Associations between demographic characteristics, school schedules, activity choices, family functioning, and sleep behaviors were estimated using nationally representative time-diary data from 2,454 children (ages 5.5 to 11.9 years) and adolescents (ages 12.0 to 19.1 years). For weekdays, African American adolescents, Asian children, and those with earlier school start times and longer travel times to school reported fewer sleep hours. More time spent watching television (for children), doing homework (for adolescents), and engaging in religious activities predicted fewer hours, whereas a longer time spent on meals predicted greater hours of weekday sleep. For younger children, greater parental warmth predicted more hours of weekday sleep, whereas for adolescents, stricter household rules were protective. On weekends, African American adolescents and Hispanic children slept less, and there were strong effects of activity choices including time spent on television, computer and videogames, sports, religious activities, socializing, and employment. In accounting for age-related decreases in sleep hours from childhood to adolescence, earlier school start times, greater hours of homework, greater paid employment, less time spent on meals, and fewer household rules were all significant mediators.

Associations between sleep and the body mass index (BMI) and overweight status of children and adolescents were estimated using longitudinal data from a nationally representative sample of 2,281 children aged 3-12 years at baseline. Controlling for baseline BMI, children who slept less, went to bed later, or got up earlier at the time of the first assessment had higher BMIs 5 years later and were more likely to be overweight. Child age moderated the relationship between bedtime and BMI. In addition, the study reports nationally representative data on the sleep habits of American children aged 3-18 years. This study underscores the likely importance of sleep on children's physical health and suggests that sleep is important for understanding childhood weight problems.

To meet the long-term care needs of Baby Boomers, social and public policy changes must begin soon. Meeting the financial and social service burdens of growing numbers of elders will not be a daunting task if necessary changes are made now rather than when Baby Boomers actually need long-term care.

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