ASMR sleep refers to the use of Autonomous Sensory Meridian Response triggers, typically soft sounds like whispers, rain, tapping, or brushing, to induce relaxation and facilitate falling asleep. ASMR produces a tingling sensation starting at the scalp and moving down the spine, which reduces physiological arousal, lowers heart rate, and activates the parasympathetic nervous system. Millions worldwide use ASMR audio tracks before bed to transition from wakefulness to sleep more smoothly, making it one of the most searched sleep aid techniques online.
ASMR sleep leverages gentle auditory triggers to activate relaxation responses in the nervous system, helping reduce sleep onset time and anxiety. It works through repetitive, predictable sounds that calm the mind and body naturally without medication.
What is ASMR, exactly?
Autonomous Sensory Meridian Response is a physical sensation characterized by tingling that begins on the scalp and may spread down the neck and spine in response to specific auditory, visual, or tactile stimuli. First named and defined in 2010 by online communities, ASMR has grown from a niche internet phenomenon into a recognized sensory experience studied by neuroscientists and sleep researchers worldwide.
The autonomic aspect refers to the involuntary nature of the response, which cannot be forced or faked. The sensory component highlights that it originates from external stimulation through the senses, particularly hearing. Meridian describes the wave-like quality of the tingling sensation as it travels through the body. Response indicates that not everyone experiences ASMR, with research suggesting approximately 20-50% of the population reports sensitivity to ASMR triggers (University of Sheffield, Department of Psychology, 2018).
- ASMR trigger
- A specific sound, visual, or tactile stimulus that reliably produces the tingling ASMR sensation in responsive individuals, such as whispering, tapping, or personal attention role-plays.
Common ASMR triggers include whispered speech, soft-spoken voices, tapping on various surfaces, scratching textures, page turning, hair brushing sounds, rain or water sounds, and close personal attention scenarios. The triggers work best when delivered with intentionality, repetition, and a predictable rhythm that allows the nervous system to settle into a receptive state.
ASMR content exploded on platforms like YouTube starting around 2010, with creators producing long-form audio and video specifically designed to trigger the response. By 2026, ASMR has evolved beyond entertainment into a recognized wellness tool, integrated into meditation apps, sleep programs, and therapeutic settings. The physiological basis involves reduced heart rate, increased skin conductance response during the tingling phase, and activation of brain regions associated with reward, emotional regulation, and social bonding.
Understanding what ASMR is requires recognizing both its subjective experiential quality and its measurable physiological effects, making it a bridge between personal sensory experience and evidence-based relaxation techniques.
Why does ASMR help with falling asleep?
Read also : ASMR & Sleep
ASMR facilitates sleep onset by directly activating the parasympathetic nervous system, the body's rest-and-digest mode that counteracts the arousal and stress responses keeping people awake. The gentle, repetitive nature of ASMR triggers creates a cognitive anchor that redirects attention away from racing thoughts and worries, a primary barrier to falling asleep for many individuals.
Research from the Sleep Foundation indicates that approximately 33% of adults report difficulty falling asleep at least three nights per week (National Sleep Foundation Sleep in America Poll, 2022). ASMR addresses this by providing a non-pharmaceutical intervention that engages the mind just enough to prevent rumination while simultaneously calming physiological arousal markers.
- Parasympathetic activation
- The state when the vagus nerve stimulates rest responses including decreased heart rate, lowered blood pressure, reduced cortisol, and enhanced digestive function, opposite to fight-or-flight activation.
The mechanism works through several interconnected pathways. First, ASMR triggers capture attention without stimulating alertness, creating what researchers call selective attention without arousal, a rare cognitive state ideal for sleep transition. Second, the predictable, repetitive nature of ASMR sounds provides temporal structure that helps the brain shift from beta waves associated with active thinking to alpha and theta waves characteristic of drowsiness and light sleep stages.
Third, ASMR produces measurable reductions in heart rate. A study published in peer-reviewed journals found that participants watching ASMR videos experienced significant decreases in heart rate compared to non-ASMR control videos, with those who experienced tingles showing the greatest cardiovascular calming effects. This physiological shift mirrors the natural progression toward sleep when the body temperature drops and circulation slows.
Fourth, ASMR may trigger endorphin and oxytocin release, neurochemicals associated with bonding, trust, and relaxation. The personal attention aspect of many ASMR triggers, where the content simulates one-on-one care scenarios like hairdressing or medical examination, may activate social bonding circuits in the brain that promote feelings of safety, a prerequisite for deep sleep.
Finally, ASMR creates a sound masking effect, blocking out environmental noise disruptions or internal mental chatter that would otherwise maintain wakefulness. By filling the auditory environment with controlled, soothing stimuli, ASMR prevents the orienting response where sudden sounds jolt attention and spike arousal, keeping the nervous system in a stable, descending trajectory toward sleep.
The most effective ASMR triggers
While individual preferences vary significantly, certain ASMR triggers consistently produce relaxation and tingles across larger populations, making them the foundation of sleep-focused ASMR content. Understanding the most effective triggers helps users find what works best for their nervous system and sleep needs.
Whispered speech ranks among the most popular and effective ASMR triggers. The sibilant sounds, close proximity suggested by whispered delivery, and the intimate communication style all combine to produce strong responses. Whispers work particularly well because they require listener attention to parse the words, occupying cognitive resources without stimulating alertness, while the soft volume naturally encourages auditory focus and relaxation.
- White noise variants
- Sound frequencies distributed evenly across the audible spectrum, including pink noise (emphasis on lower frequencies) and brown noise (even deeper bass emphasis), used to mask disruptive sounds and promote neural synchronization.
Rain sounds and water audio represent one of the most universally calming ASMR categories. Rainfall produces unpredictable yet statistically consistent sound patterns that engage attention without creating expectation or tension. The frequency profile of rain naturally masks higher-frequency environmental sounds while providing a sonic blanket that signals safety to the nervous system. Ocean waves, stream babbling, and gentle waterfalls produce similar effects through rhythmic, repetitive patterns.
Tapping and scratching on various surfaces creates crisp, textured sounds that many find deeply satisfying. The repetitive nature establishes predictable rhythm while subtle variations in tone and intensity maintain just enough novelty to sustain attention. Wood, glass, cardboard, and fabric produce distinct acoustic signatures, allowing users to discover which textures resonate most with their sensory preferences.
Personal attention role-plays simulate scenarios like haircuts, medical examinations, spa treatments, or makeup application. These triggers combine soft-spoken or whispered narration with associated sounds like brushing, spray bottles, or gentle hand movements. The role-play format activates social bonding responses and memories of nurturing care, creating psychological safety that facilitates sleep.
Page turning and paper sounds offer crisp, clean audio with natural pauses and gentle rustling. The association with reading and quiet study environments may trigger conditioned relaxation responses in many listeners. Similarly, typing sounds, especially on mechanical keyboards, provide rhythmic patterns that some find hypnotically soothing.
Mouth sounds and eating constitute a more divisive category, with strong positive responses from some and aversion from others. Gentle mouth sounds, gum chewing, or soft eating can produce intense tingles for responsive individuals, though these triggers require careful personal testing to determine compatibility.
| ASMR Trigger Type | Primary Mechanism | Best For |
|---|---|---|
| Whispers | Intimate communication, cognitive engagement | Racing thoughts, anxiety |
| Rain/Water | Sound masking, rhythmic consistency | Environmental noise sensitivity |
| Tapping | Repetitive rhythm, predictable patterns | Those needing cognitive anchor |
| Personal attention | Social bonding activation, safety signals | Loneliness, stress from isolation |
| Binaural recording | 3D spatial audio, immersive experience | Headphone users seeking deep immersion |
The effectiveness of triggers depends partly on delivery quality. Binaural recording techniques, which use two microphones to capture spatial audio information, create three-dimensional soundscapes that significantly enhance immersion and response intensity when heard through headphones. High-quality audio equipment and quiet recording environments maximize trigger clarity and minimize distracting artifacts.
How Nala approaches ASMR sleep content
Nala offers over 300 bilingual meditation and sleep sessions developed with 13 specialized experts across French and English. The app was created by founder Mathias Robin through 18 months of bootstrap development in France, focusing on delivering authentic, high-quality audio experiences without corporate venture backing.
The Nala approach to ASMR sleep integrates the proprietary Sovaluna 5-phase methodology: somatic awareness, vagal activation, conscious breathing, progressive descent, and frequential entrainment. This structure guides users from active wakefulness through parasympathetic engagement to sleep onset using evidence-informed techniques tailored to each expert's specialty.
Rather than generic ASMR content, Nala's experts each bring distinct sonic signatures and trigger specializations. This diversity allows users to explore different ASMR approaches, from nature soundscapes and rain atmospheres to whispered guidance and sound bath experiences, all within a cohesive framework designed specifically to support sleep transition.
The bilingual format serves both native speakers and language learners, with sessions available in French and English, ensuring accessibility across European and North American markets while maintaining the audio quality essential for effective ASMR experiences.
2020-2025 ASMR scientific studies
Read also : Sleep meditation
Scientific research into ASMR expanded significantly between 2020 and 2025, moving from exploratory studies documenting the phenomenon to investigations of underlying mechanisms and therapeutic applications. While ASMR research remains a relatively young field, peer-reviewed publications have established foundational understanding of its physiological and psychological effects.
Research published in 2018 at the University of Sheffield examined physiological responses during ASMR experiences, finding significant reductions in heart rate averaging 3.14 beats per minute in participants who experienced tingles. This cardiovascular slowing provides objective evidence that ASMR produces measurable relaxation responses similar to other established calming techniques like deep breathing or progressive muscle relaxation.
- Functional MRI (fMRI)
- Brain imaging technique measuring blood flow changes to identify which brain regions activate during specific experiences, used to map neural correlates of subjective sensations like ASMR tingles.
Neuroimaging studies using functional MRI have identified brain regions activated during ASMR experiences, including areas associated with emotional regulation, reward processing, and social cognition. The medial prefrontal cortex, nucleus accumbens, and insula show activation patterns during ASMR that overlap with experiences of pleasure, relaxation, and interpersonal connection, helping explain why ASMR feels both physically pleasurable and emotionally comforting.
Research into individual differences has explored why some people experience ASMR while others do not. Studies suggest that ASMR responders may have differences in sensory processing sensitivity, resting-state brain connectivity, or trait characteristics like openness to experience. Approximately 20-50% of surveyed populations report experiencing ASMR sensations, though this percentage varies across studies depending on definition and measurement approaches.
Mental health applications have emerged as a research focus, with studies examining ASMR's potential for managing symptoms of depression, anxiety, and insomnia. Survey research indicates that many ASMR consumers report using content specifically for stress reduction and sleep improvement, with subjective reports of effectiveness. However, rigorous controlled trials comparing ASMR to established interventions remain limited as of 2025, representing an important direction for future research.
One significant limitation across ASMR research is the challenge of creating appropriate control conditions. Since ASMR response is subjective and varies by individual, designing experiments that isolate ASMR effects from general relaxation responses or placebo effects requires careful methodology. Additionally, much ASMR research relies on self-reported experiences and online surveys, which provide valuable preliminary data but require validation through laboratory studies with physiological measurement.
The growing academic interest in ASMR reflects broader recognition of its widespread use and potential therapeutic value, though researchers emphasize that more rigorous investigation is needed before clinical applications can be confidently recommended.
ASMR vs binaural beats vs sound healing
ASMR, binaural beats, and sound healing represent three distinct approaches to using audio for relaxation and sleep, each with different mechanisms, experiential qualities, and evidence bases. Understanding these differences helps users select the most appropriate technique for their needs and preferences.
ASMR relies on specific trigger sounds that produce tingling sensations and activate relaxation through attention capture, parasympathetic engagement, and possible endorphin release. The experience is subjective, varies by individual, and depends on trigger sensitivity. ASMR content typically features recognizable real-world sounds like tapping, whispering, or rain, creating narrative or sensory experiences rather than abstract tones.
- Binaural beats
- An auditory illusion created when two slightly different frequencies are presented separately to each ear through headphones, causing the brain to perceive a third frequency equal to the difference between them.
Binaural beats use the brain's frequency-following response, where neural oscillations begin synchronizing with perceived rhythmic stimuli. When a 200 Hz tone plays in one ear and 210 Hz in the other, the brain perceives a 10 Hz beat frequency, theoretically entraining brainwaves toward that frequency. Delta frequencies (1-4 Hz) correlate with deep sleep, theta (4-8 Hz) with drowsiness and meditation, alpha (8-13 Hz) with relaxation, and beta (13-30 Hz) with active thinking. Proponents suggest binaural beats can guide the brain toward desired states, though research evidence shows mixed results with some studies finding modest effects and others finding none.
Sound healing encompasses practices like singing bowls, gongs, tuning forks, and sound baths, rooted in traditions claiming that specific frequencies or harmonic relationships produce healing effects in the body. Singing bowls, typically made of metal alloys, produce rich overtones and sustained resonance when struck or circled with a mallet. Sound bath experiences immerse participants in these layered frequencies, creating meditative states through sustained attention and vibrational exposure.
| Approach | Primary Mechanism | Evidence Level | Equipment Needs |
|---|---|---|---|
| ASMR | Trigger-based relaxation, tingles | Emerging research, physiological effects documented | Headphones recommended, speakers acceptable |
| Binaural beats | Brainwave entrainment hypothesis | Mixed research results, modest effects if any | Headphones required for effect |
| Sound healing | Frequency resonance, meditation facilitation | Limited rigorous research, strong traditional practice | Live instruments or high-quality recordings |
For sleep specifically, ASMR offers the advantage of diverse trigger options, allowing personalization based on individual response patterns. Binaural beats provide structured frequency protocols but require headphones and may not work for everyone. Sound healing creates rich sonic environments that facilitate meditation and relaxation, though the specific frequency claims lack robust scientific validation. Many users find value in all three approaches, sometimes combining elements, such as ASMR content with embedded binaural beats or sound bath recordings with whispered guidance.
ASMR sound bath at Nala: Onyx's specialty
Nala's sound bath experiences represent a specialized intersection of ASMR triggers and sound healing traditions, expertly delivered through sessions guided by Onyx, one of the app's 13 specialized experts. Sound baths combine sustained resonant frequencies from instruments like singing bowls with the immersive qualities that characterize effective ASMR content.
- Sound bath
- An immersive listening experience where participants lie comfortably while sustained, layered sounds from instruments like singing bowls, gongs, or chimes create a meditative acoustic environment.
Onyx's approach focuses on creating rich harmonic soundscapes that facilitate the transition from wakefulness to sleep through frequency layering and careful pacing. Singing bowls produce complex overtone series where multiple frequencies resonate simultaneously, creating what acousticians call beating patterns as the slightly different frequencies interact. This produces a shimmering, wavering quality that captures attention and encourages the mind to settle into a receptive, non-analytical listening mode.
The effectiveness of sound baths for sleep preparation comes through multiple pathways. The sustained tones provide continuous auditory input that masks environmental noise and internal mental chatter. The harmonic complexity creates acoustic richness that remains engaging without stimulating active thinking. The vibrational quality, even when experienced through recordings rather than live, produces a felt sense of immersion that many describe as enveloping or cocooning.
Traditional sound healing practices attribute specific effects to particular frequencies or musical intervals, though scientific validation of these specific claims remains limited. What research does support is that sustained tones at moderate volumes can facilitate meditative states, reduce perceived stress, and create conditions conducive to relaxation and sleep onset. The mechanisms likely involve the same attention capture and parasympathetic activation that underlie other effective ASMR triggers.
Onyx's sound bath sessions at Nala integrate these elements within the Sovaluna 5-phase framework, beginning with somatic grounding, progressing through vagal tone activation and conscious breathing, then descending into the sound bath proper where singing bowl frequencies provide the frequential entrainment phase. This structured progression ensures users don't simply hear pleasant sounds but move through a guided process designed to systematically downregulate arousal and prepare the nervous system for sleep.
Sound bath content works particularly well for individuals who find vocal ASMR triggers distracting or who prefer non-verbal audio environments. The instrumental nature eliminates language processing demands, making sound baths accessible regardless of linguistic background and suitable for those who find words keep them mentally engaged rather than relaxed.
Zara Nala: the whispered ASMR voice
Among Nala's 13 specialized experts, Zara brings particular expertise in whispered ASMR delivery, creating sessions that leverage the intimate, calming qualities of soft-spoken and whispered guidance. Whispered ASMR represents one of the most popular and effective trigger categories, with millions of dedicated listeners seeking this specific delivery style for sleep and relaxation.
Zara's whispered sessions combine gentle vocal delivery with intentional pacing, allowing space between phrases for the nervous system to process and respond. The whispered quality creates acoustic characteristics distinct from normal speech: emphasized sibilant sounds, reduced volume requiring focused attention, and an implied intimacy that activates social bonding responses in the brain.
- Sibilance
- The hissing sound quality of certain consonants like S, Z, SH, and CH, particularly prominent in whispered speech and frequently reported as a powerful ASMR trigger by responsive individuals.
The psychological impact of whispered communication extends beyond the acoustic properties. Whispering signals confidentiality, closeness, and personal attention, all of which create feelings of safety and care. In evolutionary terms, whispered communication occurs in contexts of intimacy or shared secrecy, activating neural circuits associated with trust and bonding. This activation produces oxytocin release, a neurochemical that promotes relaxation, reduces stress hormone levels, and facilitates social connection, all beneficial for sleep preparation.
Zara's content at Nala includes guided meditations, body scans, and sleep stories delivered in whispered tones, each structured to progressively reduce arousal and guide attention inward. The whispered delivery works synergistically with the Sovaluna methodology, where the voice itself becomes a vagal activation tool, stimulating the parasympathetic nervous system through both acoustic qualities and the psychological safety the whispered tone conveys.
For users exploring Nala's ASMR offerings, Zara's whispered sessions provide an accessible entry point, particularly for those new to ASMR who want to experience one of the most universally effective trigger types. The combination of expert vocal delivery, high-quality binaural recording, and sleep-specific content structure distinguishes these sessions from generic ASMR content available on free platforms, offering a curated experience optimized specifically for sleep transition rather than entertainment or casual relaxation.
ASMR doesn't work on me: what to do?
Approximately half of the population does not experience ASMR tingles or finds ASMR triggers ineffective or even irritating. This variability is normal and reflects genuine differences in sensory processing, neural connectivity, and individual preferences rather than any deficiency or failure to respond correctly.
If ASMR doesn't produce relaxation or tingles, several alternative approaches can provide similar sleep benefits. First, recognize that the tingling sensation itself is not necessary for ASMR to provide sleep benefits. Some people experience relaxation and sleep improvements from ASMR content without ever feeling tingles, as the gentle sounds still provide noise masking, attention capture, and parasympathetic activation through other pathways.
Second, experiment with different trigger categories. ASMR encompasses enormous variety, from whispers to tapping to nature sounds to crinkling to role-plays. An individual might find whispered speech irritating but respond strongly to rain sounds or tapping. Systematic exploration across trigger types increases the likelihood of finding compatible stimuli.
Third, consider non-ASMR alternatives that provide similar functional benefits. Guided meditation with normal-volume narration offers structured attention direction and relaxation without ASMR-specific triggers. Progressive muscle relaxation provides systematic body awareness and tension release. Ambient nature recordings deliver sound masking and gentle acoustic environments without trigger-focused design. White noise, pink noise, or brown noise create consistent sound blankets that block disruptions and facilitate sleep onset through entirely different mechanisms.
- Sound sensitivity
- Individual differences in how intensely and emotionally people respond to auditory stimuli, ranging from high sensitivity where sounds produce strong reactions to low sensitivity requiring intense stimuli for noticeable response.
Fourth, evaluate whether misophonia, the experience of strong negative emotional or physiological responses to specific sounds like chewing or breathing, might explain aversion to certain ASMR triggers. Misophonia and ASMR may represent opposite ends of a sensory processing spectrum, and individuals with misophonia often find ASMR content actively unpleasant. For these individuals, instrumental music, nature sounds without human elements, or silent meditation techniques may prove more compatible.
Finally, remember that no single relaxation technique works universally. Sleep hygiene, consistent schedules, cognitive behavioral therapy for insomnia, stress management, and environmental optimization all contribute to sleep quality independently of any specific audio intervention. ASMR represents one tool among many, valuable for those who respond but not essential for achieving healthy sleep.
ASMR for insomnia, anxiety, kids
ASMR applications extend beyond general sleep improvement to specific populations and conditions including clinical insomnia, anxiety disorders, and pediatric sleep challenges. While research remains preliminary, growing evidence and user reports suggest ASMR may offer adjunctive benefits in these contexts when used appropriately.
ASMR for insomnia: Insomnia disorder affects approximately 10-15% of adults with chronic symptoms (American Academy of Sleep Medicine clinical practice guidelines, 2021). Cognitive behavioral therapy for insomnia (CBT-I) represents the first-line treatment, addressing maladaptive thoughts and behaviors that perpetuate sleep difficulties. ASMR can complement CBT-I by providing a concrete sleep initiation ritual, reducing pre-sleep cognitive arousal, and creating positive sleep associations.
The key for insomnia sufferers is using ASMR as part of structured sleep hygiene rather than as a solution in itself. ASMR works best when combined with consistent sleep-wake schedules, stimulus control instructions, and addressing underlying factors like sleep anxiety or hyperarousal. For individuals with conditioned arousal where the bed has become associated with wakefulness and frustration, ASMR can help recondition the sleep environment as a place of relaxation.
- Sleep onset latency
- The time required to transition from full wakefulness to sleep, typically measured from lights out to the first epoch of any sleep stage, with normal latency ranging from 10-20 minutes.
ASMR for anxiety: Anxiety disorders affect approximately 31% of adults at some point in their lives (National Institute of Mental Health epidemiological data, 2023). The physiological arousal accompanying anxiety, including elevated heart rate, muscle tension, and racing thoughts, directly interferes with sleep initiation. ASMR addresses these mechanisms by activating the parasympathetic nervous system, providing cognitive distraction from worry, and reducing measurable arousal markers.
Research has documented that ASMR consumers frequently report using content specifically for anxiety reduction, with subjective improvements in mood and stress levels. While ASMR should not replace evidence-based anxiety treatments like cognitive behavioral therapy or appropriate medication, it offers a self-directed, accessible tool for managing acute anxiety symptoms, particularly when they interfere with sleep.
The personal attention and safe intimacy conveyed through many ASMR triggers may be particularly relevant for anxiety, as these elements activate social safety circuits in the nervous system. For individuals whose anxiety includes social components or stems from loneliness, ASMR content simulating caring interactions may provide unique benefits beyond generic relaxation techniques.
ASMR for children: Pediatric sleep problems affect approximately 25-40% of children across various age groups (American Academy of Pediatrics sleep guidelines, 2016). ASMR for children requires careful consideration of content appropriateness, volume levels, and integration with bedtime routines.
Age-appropriate ASMR content for children typically emphasizes nature sounds, gentle instrumental music, soft-spoken stories, and avoid triggers that might seem strange or unsettling to young listeners. The whispered intimacy that adults find relaxing might confuse or unsettle children unfamiliar with the context. Instead, content framed as bedtime stories, nature adventures, or imagination journeys with ASMR-quality production values works better for pediatric audiences.
Parents should supervise initial ASMR exposure to ensure volume remains safe, content is appropriate, and the child responds positively rather than with confusion or fear. ASMR should complement rather than replace important bedtime rituals like parental connection, predictable routines, and age-appropriate sleep schedules. For children with anxiety, sensory processing differences, or attention difficulties, ASMR may provide helpful structure and calming input, though individual response varies significantly.
Importantly, Nala's content and similar meditation apps typically target adult audiences. Parents seeking ASMR for children should look for content specifically created for pediatric use, with appropriate language, pacing, and themes suited to developmental stages.
Frequently Asked Questions
Does ASMR work without headphones?
What is the ideal duration for ASMR sleep sessions?
Can ASMR replace meditation for relaxation?
Why does rain ASMR work so well for sleep?
Is it safe to use ASMR every night?
What brain regions activate during ASMR?
Can ASMR help with sleep apnea or other sleep disorders?
Should ASMR volume be loud or soft?
What makes Nala ASMR different from YouTube ASMR?
Do binaural beats actually change brainwaves?
Can I become immune or habituated to ASMR triggers?
Is ASMR scientifically proven to improve sleep quality?
What should I do if ASMR makes me feel anxious or uncomfortable?
How long does it take to feel ASMR effects?
Should I use ASMR in the morning or only at night?
Sources
- University of Sheffield, Department of Psychology - ASMR physiological responses and heart rate reduction study, 2018
- National Sleep Foundation - Sleep in America Poll data on sleep difficulties prevalence, 2022
- American Academy of Sleep Medicine (AASM) - Clinical practice guidelines on insomnia prevalence and treatment, 2021
- National Institute of Mental Health (NIMH) - Epidemiological data on anxiety disorder lifetime prevalence, 2023
- American Academy of Pediatrics (AAP) - Pediatric sleep guidelines and prevalence of childhood sleep problems, 2016
