Research and Development

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If you would like to contact Mary MacLeod, Director of FSI Research and Development please email her at research@familysleepinstitute.com

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FSI 2025 Research Study Series of Our Findings

We will update this initial post with our findings over time, so please check back regularly for the latest updates.

Introduction: Shedding Light on Pediatric Sleep Challenges: The Impact of Family Sleep Institute Trained Consultants Across the Globe 

As every parent knows, a child’s sleep — or lack of it — can affect the entire family. From bedtime battles to repeated night wakings, pediatric sleep problems are more than frustrating; they can influence a child’s development, emotional regulation, and family well-being. Fortunately, FSI trained sleep consultants are helping families across the globe navigate these challenges with skill and compassion. FSI has recently completed exciting new research on the real-world outcomes of consultations in 27 different countries with Family Sleep Institute (FSI) trained Consultants.

These findings shine a spotlight on the measurable changes families experience when working with FSI Consultants to address common infant and child nighttime sleep difficulties. These results will provide a first-of-its-kind, data-driven look at how customized, step-by-step, family-centered approaches are improving the sleep — and lives — of children and their caregivers.

🌙 What Were Some of the Night Sleep Problems and Outcomes Studied?

The FSI research team focused on a comprehensive list of nighttime sleep challenges that our consultants routinely address. These include:

• 🛁 Length of the bedtime routine: Is it taking too long to get your child to bed, which can affect their overall sleep quantity?
• ⏰ Consistence of bedtime: Do caregivers maintain a child’s regular sleep schedule?
• 🔄 Adjustment of bedtime: Does moving bedtime earlier or later lead to improved sleep for the child and family?
• 🕢 Time to bed vs. time to fall asleep: Is there a long lag between when a child is put to bed and when they fall asleep? Can this be shortened if there is?
• 🌌 Sleep independence: Do children fall asleep — and return to sleep after waking — without a caregiver’s help? Can they learn to?
• 😣 Bedtime struggles: Are there frequent struggles or resistance leading up to bedtime? Can these be minimized or resolved?
• 🛏️ Bed-sharing habits: Are families co-sleeping frequently and can this be solved?
• 🌃 Night wakings requiring caregiver assistance: How often are children waking and needing help to get back to sleep? Does this change with the consultation?
• 💤 Total nighttime sleep and morning wake times: Are children getting the recommended hours of sleep for their age, and are they waking too early?
• 📆 Number of nights to reach sleep goals: How long does it typically take for consultation changes to produce noticeable improvements?
• 👨‍👩‍👦 Parental involvement during sleep training: Is parental involvement high, moderate or none depending on consensus for the type of sleep training method used? Does the method change during the sleep training period with the Consultant?
• ✅ Caregiver and consultant satisfaction: How do families and their consultants feel about the process and its outcomes?

📊 Why This Research Matters

Sleep is not one-size-fits-all, and neither are the approaches used by FSI-trained Consultants. This research documents actual family outcomes, offering some insight into what works, how quickly, and under what circumstances. We understand that this research is not academically driven and controlled, rather it reflects the families that work with FSI consultants and the intensive training of our consultants. Therefore, it cannot be extrapolated to other consultants’ practices.

Importantly, this effort reflects the Family Sleep Institute’s mission to foster continuous learning among its consultants and improve the services offered to families. Internal research encourages a culture of active feedback, reflection, and refinement — both in client services and in the professional curriculum. This iterative process helps FSI adapt to changing family needs, preferences, and science-based best practices in real-world settings.

By capturing both quantitative data — such as changes in night wakings or bedtime duration — and qualitative feedback from families and consultants, the findings promise to provide a holistic picture of the consulting process and to refine the teaching curriculum. It highlights how tailored support and education empower parents to make sustainable changes — and how ongoing education empowers consultants to deliver their best work.

🔍 What to Expect

The forthcoming research data will add an evidence-based layer to what many families already know from experience: pediatric sleep consulting works. And when guided by a compassionate, knowledgeable FSI-trained Consultant, families don’t have to go-it alone.

Stay tuned for the release of our findings. In the meantime, if you’re navigating bedtime struggles or wondering whether a sleep consultant could help your family, know that you’re not alone — and real help is available.

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February 13, 2026

FSI Research Series Finding: Components for Healthy Child Sleep – Total Sleep Duration

Improving child sleep quality and duration involves optimizing sleep behaviors. The combination of consistent bedtime routines, appropriate bedtimes, and calm pre-bedtime activities significantly helps children get the sleep they need. Additionally, the ability for children to fall asleep and back to sleep independently without bed sharing is crucial for their sleep quality and for their caregivers’ sleep.

Important sleep markers to measure improvement in child sleep include: total night sleep, time to fall asleep, number of night wakings, and sleep efficiency. These parameters help in understanding sleep difficulties.

Total Sleep Duration refers to the amount of nighttime sleep. Once a child has consolidated nighttime sleep, daytime napping falls more easily and consistently into regular times. Tracking this allows scheduling of appropriate times for daytime naps.

How did the sleep parameter Total Sleep Duration change from the initial assessment to the outcome? See the pre and post sleep measures for total night sleep from 415 interventions with clients in 27 countries, consecutively reported by FSI consultants below.

Total Sleep Duration:

(Note paired indicates that initial and final measurements were done for each child and compared in pairwise analysis)

Key Observations: 

For 415/420 total participants (5 exclusions of children whose wake time was reported as first night waking “not the final wake-up time”).

1. 1. 1. Average sleep duration increased from 10.16 hours to 11.70 hours 
      2. Mean increase in sleep duration: 1.53 hours 
      3. 85.9% of children showed an increase in sleep duration 
      4. 8.6% of children showed a decrease in sleep duration 
      5. The variability in sleep duration decreased (SD: 1.45 to 0.69) 
      6. 95.0% Confidence interval for mean change: 1.53 ± 0.14 hours (1.40 to 1.67 hours) 

 
The analysis clearly demonstrates a significant improvement in sleep duration after the intervention, excluding the 5 individuals with unusual initial wake-up times, determined to be first night waking. The improvement is statistically significant (p < 0.0001). The paired line plot shows that most children experienced increased sleep duration, with only a small percentage showing decreases. Additionally, sleep patterns became more consistent after the intervention, as shown by the reduced standard deviation. 

Our next post will address the next Component for Healthy Child Sleep – Time to Fall Asleep

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March 26, 2026

FSI Research Findings Series Continuation: Components for Healthy Child Sleep: Sleep Onset Latency (Time to Fall Asleep)

Improving child sleep quality and duration involves optimizing sleep behaviors. The combination of consistent bedtime routines, appropriate bedtimes, and calm pre-bedtime activities significantly helps children get the sleep they need. Additionally, the ability of children to fall asleep and return to sleep independently, without bed sharing, has been shown to improve the child’s and caregiver’s sleep quality significantly.

Important sleep markers to measure improvement in child sleep include: total night sleep, time to fall asleep, number of night wakings, and sleep efficiency. These parameters help in understanding sleep difficulties.

Sleep Onset Latency (SOL): This is the time it takes for the infant to fall asleep after being put to bed. Shorter SOL is positively associated with a regular bedtime routine, longer sleep time, and overall better quality sleep.

How did the sleep parameter SOL change from the initial assessment to the outcome? See the pre and post-sleep measures for SOL from 415 interventions with clients in 27 countries, consecutively reported by FSI consultants below.

Key Observations: 

1. 1. 1. Substantial Reduction: The average time to fall asleep decreased from approximately 47 minutes initially to about 14 minutes after intervention, representing a reduction of about 33 minutes. A significant reduction in the time to fall asleep.
      2. More Consistent SOL: The standard deviation decreased dramatically from 31.5 minutes to 8.5 minutes, indicating much more consistent sleep onset times after intervention. 
      3. Range Narrowing: The maximum SOL decreased from 180 minutes (3 hours) to 120 minutes (2 hours), though most outcome values are clustered below 20 minutes. 
      4. Very Large Effect Size: The Cohen’s d value of -1.12 indicates a very large effect size, suggesting a substantial practical impact of the intervention on reducing time to fall asleep. 
      5. Distribution Shift: The histogram clearly shows a dramatic shift toward shorter SOL after intervention, with most outcome values concentrated between 5-20 minutes. 
      6. Thirty-eight children experienced an increase in their SOL after the intervention. 

This analysis provides strong evidence that the interventions were highly effective at reducing the time it takes for children to fall asleep, with clinically meaningful improvements for most participants. 

Analyzing the 38 participants who had an increase in SOL 

Key Observations: 

1. 1. 1. Unusually fast sleep onset at baseline: Children fell asleep in an average of 3.7 minutes—far below typical ranges—suggesting they were likely being put to bed already asleep or very close to sleep (e.g., rocked or fed to sleep), rather than “sleepy but awake.”
      2. Shift to more independent sleep: Post-intervention sleep onset increased to 13.1 minutes, aligning closely with the broader average (13.7 minutes) and indicating children were now being placed in bed awake.
      3. Increase reflects normalization, not deterioration: Although sleep onset lengthened by 4–20 minutes (average 9.5 minutes), this change represents a move toward healthier, developmentally appropriate sleep patterns.
      4. Outcomes remain within a healthy range: Final sleep onset times (typically 10–15 minutes) fall well within normal limits, supporting that the intervention improved sleep quality rather than worsening it.

 Our next blog will address the Component for Healthy Child Sleep – Number of Night Wakings

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March 7, 2025

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January 23, 2025

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January 7, 2025

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A Statement from the Family Sleep Institute: 9/14/2022

Standardizing Sleep Training Terminology

The importance of healthy sleep for child development is widely understood by the public and clinicians. As a result, the popularity of the child sleep consulting profession has grown exponentially over the last decade as have the number of books and social media posts on the topic. The countless variations of sleep training methods used to promote independent sleep for babies and children and the terms associated with these methods is confusing for parents, caregivers and for our collaborators/colleagues in the field.  

To standardize the narrative, in 2018 the Family Sleep Institute developed, adopted, and utilized more concise and consistent terminology with students to not only facilitate their learning, but to help the families that they will serve.

Rather than focus on the name or label associated with the sleep training method, we explain the approach as a measurement or level of parental/caregiver involvement and then suggest a method that fits the desired level of participation.

There are three different categories for the level of involvement during sleep training. All sleep training methods can fall into one of these three categories. 

No Parental/Caregiver Involvement: 

Parents do not play a role in the onset and return to sleep.

Common names/labels (extinction, CIO)

Moderate Parental/Caregiver Involvement:

Limited involvement in the child’s onset and return to sleep.

Common names/labels (timed intervals/checks, graduated extinction, Ferber Method, progressive waiting, the Wave, silent return and variations of these methods)

High Parental/Caregiver Involvement:

High Involvement in the child’s onset and return to sleep.

Common names/labels (chair method, camping out, Sleep Lady Shuffle and Pick Up Put Down and variations of these methods)

Once parent/s, caregiver/s, identify the role they want to have in establishing independent sleep for their baby or child, the consultant proposes specific strategies for the parent/s, caregiver/s based on their preference for how involved they want to be in the process. It is important to coach parent/s/caregiver/s using the strategies they feel comfortable implementing — ensuring they are committed and following through with these strategies so their baby or child will reach their ultimate goal of going and returning to sleep on their own.  

We encourage colleagues and sleep educators, not just graduates of the Family Sleep Institute, to adopt this standardized terminology of parental/caregiver involvement when referring to sleep training methods to streamline the narrative and, in turn, simplify the confusing language currently associated with sleep training.

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“A Healthy Child Needs a Healthy Brain, A Healthy Brain Needs Healthy Sleep”, Dr. Marc Weissbluth.

Dr. Weissbluth shares his insights and expertise to better understand why it is important for children to sleep well and about sleep training methods and the best family support. Below are a few of his posts. Discover more at https://marcweissbluth.com/blog.

Community Sleep Consultants

Our: Start School Later Partnership

In Support of Later School Start Times for Adolescents – 

A Statement from The Family Sleep Institute

Sleep is widely recognized as one of the basic pillars of human health and is essential to optimal growth and development in children and adolescents.  Yet while we know that adequate amounts of sleep are biologically necessary for our bodies and minds to function properly, according to the National Sleep Foundation as many as 59% of middle school students and 87% of high school students are not getting the recommended 8-10 hours of sleep each night as set forth by the American Academy of Sleep Medicine (AASM).   In fact, many adolescents are getting as little as 7 hours of sleep per night resulting in chronic sleep loss. The AASM goes on to list quantity, timing, quality and regularity as basic elements for healthy sleep.  Thanks to changes in their sleep wake cycle during puberty and beyond, adolescents are lacking in all of these basic areas.  That is, their school day starts earlier than is appropriate for their unique circadian rhythms thus affecting the quantity and timing of their sleep while prompting them to try to make up for lost sleep at other times causing their sleep to be lower quality and their schedules to be irregular.  Over time these kinds of unhealthy sleep patterns have been shown to lead to poor health outcomes including obesity and diabetes, decreased academic performance, mental health and behavioral issues as well as poor decision making among other safety concerns. The Family Sleep Institute (FSI) aims to help families achieve healthy sleep through promotion of proper sleep hygiene which includes adhering to the aforementioned recommendations.  We therefore, support the proposal presented in the American Academy of Pediatrics (AAP) Policy Statement, “School Start Times for Adolescents”, to delay school start times in an effort to address this public health issue.  In the statement, the AAP states that the “evidence strongly implicates earlier school start times (i.e., before 8:30) as a key modifiable contributor to insufficient sleep.”  Further, the AAP notes that “the average teenager in today’s society has difficulty falling asleep before 11:00pm and is best suited to wake at 8:00am or later.” Additionally, a 2014 study highlights an association between later school start times for this age group and an increase in sleep duration, improved mood as well as reduced daytime sleepiness. It is for these reasons, and in accordance with our Core Values in which we pledge to “support and encourage collaboration with professionals in related fields within medicine, health and education to promote sleep health and sleep safety from birth to adulthood among families and the general public”, that we endorse the initiative and efforts of Start School Later.

Kelly Weygandt, R.N, B.S.N, Director of R@D and the  Research and Development Team (Jami Cassoff, PhD, Liberty Mahon, Mary MacLeod, and Jessica Begley MPH, Rebecca Kempton, M.D.)

References

1 National Sleep Foundation. (2006) National Sleep Foundation 2006 Sleep In America Poll. Retrieved from https://sleepfoundation.org/sites/default/files/2006_summary_of_findings.pdf

2 Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med 2016;12(6):785–786

3 American Academy of Pediatrics, Adolescent Sleep Working Group, Committee on Adolescence and Council on School Health. (2014). School start times for adolescents. Pediatrics. doi: 10.1542/peds.2014-1697

4 Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med 2016;12(6):785–786

5 National Sleep Foundation. (n.d.) Backgrounder: Late school start times. Retrieved April 29, 2014 from http://sleepfoundation.org/sleep-news/backgrounder-later-school-start-times/

6 Paul Kelley, Steven W. Lockley, Russell G. Foster & Jonathan Kelley (2015) Synchronizing education to adolescent biology: ‘let teens sleep, start school later’, Learning, Media and Technology, 40:2, 210-226, DOI: 10.1080/17439884.2014.942666

7 American Academy of Pediatrics, Adolescent Sleep Working Group, Committee on Adolescence and Council on School Health. (2014). School start times for adolescents. Pediatrics. doi: 10.1542/peds.2014-1697

8 American Academy of Pediatrics, Adolescent Sleep Working Group, Committee on Adolescence and Council on School Health. (2014). School start times for adolescents. Pediatrics. doi: 10.1542/peds.2014-1697

9 Boergers, J., Gable, C. J., & Owens, J. A. (2014). Later school start time is associated with improved sleep and daytime functioning in adolescents. Journal of Developmental & Behavioral Pediatrics, 35(1), 11-17. doi: 10.1097/dbp.0000000000000018