Study reveals gaps in child sleep guidelines in Canadian provinces

Thousands of licensed child care centers across Canada may not be ensuring that children are sleeping properly and healthily due to inconsistent sleep standards.

A new UBC study led by pediatric sleep expert and emeritus professor of nursing, Dr. Wendy Hall, found that sleep regulations for licensed daycare facilities vary greatly between provinces and territories Canadians, often leaving centers without clear guidelines for supporting children’s sleep needs.

We found significant disparities in sleep-related regulations between provinces and territories. For example, the BC regulations have no specific guidelines on general or daily sleep scheduling, focusing instead on maintaining a safe sleep environment through factors such as positioning, equipment safety, and prohibited practices.”

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

Alberta’s regulatory requirements do not specify sleep scheduling or space, but they do specify staffing requirements. In the Atlantic provinces, regulations vary on scheduling incorporating time to rest or sleep in the day. Ontario regulations specify daily amounts of sleep, age-specific sleeping spaces and equipment, and personnel, sleep positioning and monitoring, and prohibited practices. Quebec regulations do not specify general or daily sleep scheduling, sleep/rest staffing, sleep positioning, or sleep monitoring. Operating manuals are available to help licensees interpret the regulations, but many manuals are outdated.

Dr. Hall noted that almost three-quarters of children in Canada are in daycare settings: 56 percent are in some form of daycare and an additional 26 percent are on waiting lists. “The lack of consistent regulations creates confusion about the appropriate number and length of naps/rest periods for children, especially in different age groups. Although naps are crucial for development, many centers prioritize only a rest period per day, which may not meet the needs of infants “or may exceed the needs of three- to four-year-olds.”

The definition of an “infant” also varies by province (the age range can vary from 12 to 24 months), which affects guidelines for sleeping space and equipment and the development of children

The study also notes that there are equity issues as well. Children from lower socioeconomic backgrounds who may not sleep as much at night may particularly benefit from access to naps during the day, but there are no consistent provisions for this in daycare in Canada.

To ensure that children have quality, sufficient and restful sleep, Dr. Hall recommends looking at Canada’s 24-hour movement guidelines as a good starting point for early years. These guidelines integrate children’s physical activity, sedentary behavior and sleep, recommending naps for infants and children under two and nap options for ages three to four.

Daycare centers should also emphasize safe sleep practices, monitoring children during sleep to ensure their safety. Only the regulations in BC and Ontario emphasize sleep positioning.

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

Parents can monitor their children’s sleep patterns, talk to caregivers about their children’s needs, and familiarize themselves with sleep guidelines. For example, the American Academy of Sleep Medicine guidelines are helpful in the context of recommendations for a 24-hour period, but they do not separate naps from nighttime sleep. The Canadian 24-Hour Movement Guidelines provide specific recommendations for naps within the broader framework of sleep.