Sleep health of children and adolescents in foster and kinship care: A systematic review.

BACKGROUND

Sleep is essential for health and development. Despite known connections between child maltreatment and sleep disturbances, previous reviews have not focused on children's sleep in foster and kinship care.

OBJECTIVE

We conducted a systematic review to understand and synthesize the sleep health characteristics of 0-18-year-old children in foster and kinship care.

METHODS

We searched seven electronic databases in May 2024 (updated March 2025) and included primary quantitative studies with sleep health (e.g., duration, efficiency, quality) data for children and adolescents in foster and kinship care. We assessed the methodological quality of each article with the most relevant Joanna Briggs Institute critical appraisal tool. Given study heterogeneity (e.g., outcomes, ages), findings are presented narratively.

RESULTS

Twenty-five publications (with 21 unique samples) met review criteria. Sleep duration (k = 9/21), quality/sleep problems (k = 8), efficiency (k = 7), and parasomnias (k = 7) were most often evaluated. Sleep efficiency difficulties (e.g., falling asleep, staying asleep), general sleep problems, parasomnias (e.g., nightmares, bedwetting), and sleep prescriptions/supplements were commonly reported in foster/kinship care. Sleep duration findings were mixed and may connect to sleep timing. Surprisingly, no significant insomnia differences were noted between foster/kinship and community samples, but insomnia (k = 2) comprised the least evaluated outcome. A noteworthy limitation in this body of literature is the common use of sleep measures lacking psychometric data.

CONCLUSIONS

Research on the sleep health of children in foster and kinship care is sparse and heterogeneous. Additional research is urgently needed to help clinicians, care providers, and researchers better understand and promote sleep health in care.