Foster agency workers’ perceptions of sleep health among children in foster care

Quality sleep during the formative years directly contributes to healthy physical and emotional outcomes via interactions with multiple bioregulatory systems. At the same time, sleep regulation is adversely affected by trauma, unstable/inconsistent environments and insecure attachment to a caregiver, suggesting youth in foster care are at extraordinary risk for sleep disturbances. To date, however, the sleep health of these children has received scant attention. The current study surveyed 43 foster care licensing agency personnel (95.3% female) who work directly with foster families about their experiences and perceptions of sleep among these children. On average, participants reported having worked with foster families for almost 10 years (M = 9.6 years; SD = 7.6) at the time of survey completion. The most frequently endorsed sleep-related problems were difficulty falling asleep (endorsed by 86% of participants), resisting/refusing to go to bed (65.1%), nightmares (62.7%), nighttime fears (62.7%) and wetting the bed (62.7%). These problems were perceived to sometimes contribute to child placement disruption. With regard to sleep-focused education/training, a majority of participants believed a brief, group-based training about sleep would be the most effective approach for helping caregivers to ensure children receive adequate sleep. While preliminary, findings indicate trauma-related sleep disturbances are common among children in foster care and potentially contribute to placement instability. In addition to more research, there is need for child welfare policies and programs to promote healthy sleep.