnourished infants which may reflect delayed
neurological development that can be reffiidiated by nutritional rehashy
bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl
developing countries who participate in subsistence and domestic labor
on top of schooling often are marginally nourished A rare empirical
study of nutrition activity and sleep tested whether sleep plays an enershy
gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily
workloads sleep duration in this sample ofSenegalese girls was no greater
than reported for Western counterparts (Benefice et al 2004) Activity
level during the day did not predict amount ofsleep although malnourshy
ished Senegalese girls did sleep longer and more deeply than their better
nourished peers Continuing expansion of inequities in resources and
nutrition enlarges the need for understanding the impact ofmalnutrition
on sleep and its regulation
In sum viewed globally schedules activity levels and sleep budgets
ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy
tion on sleep remains understudied and merits attention
Cross-cultural Studies
A new generation of empirical cross-national research is just emerging
and aims to characterize sleep practices and ecology during human
development A parallel trend is the documentation of everyday sleep
settings and behaviors in larger if not yet population-based samples
within Western populations as welL These studies are valuable not only
for delineating actual normative conditions and practices but also for
characterizing their within-population variability Alliance of such
research with developmental study designs will significantly accelerate
identification of the predictors of key outcomes including sleep behavshy
ior and quality self-regulation and sleep difficulties Early steps in this
direction include reports documenting developmental curves and variashy
tion for sleep schedule duration difficulties and bed sharing in a Swiss
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
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Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
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young child experience in workingAme
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Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
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Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
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Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
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Biology 14762-768 Hofer M (1978) Hidden regulatory pro
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for childhood overweight in 6-to 7-)
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from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
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nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
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lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
180 Sleep and Development
longitudinal study of nearly 500 children ages I month through 10 years
(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein
Molinari amp Largo 2005) Population-typical age curves that include
centile distributions of individual variation provide both bases for indishy
vidual assessment and a reality check for the cultural expectations that
inform parental and clinical goals and assessments
More recent studies have begun to solicit details of sleep ecology
(setting arrangements and parent behaviors) using the internet to recruit
larger samples ofparental reports on early sleep Findings from a sample
ofover 5000 parents in the United States and Canada document features
of sleep ecology to age three and their relationship to sleep patterns
including the emergence ofsleep consolidation (Sadeh et al 2009)They
also emphasized dramatic infant variation in sleep duration during the
first year Excluding age parent behaviors (regularity ofbedtime routines
sleep interventions) were the principal factors related to night sleep
duration and quality A limitation of this approach is reliance on parent
perceptions that are filtered by their access to and evaluation of the
relevant informationYet there may be advantages insofar as parent pershy
ceptions such as are reflected in reported sleep problems predict childshy
care and form the developmental niche
The same internet measure was used to sample nearly 30000 parents
of under-3 children in I2 Asian and 5 Western Anglophone countries or
regions This new evidence shows large population differences in sleep
schedules and duration bed- or room-sharing practices and perceived
sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While
it lends empirical support for our earlier ethnographic analysis more
importantly this study lays the fou~dations for identification of populashy
tion differences and similarities in sleep conditions behaviors and outshy
comes For example parent behaviors emerged as the strongest predictors
of nighttime sleep and mediated the relationship of co-sleeping and
co-rooming with reduced sleep duration and quality (Mindell Sadeh
Kohyama amp How in press)
In summary new evidence about sleep ecology in infancy and todshy
dlerhood consistently points to the impact of social actors (parents) on
the development ofsleep patterns and problems Thus the developmental
niche sculpts the systems regulating sleep
Develol
cultural Models of Child Developn Parenting and Sleep
Expanding cross-cultural research probil
practices and outcomes also increases the
tural rationales and meanings that under and behaviors Cultures are distinguished
of behavior and living conditions but
motivate behavior and give meaning to c
that an account of the role of culture ir
sleep would be incomplete without a ( tion or how culture operates in thougr
tural approach suggests that by syst
perceptions and behavior cultural belief
appropriate parenting are powerful det
mental niche in which children grow Ul
as satisfactory or problematic This secti
tural analysis that permits linkage to 1
health
Cultural Models
Culture comprises complex arrays ofd
tices and it is organized by intersectin
provide integrated accounts ofhow d
in it These cognitive cultural resourCf
experience-based properties that gene
to make sense ofexperience address c
amp Quinn 1997) Cultural models act
nize a phenomenological domain (~ basis for thought and action by recr
to the domain mapped by the model structured experience-based sets of
tion (child) or concept (daughter) th
tions and specific exemplars and el
features (Shore 1996) Schemas als
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
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(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
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Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
Developmental Cultural Ecology of Sleep 181
ldren ages I month through 10 years
go 2003 Jenni Fuhrer Iglowstein
ion-typical age curves that include
ariation provide both bases for indishy
ck for the cultural expectations that
nd assessments In to solicit details of sleep ecology
ehaviors) using the internet to recruit
n early sleep Findings from a sample States and Canada document features
j their relationship to sleep patterns
onsolidation (Sadeh et al 2009)middotThey
ariation in sleep duration during the laviors (regularity ofbedtime routines
mcipal factors related to night sleep
of this approach is reliance on parent
their access to and evaluation of the
ly be advantages insofar as parent pershy
eported sleep problems predict child-
niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or
IS large population differences in sleep
room-sharing practices and perceived
Wiegand How amp Goh in press)While
lUr earlier ethnographic analysis more
)undations for identification of populashy
in sleep conditions behaviors and outshy
viors emerged as the strongest predictors
ed the relationship of co-sleeping and
) duration and quality (Mindell Sadeh
about sleep ecology in infancy and todshy
the impact of social actors (parents) on
as and problemsThus the developmental
ting sleep
Cultural Models of Child Development Parenting and Sleep
Expanding cross-cultural research probing associations between sleep
practices and outcomes also increases the ned for inquiry into the culshy
tural rationales and meanings that underlie differences in sleep ecology
and behaviors Cultures are distinguished by not only distinctive patterns
of behavior and living conditions but also the belief and values that
motivate behavior and give meaning to experience From this it follows
that an account of the role of culture in the developmental ecology of
sleep would be incomplete without a consideration of cultural cognishy
tion or how culture operates in thought and emotion The ecobioculshy
tural approach suggests that by systematically infonning caregiver
perceptions and behavior cultural belief about human development and
appropriate parenting are powerful determinants of both the developshy
mental niche in which children grow up and the assessment ofoutcomes
as satisfactory or problematic This section considers an approach to culshy
tural analysis that permits linkage to human behavior experience and
health
Cultural Models
Culture comprises complex arrays ofdistributed belief values and pracshy
tices and it is organized by intersecting cognitive models or schemas that
provide integrated accounts of how the world works and how one lives
in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action
to make sense of experience address challenges and pursue goals (Strauss
amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy
nize a phenomenological domain (such as human development) as a
basis for thought and action by recruiting multiple cognitive resources
to the domain mapped by the model (Shore 1996) Schemas in turn are
structured experience-based sets of representations regarding a percepshy
tion (child) or concept (daughter) that include both generalized proposishy
tions and specific exemplars and embodied-affective and motivational
features (Shore 1996) Schemas also concern social phenomena from
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
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Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
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Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
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consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
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for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
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lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
182 Sleep and Development
roles (father) to persons (dad) to stereotypes (dads) to self (person)
Models and their informing schemas range in particularity from specific
scripts (infant feeding) to foundational schemas (gender) that inform
multiple domains And they are not merely abstractions but also autoshy
matic and visceral
By scaffolding both behavior and interpretation of others behavior
cultural models and schemas move out of the realm of personal experishy
ence to circulate in the world and become tangibly real (Garro 2000)
Cultural cognition also attains moral force through the internalized
values that motivate scripts and the ability to live by shared codes and do
the right thing thereby become crucial to cultural competence and even
to health For example ability to achieve internalized cultural lifestyle
goals has been associated with physical and mental health status in both
Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro
Ribeiro amp Dos Santos 2007)
Cultural Model of Child Development US
Results from our study of middle-class Atlanta families exemplify how
cultural models and scripts work translating a large domain into the
organization of daily life (DeCaro amp Worthman 2007) Parental models
of young child development identified two core needs namely that for
security and safety as well as that for opportunity and growthThe former
requires stability control predictability and support that create a proshy
tected space for development The latter involves enrichment stimulashy
tion exploration and spontaneity for physical and psychosocial growth
Resolution of the tension between these two fundamental needs relied
on parent efforts to strike a balance between them that optimizes the
specific childs development Action schemas for parenting related to
securitysafety included producing a predictable simple schedule with
continuous surveillance by good caregivers Those for opportunity
growth included good schooling extracurricular activities and play
opportunities That for balance included tailoring to individual child
needs and abilities and subordination ofparental priorities and schedules
to childrens needs The moral corollary was that parent stress indexes
effort and compliance with demands of this model and thus signals
parental virtue We found that parents of young children did enact this
Devel
model and related schemas in the orgar
that maternal and family functioning mlt
tion and arousal regulation (DeCaro amp
fmdings explored how cultural models
mas for appropriate parenting systematic
niche and shape child psychobehavioral
Cultural Models ofSleep US
Similarly sleep behavior and settings at
of sleep and schemas for appropriate sle
of development and schemas for par
target of the Adanta family study (DeC sleep was integral to its round-the-cloc
graphic interviews Based on this evi
this discussion a rough cultural mode includes two dimensions restoration
column)The restorative dimension tre
tial and positive function an autonom
escape or withdrawal from daily care a
sensitive to disturbances The dimen
physiologically and socially bounded and sleep should be scheduled fitted i
into a single block in proper settings I
regulation autonomy and indepenc
sloth or disorganization poor sleep
and sleep loss reflects self-control an
relates to the notion that Western
a foundational schema of the self as il
dent (Markus amp Kitayama 1991 C
2002 and comments) The American cultural model
that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc
1) essential something of which 0
and physical health (though how m
maintenance permissive for deman
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
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DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
Developmental Cultural Ecology of Sleep 183
stereotypes (dads) to self (person)
lS range in particularity from specific
ional schemas (gender) that inform
t merely abstractions but also autoshy
nd interpretation of others behavior
out of the realm of personal experishy
become tangibly real (Garro 2000)
lOral force through the internalized
ability to live by shared codes and do
lcial to cultural competence and even
achieve internalized cultural lifestyle
sical and mental health status in both cans (Dressler 2004 Dressler Balieiro
nent us
e-class Atlanta families exemplify how
~ translating a large domain into the D amp Worthman 2007)middot Parental models
ltifled two core needs namely that for
or opportunity and growthThe former
tability and support that create a proshy
he latter involves enrichment stimulashy
y for physical and psychosocial growth
en these two fundamental needs relied
ance between them that optimizes the
ction schemas for parenting related to
ing a predictable simple schedule with
od caregivers Those for opportunity
ing extracurricular activities and play
included tailoring to individual child
lation ofparental priorities and schedules corollary was that parent stress indexes
emands of mis model and thus signals
parents of young children did enact this
model and related schemas in the organization of daily fanilly life but
mat maternal and family functioning moderated markers of child emoshy
tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These
fmdings explored how cultural models of child development and scheshy
mas for appropriate parenting systematicallytStructure the developmental
niche and shape child psychobehavioral outcomes
Cultural Models ofSleep US
Sinlllarly sleep behavior and settings are grounded in cultural accounts
ofsleep and schemas for appropriate sleep and also intersect with models
of development and schemas for parenting Although not the direct
target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)
sleep was integral to its round-the-clock activity monitoring and ethnoshy
graphic interviews Based on this evidence for illustrative purposes in
this discussion a rough cultural model of sleep can be delineated that
includes two dimensions restoration and regulation (see Table 82 left
column)The restorative dimension treats sleep as a mysterious but essenshy
tial and positive function an autonomous self-maintenance behavior an
escape or withdrawal from daily care and demands and a vulnerable state
sensitive to disturbances The dimension of regulation casts sleep as a
physiologically and socially bounded state one is either awake or asleep
and sleep should be scheduled fitted into life demands and consolidated
into a single block in proper settings In moral terms sleep expresses selfshy
regulation autonomy and independence sleeping too much reRects
sloth or disorganization poor sleep reRects a failure in self-regulation
and sleep loss reRects self-control and life demands This model of sleep
relates to the notion that Western societies characteristically feature
a foundational schema of the self as independent rather than interdepenshy
dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier
2002 and comments)
The American cultural model of sleep interdigitates with schemas
that shape sleep behaviors and settings (Table 82 middle column)
(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as
I) essential something of which one should get enough for mental
and physical health (though how much is enough is uncertain) 2) selfshy
maintenance permissive for demanding space to meet individual sleep
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
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Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
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Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
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Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
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Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
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(Eels) Ethnography and human developne
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Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
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It sleep development and the sudden
-282 ~htly use of computer by adolescents
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lT Hamp Goh DYT (in press) Crossshy
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R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
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Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
184 Sleep and Development
TABLE 82 Cultural model and schemas of sleep in the USAn outline
Components of cultural Action schemas Parenting schemas
model scripts
Restoration
Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain
Self maintenance Meet inclividual Child sleeps alone maycrash
requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space
separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance
stimuli Regulation
Distinct bounded Limit to specific time Establishmaintain bedtimes place
Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block
Subordinate to life Schedule curtail as Structure regular schedule demands needed
Moral frame
Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent
Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency
Foundational schema
Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence
requirements 3) withdrawal involving solitary quiet comfortable and
separate spaces and 4) vulnerable requiring minimization or shielding
from disruptive stimuli The corresponding moral framework posits sleep
as sustaining natural and involuntary Consequendy good sleep is treated
as a positive good because it is necessary and a need for sleep can excuse
taking time out from work and social demands
The regulation aspect of sleep clearly stands in tension to its restorshy
ative aspect Regulation mandates a push to sleep in a single well-timed
nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing
daily demands and thus to curtail it when necessary Moral entailments
Deveilt
include that sleep steals time from life pri
good social adjustment produced by attin
ing life demands combined with the self-(
ingly Thus sleeping too much at ina
inability to sleep through the night may
of physiology and thus as psycholo
Moreover sleep at the wrong time an(
count as real sleep Demands related tc
demonstrated sleep needs illness or inin
an airport) may be invoked to excuse no
damages These tensions become partiet
tion and parenting
Intersecting Models of Sleep and Child
Consideration of cultural models an American normative practices of sleel
infancy and childhood (Table 82 rieuro
sleep directly inform parenting goals
understood to have special sleep nee
curve in sleep-wake regulation it is t
ensure that the child gets proper sleep For proper child development parent
by providing a separate specified bed
from disturbances (noise light heato
of a young childs sleep dysregulation
extended Setting up and furnishing
crucial preparations for parenthood a
to undergo a protracted period ofdisI
the childs early years Concurrendy
well-regulated sleep in their child c
and maintaining bedtimes and regula
soli dated nighttime sleep with approl
cess may require parents to be firn When a baby has repeated problerr
need to show some tough love (St
large on-line survey ofNorthAmer
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
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BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23
Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
cardiovascular regulation at school ent
Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
ofsleep in the US An outline
(s Parenting schemas
but Provid~ adequate protected sleep
ertain Child sleeps alone may crash
s [uiet Provide separate sleeping space
ing nul Minimize stimuli disturbance
fie time Establishmaintain bedtimes
leep into Foster single nighttime blocks
tail as Srrncrure regular schedule
necessiry good sleep = good child == good parent
self right sleep = good child good parent
Tough love to master sleep ividual habits =learn independence iliry
volving solitary quiet comfortable and
)le requiring minimization or shielding
esponding moral framework posits sleep
ltary Consequently good sleep is treated
lecessary and a need for sleep can excuse
ld social demands ~ep clearly stands in tension to its restorshy
es a push to sleep in a single well-tuned
bedroom to subordinate sleep to ongoing
tail it when necessary Moral entailments
Developmental Cultural Ecology of Sleep I8S
include that sleep steals time from life priorities Sleeping right expresses
good social adjustment produced by attitudes and commitment to meetshy
ing life demands combined with the self-control to regulate sleep accordshy
ingly Thus sleeping too much at inappropriate times or places or
inability to sleep through the night may be Viewed as failures of will or
of physiology and thus as psychological or physical dysfunction
Moreover sleep at the wrong time and place or broken sleep may not
count as real sleep Demands related to the restorative aspect such as
demonstrated sleep needs illness or inimical conditions (eg living near
an airport) may be invoked to excuse nonconforming behaviors or claim
damages These tensions become partculady apparent in sleep socializashy
tion and parenting
Intersecting Models ofSleep and Child Development US
Consideration of cultural models and morals provides insight into
American normative practices of sleep socialization and difficulties in
infancy and childhood (Table 82 right column) Prevailing views of
sleep directly inform parenting goals for child sleep The young are
understood to have special sleep needs and undergo a developmental
curve in sleep-wake regulation it is the parents responsibility both to
ensure that the child gets proper sleep and acquires correct sleep habits
For proper child development parents should foster adequate safe sleep
by providing a separate specified bed and sleeping space that is buffered
from disturbances (noise light heatcold) And they should be indulgent
of a young childs sleep dysregulation and periodic crashes when overshy
extended Setting up and furnishing the newborns sleeping space are
crucial preparations for parenthood among Americans who also expect
to undergo a protracted period ofdisrupted sleep-wake schedules during
the childs early years Concurrently parents are expected to inculcate
well-regulated sleep in their child as swiftly as possible by establishing
and maintaining bedtimes and regular daily schedules that promote conshy
solidated nighttime sleep with appropriate amounts ofnappingThe proshy
cess may require parents to be firm as this popular source suggested
When a baby has repeated problems falling asleep Mom and Dad may
need to show some tough love (Staff 2009 p 54) Correspondingly a
large on-line survey ofNorth American parents found that longer more
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
REFERENCES
BaHammam A Bin Saeed A AI-Faris E amp Shaikh S (2006) Sleep duration and its correlates in a sample ofSaudi elementary school children Singapore Medicaljoumal 47875-881
BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23
Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
cardiovascular regulation at school ent
Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
186 Sleep and Development
consolidated infant night sleep at ages 0-3 years was associated with
parental behaviors fostering self-soothing and independence (Sadeh
et al 2oo9)Variation from the ideal cultural model was extensive over
a third ofinfants sleep in their parents room or bed
Within a few months after birth American parents routinely are
asked Is shehe a good babyThe question actually inquires whether
the baby sleeps through the night goes to sleep without a lot of fussing
and crying and is easy to soothe ifshehe wakes up The moral stakes are
clearly expressed good or correct sleep habits manifest good infant
development that results from good parenting The sleep habits and
soothability of the child symbolize both the current quality of the parshy
ent-child relationship and the cumulative quality of care for the childs
appropriate mastery ofself-regulatory skills Good babies have good parshy
ents Given these views and the intense investments of parenting the
moral-in addition to existential--distress that goes with refractory
infant crying bedtime struggles and sleep problems can be personal and
profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably
bedtime and sleep problems account for a 20-30 ofpediatric consults
(Moore Meltzer amp MindeD 2008)
In sum cultural models on sleep perceptions practices and settings
are readily tapped as illustrated above for a weD-studied population the
United States Attention to the moral dimensions that motivate such
models furthermore can yield fresh insight into social pressures and
affective loading on what counts as sleep how it should be done and
what can go wrong that influence how people behave and what sleep
problems they experience
Non-Western Cultural Models ofSleep
Our earlier survey of ethnographic accounts for the study of sleep ecolshy
ogy (Worthman and Melby 2002) also provided an overview of diverse
cultural cognitions and practices around sleep Some elements ofcultural
models in non-Western societies overlap with those extant among
Americans but other widespread themes do not These include domishy
nant concerns for danger and for social integration in sleep A correshy
sponding foundational schema is the interdependent self viewed in
Deveh
terms of relationships with others rather 1
(Oyserman et al 2002) From that perspe
social integration and security For heuristic purposes the prevalen1
ofsociability and danger have been outli
contrast with the US cultural model T the boundary ofsleep-wake as rather fuz
alertness and social engagement Sleep 2
determined by relationships and ones p
sleeping is opportunistic and accommc social priorities Overall an emphasis OJ
framed by people also counterbalance
TABLE 83 Other cultural models and schen
Components ofcultural Action schemas
model
Sociability Sleep as needed and fluid unbounded
possible Sleep with proper Social behavior
partuers Coordinate to life Opportunistic
demandsaccommodating Do not sleep alone Anchored by people
Danger Seek sleeping partn Not of this world Observe conditions Risky necessity
for safety Avoid extended Death-like difficult
deep sleep to break Moral logic
right sleep = sociiSociability social life integration = seand status
good sleep sociDanger social or spiritual alignmspiritual conditions safety
Foundational schema The connected self Sleep as social bel
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
REFERENCES
BaHammam A Bin Saeed A AI-Faris E amp Shaikh S (2006) Sleep duration and its correlates in a sample ofSaudi elementary school children Singapore Medicaljoumal 47875-881
BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23
Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
cardiovascular regulation at school ent
Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
ages 0-3 years was associated with
soothing and independence (Sadeh
eal cultural model was extensive over
ents room or bed birth American parents routinely are
he question actually inquires whether
goes to sleep without a lot of fussing
- shehe wakes upThe moral stakes are
ect sleep habits manifest good infant
~ood parenting The sleep habits and
~e both the current quality of the parshymulative quality of care for the childs
tory skills Good babies have good par-
intense investments of parenting the
al--distress that goes with refractory
Developmental Cultural Ecology ofSleep 187
terrns of relationships with others rather than of independent autonomy
(Oyserman et al 2002) From that perspective sleep relates intimately to
social integration and security
For heuristic purposes the prevalent (though not universal) themes
ofsociability and danger have been outlined (Table 83 left column) for
contrast with the US cultural model The dimension of sociality poses
the boundary ofsleep-wake as rather fuzzy graded along a continuum in
alertness and social engagement Sleep also constitutes a social behavior
determined by relationships and ones place in society Correspondingly
sleeping is opportunistic and accommodating fItted into daily life and
social priorities Overall an emphasis on sleep as sociable anchored and
framed by people also counterbala~ces the theme of danger and risk
TABLE Other cultural models and schemas for
and sleep problems can be personal and Components of cultural Action schemas Parenting schemas
rtinLehtonen ampYoung 2005) Notably model
)tint for a 20-30 of pediatric consults
8) deep perceptions practices and settings
tbove for a well-studied population the
moral dimensions that motivate such
fresh insight into social pressures and
ts as sleep how it should be done and
lce how people behave and what sleep
ifSleep
hic accounts for the study ofsleep ecolshy
)2) also provided an overview of diverse
s around sleep Some elements ofcultural
ties overlap with those extant among
ad themes do not These include domishy
for social integration in sleep A crreshy
1 is the interdependent self viewed in
Sociability
Fluid unbounded
Social behavior
Opportunistic accommodating
Anchored by people Danger
Not of this world Risky necessity
Death-like difficult to break
Moral logic
Sociability social life and status
Danger social or spiritual conditions
Foundational schema The connected self
Sleep as needed and possible
Sleep with proper partners
Coordinate to life demands
Do not sleep alone
Seek sleeping partners Observe conditions
for safety Avoid extended
deep sleep
right sleep =social integration = security
good sleep = social spiritual alignment safety
Sleep as social behavior
Permit sleep contingent on need
Carry provide sleeping partners
Fit sleep into ongoing activities
Rapid response to fuss cry
Passive surveillance Provide social spiritual security
Expect sleep in high stimulus load
calm adaptable sleep = secure child = good conditions
untroubled sleep safe child = good parent
Accommodate to master fluid sleep = learn interdependence
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
REFERENCES
BaHammam A Bin Saeed A AI-Faris E amp Shaikh S (2006) Sleep duration and its correlates in a sample ofSaudi elementary school children Singapore Medicaljoumal 47875-881
BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23
Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
cardiovascular regulation at school ent
Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
I88 Sleep and Development
Many societies ally sleep with altered states unworldly or moribund and
regard it as a dangerous necessity andor spiritual opportunity Deep
sleep risks encounters with incorporeal realms and malign or beneficent
forces as such profound sleep may be difficult to break and require the
presence ofothers for safe return
Action schemas (Table 83 middle column) related to the sociability
component emphasize avoidance of sleeping alone sleeping with proper
partners and flexibility in time and place for sleep Entailments from the
danger component include measures for safety fmding security in sleepshy
ing partners proper conditions and cultivation of moderate sleep depths
with avoidance ofprotracted deep sleep From a moral perspective sleepshy
ing right or properly expresses the social integration that generates
security while a good sleep expresses the social or spiritual alignment
that generates safety It is both boon and existential barometer Priorities
for parenting from such cultural views (Table 83 right column) include
largely on-demand sleep schedules that fit into daily life infant carrying
and provision of sleeping partners and rapid response to fussing and
crying with expected rapid development ofrobust self-soothing Danger
is palliated through passive surveillance from presence of others provishy
sion of social and spiritual security (proper sleep partners amulets) and
sensory loads involved in social sleep
From this generalized non-Western cultural view unfussy adaptshy
able sleep is a hallmark of the secure properly adjusted child while
untroubled sleep reflects safety Each in turn comes from good condishy
tions mediated in part through parents (usually mothers) but also reflecshy
tive ofthe social order The resultanJ well-regulated interdependent child
fits in
This section has hazarded broad generalizations to explore the role
ofcultural models and their related behavioral developmental and moral
agendas in formation of the developmental niche for sleep
Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the
exception of co-sleeping if infancy (McKenna 2000) the analysis of
cultural models and moral agendas has been largely absent from sleep
science and medicine But the large roles they play in determining behavshy
ior and health makes them promising targets for systematic study with
real practical value
Develop
Conclusion
This chapter has outlined conceptual aI
steps toward bridging gaps in sleep science
current accounts of sleep function and dy So far results are promising We noW reee
strued as social that it is heavily influenc largely culturally determined and that cuI
sleep behavior settings and sensibilities empirically expand these insights and l
understanding sleep particularly during c
has discussed conceptual and method
Accumulating evidence from our own at
the contexts of sleep are important facto
An ecological approach has proved to 1 sleep patterns and settings their variatic
tions and key variables driving sleep ou
tive can be extended to life course a
comparative study of sleep ecology Recognition ofthe importance ofc
culture matters for sleep The challeng
tractable terms that can be related to
physiology and quality Two framewor~ challenge one being the ecobiocultur
and the other being cultural models a
cognition The ecobiocultural model bull key pathways by which culture infiuen
developmental niche And indeed new
fied a decisive role of parent behavior
ties Such work resonates with discove as was highlighted in our comparativ
recent family study in Egypt How
reflects culturally characteristic social
Equally pressing are wider issues 0
housing and settlement patterns W
and inequity that influence sleep ane
global shifts
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
REFERENCES
BaHammam A Bin Saeed A AI-Faris E amp Shaikh S (2006) Sleep duration and its correlates in a sample ofSaudi elementary school children Singapore Medicaljoumal 47875-881
BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23
Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
cardiovascular regulation at school ent
Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
i states unworldly or moribund and
andor spiritual opportunity Deep
real realms and malign or beneficent
be difficult to break and require the
dle column) related to the sociability
f sleeping alone sleeping with proper
place for sleep Entailments from the
es for safety finding security in sleep-
l cultivation ofmoderate sleep depths
Jeep From a moral perspective sleepshy
the social integration that generates
~esses the social or spiritual alignment n and existential barometer Priorities
ews (Table 83 right column) include
that fit into daily life infant carrying
s and rapid response to fussing and
pment ofrobust self-soothing Danger
llance from presence of others provishy
y (proper sleep partners amulets) and
~ep
Western cultural view unfussy adapt-
secure properly adjusted child while d dilch in turn comes from goo conshy
lrents (usually mothers) but also refiecshy
mt well-regulated interdependent child
oad generalizations to explore the role
~d behavioral developmental and moral
le developmental niche for sleep
se factors can reveal the cultural roots of
hether perceived or actual With the aney (McKenna 2000) the analysis of
ldas has been largely absent from sleep
ge roles they play in determining be~avshyarising targets for systematic study with
Developmental Cultural Ecology of Sleep 189
Conclusion
This chapter has outlined conceptual approaches and surveyed flrst
steps toward bridging gaps in sleep science and anthropology that limit
current accounts of sleep function and dysfunction in the real world
So far results are promising We now recognize that sleep can be conshy
strued as social that it is heavily influenced by context that context is
largely culturally determined and that cultural models and morals infuse
sleep behavior settings and sensibilities The present challenge is to
empirically expand these insights and explore their implications for
understanding sleep particularly duripg child development This chapter
has discussed conceptual and methodological tools for that effort
Accumulating evidence from our own and others research suggests that
the contexts of sleep are important factors in sleep behavior and quality
An ecological approach has proved to be a valuable tool for studies of
sleep patterns and settings their variation within and between populashy
tions and key variables driving sleep outcomes The ecological perspecshy
tive can be extended to life course analysis as demonstrated in our
comparative study ofsleep ecology
Recognition of the importance ofcontext has led to another insight
culture matters for sleep The challenge is to operationalize culture in
tractable terms that can be related to outcomes such as sleep behavior
physiology and quality Two frameworks from anthropology address this
challenge one being the ecobiocultural model of human development
and the other being cultural models and schemas that ground cultural
cognition The ecobiocultural model of human development points to
key pathways by which culture influences child outcomes by shaping the
developmental nicheAnd indeed new cross-cultural research has identishy
fled a decisive role of parent behaviors in child sleep and sleep difficulshy
ties Such work resonates with discovery of the social dimension ofsleep
as was highlighted in our comparative study of sleep ecology and more
recent family study in Egypt How where and how well people sleep
reflects culturally characteristic social relationships and views of the self
Equally pressing are wider issues of family and household structure
housing and settlement patterns work and leisure activities nutrition
and inequity that influence sleep and presently are undergoing dramatic
global shifts
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
REFERENCES
BaHammam A Bin Saeed A AI-Faris E amp Shaikh S (2006) Sleep duration and its correlates in a sample ofSaudi elementary school children Singapore Medicaljoumal 47875-881
BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23
Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
cardiovascular regulation at school ent
Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
190 Sleep and Development
Sleep follows cultural models and related schemas about how to
behave how things work and how they go wrong Ai illustrated in the
case of the United States analysis of these frameworks in cultural cognishy
tion is critical for understanding sleep behavior and ecology It also reveals
the moral dimension of sleep accounting for the distress and perceived
dysfunction that erupt when behaviors or outcomes do not conform to
cultural expectations These dynamics are clearly in play in parenting and
child sleep Ai the generalized contrasting models from non-Western
societies illustrate there are different ways to view what sleep is how best
to do it and how these relate to child development and parenting Put
most simply the meanings attached to sleep can prove important for
understanding sleep behavior and distress throughout the life course
In sum although the comparative study ofsleep in human developshy
ment is in its infancy many factors converge to predict its rapid growth
and capacity to yield important insights into sleep and its relationship to
developmental processes Concerns about sleep problems and their psyshy
chobehavioral sequelae alongside globalizing changes that affect sleep
lend practical urgency to a project that promises fully to engage sleep
science with human diversity in everyday social life
REFERENCES
BaHammam A Bin Saeed A AI-Faris E amp Shaikh S (2006) Sleep duration and its correlates in a sample ofSaudi elementary school children Singapore Medicaljoumal 47875-881
BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258
Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23
Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8
Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I
Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16
265-274
Develc
Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro
101-12I DeCa~]A amp Worthman CM (2007) Cu
young child experience in workingAme
Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C
cardiovascular regulation at school ent
Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)
changing associations between family
Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (
21-31middot Rib RFDresslerWW Balielro M C euomiddot
consonance and psychological distress tiple cultural domains Culture ~edi~n
EkirchA R (200S) At days close NIght In
Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi
Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens
Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~
associated with poor sleep quality m a
Biology 14762-768 Hofer M (1978) Hidden regulatory pro
P P G Bateson amp P j Klopfer (Eds
behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li
for childhood overweight in 6-to 7-)
Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L
from infancy to adolescence Refe
Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped
jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5
Markus H R amp Kitayarna S (1991) C nition emotion and motivation P
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
I
and related schemas about how to
they go wrong As illustrated in the
)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved
viors or outcomes do not conform to
lics are clearly in play in parenting and
mtrasting models from non-Western
nt ways to view what sleep is how best
child development and parenting Put
led to sleep can prove important for
distress throughout the life course
ative study ofsleep in human developshy
rs converge to predict its rapid growth
lsights into sleep and its relationship to
ns about sleep problems and their psyshy
globalizing changes that affect sleep
ct that promises fully to engage sleep
everyday social life
~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore
Idaptation to disease A cross-cultural examshy
-258 artin L M Lehtonen L amp Young S N
lable crying bouts in infants with and withshy
ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy
466-508 G M (2004) Nutritional status growth and
e adolescent girls European Journal of Clinical
19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16
Developmental Cultural Ecology ofSleep 191
Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to
diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I
DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull
DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583
DeCaro] A amp Worthman C M (2008b) Return to school accompanied by
changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195
DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I
DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224
EkirchA R (2005) At days close Night in times past NewYork Norton
Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont
daytime functioning of fifth-grade children in Israel Sleep 21 250-256
Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory
Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity
associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768
Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum
Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418
Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration
from infancy to adolescence Reference values and generational trends Pediatrics III 302-307
jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy
dren in the fust 10 years oflife Pediatrics II5 233-240
jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between
culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy
nition emotion and motivation Psychological Review 98224-253
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
I92 Sleep and Development
McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216
McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker
McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347
McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282
Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432
MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine
MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine
Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581
Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86
Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72
Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376
Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46
Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17
Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707
Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34
Developn
Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d
Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B
in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs
Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran
Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press
Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor
UK Cambridge University Press Super C M amp Harkness S (1986)The develo)
tion at the interface of child and culture
Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)
epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M
(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl
Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut
407-417 Watkins K (2008) Education for All Global
Oxford University Press and UNESCO
Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n
off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should
the study of human development In R
(Eels) Ethnography and human developne
inquiry (pp 305-324) ChicagoThe UruV( Worthman C M (1999) Comparative ecolog
ofPhysical Anthropology Suppl 28 2~
Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press
Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)
Press
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology
es on infant and childhood sleep
~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker
t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy
the study of infant death syndrome
1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective
It sleep development and the sudden
-282 ~htly use of computer by adolescents
de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors
toddlers a cross-cultural comparison
lT Hamp Goh DYT (in press) Crossshy
Idler sleep Sleep Medicine (2008) Bedtime problems and night
inics in OffUe Practice 35 569-581
R Marshall S] amp GorelyT (2004)
f behaviour during adolescence Annals
meier M (2002) Rethinking individushy
of theoretical assumptions and metashy
-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human
04) Shifworking families Parents workshy
doles cents attending school in two shifts
C E v (1999) Sleep habits in Native
de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits
n in the state of Mato Grosso do Sul
1567deg3-7deg7 mt sleep problems Origins assessment
Journal 14 17-34middot
Developmental Cultural Ecology of Sleep 193
Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and
extension on school-age children What a difference an hour makes Child
Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology
in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)
Sleep-wake cycle disturbances in protein-energy malnutrition Effect of
nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645
Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press
Staff (2009 November)The year in health from a to z Time 174 51-89
Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge
UK Cambridge University Press
Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy
tion at the interface of child and culture International Journal f Behavioral Development 9 545-569
Szyf M McGowan P amp Meaney MJ (2008) The social environment and the
epigenome Environmental and Molecular Mutagenesis 49 46--60
Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R
(2004) Sleep patterns of day-working evening high-schooled adolescents
of Sao Paulo Brazil Chronobiology International 21 239-252
Thoman E B (2006) Co-sleeping an ancient practice Issues of the past
and present and possibilities for the future Sleep Medicine Reviews IO
407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford
Oxford University Press and UNESCO
Weaver I C (2007) Epigenetic programming by maternal behavior and pharshy
macological intervention Nature versus nurture Lets call the whole thing
off Epigenetics 2 22-28
WeisnerT S (1996)Why ethnography should be the most important method in
the study of human development In R Jessor A Colby amp R Shweder
(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press
Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21
Worthman C M (2003) Energetics sociality and human reproduction Life hisshy
tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington
DC National Academies Press
Worthman C M (2008) After dark the evolutionary ecology of human sleep
InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
194 Sleep and Development
Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010
Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135
Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press
9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga
Introduction
The daytime and nighttime sleep
industrialized nations have been t( slightly over four decades (eg bull C
term sleep environment sugges~
subject the sheer variety of sleep families regarding the regularity of
which they are correlated make tt In this chapter we will explicate a ments for children in post-industr
and developmental factors associat
systems perspective it is clear that
circumstances infants and young cl
and extra-individual variables that Developmental Systems The
behaviors cannot be understood w
which that individual is embeddt
person-in-context as the focal u human behavior is only understc
texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans
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