A school-based health and mindfulness curriculum improves children’s objectively measured sleep: a prospective observational cohort study

Christina F. Chick, Anisha Singh, Lauren A. Anker, Casey Buck, Makoto Kawai, Christine Gould, Isabelle Cotto, Logan Schneider, Omer Linkovski, Rosy Karna, Sophia Pirog, Kai Parker-Fong, Christian R. Nolan, Deanna N. Shinsky, Priyanka N. Hiteshi, Oscar Leyva, Brenda Flores, Ryan Matlow, Travis Bradley, Josh JordanVictor Carrion, Ruth O’Hara

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Study Objectives: Poor sleep impedes children’s cognitive, emotional, and psychosocial development. Pediatric sleep dysregulation is common, and children who live in communities of low socioeconomic status experience additional risk factors for short sleep duration and poor sleep quality. School-based training in mindfulness and yoga-informed practices can improve children’s behavior and well-being, but effects on objectively measured sleep are unknown. Methods: Effects of a school-based health and mindfulness curriculum, which taught practices such as paced breathing, on sleep and stress were examined in 115 children (49 girls, ages 8 to 11 at baseline). Fifty-eight children in a community of low socioeconomic status received the curriculum twice weekly for 2 years. Fifty-seven children in a socioeconomic status–matched community engaged in their usual physical education class instead. In-home ambulatory polysomnography and perceived social stress were measured in all children at 3 time points: at baseline (ie, prior to curriculum exposure) and at 2 yearly follow-ups. Results: Children receiving the curriculum gained an average of 74 minutes of total sleep time, and 24 minutes of rapid eye movement sleep, per night over the 2-year study period. Children not receiving the curriculum experienced a decrease in total sleep time averaging 64 minutes per night, with no changes in rapid eye movement sleep. Sleep improved within the first 3 months of curriculum exposure, in a dose-dependent fashion. Higher curriculum engagement (eg, using the breathing exercises outside of class) was associated with larger gains in total and rapid eye movement sleep duration. Aggregate within-group changes in social stress were not significant. However, among children receiving the curriculum, those who experienced larger gains in total and rapid eye movement sleep duration also experienced larger increases in perceived social stress. Conclusions: A school-based health and mindfulness curriculum improved children’s objectively measured sleep over 2 years. Social stress did not mediate these effects; instead, mindfulness training may have increased awareness of environmental stressors, while developing tools to reduce stress vulnerability.

Original languageEnglish
Pages (from-to)2261-2271
Number of pages11
JournalJournal of Clinical Sleep Medicine
Issue number9
StatePublished - 1 Sep 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
Copyright 2022 American Academy of Sleep Medicine. All rights reserved.


All authors have seen and approved this manuscript. Work for this study was performed at Stanford University School of Medicine. This study was funded by the Lucile Packard Foundation for Children’s Health and National Institutes of Health award UL1 TR001085. The authors report no conflicts of interest.

FundersFunder number
Lucile Packard Foundation for Children’s Health
National Institutes of Health
National Center for Advancing Translational SciencesUL1TR001085


    • REM sleep
    • mindfulness
    • polysomnography
    • stress


    Dive into the research topics of 'A school-based health and mindfulness curriculum improves children’s objectively measured sleep: a prospective observational cohort study'. Together they form a unique fingerprint.

    Cite this