Does context matter? A multilevel analysis of neighborhood disadvantage and children's sleep health

Graham, Carlyn; Reither, Eric N.; Ciciurkaite, Gabriele; Dev, Dipti A.; Fargo, Jamison D.

doi:10.1016/j.sleh.2020.05.002

Cited by 12 publications

(5 citation statements)

References 53 publications

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“…Lower family income-to-needs ratio and parental education were associated with later weekday and weekend sleep midpoints in children. These findings are consistent with those of previous studies linking socioeconomic disadvantage with later bedtimes in children (4,(22)(23)(24)(25)(26). Later sleep midpoint may suggest that sleep timing is misaligned with optimal functioning of the circadian system (28).…”

Section: Socioeconomic Disadvantage Is Associated With Later Sleep Ti...supporting

confidence: 93%

“…Later sleep timing has been related to delayed circadian functioning and sleep problems (21). Socioeconomic disadvantage has been frequently associated with later bedtimes in children (4,(22)(23)(24)(25)(26). Fewer studies have focused on sleep midpoint, which captures variability in both bedtime and wake-up time.…”

Section: Socioeconomic Disparities In Sleep Duration and Timingmentioning

confidence: 99%

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Socioeconomic factors, sleep timing and duration, and amygdala resting-state functional connectivity in children

Hansen,

Simon,

et al. 2024

Front. Psychiatry

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IntroductionReduced sleep health has been consistently linked with increased negative emotion in children. While sleep characteristics have been associated with neural function in adults and adolescents, much less is known about these associations in children while considering socioeconomic context. In this study, we examined the associations among socioeconomic factors, sleep duration and timing, and resting-state functional connectivity (rsFC) of the amygdala in children.MethodsParticipants were typically-developing 5- to 9-year-olds from socioeconomically diverse families (61% female; N = 94). Parents reported on children’s weekday and weekend bedtimes and wake-up times, which were used to compute sleep duration and midpoint. Analyses focused on amygdala-anterior cingulate cortex (ACC) connectivity followed by amygdala-whole brain connectivity.ResultsLower family income-to-needs ratio and parental education were significantly associated with later weekday and weekend sleep timing and shorter weekday sleep duration. Shorter weekday sleep duration was associated with decreased amygdala-ACC and amygdala-insula connectivity. Later weekend sleep midpoint was associated with decreased amygdala-paracingulate cortex and amygdala-postcentral gyrus connectivity. Socioeconomic factors were indirectly associated with connectivity in these circuits via sleep duration and timing.DiscussionThese results suggest that socioeconomic disadvantage may interfere with both sleep duration and timing, in turn possibly altering amygdala connectivity in emotion processing and regulation circuits in children. Effective strategies supporting family economic conditions may have benefits for sleep health and brain development in children.

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Section: Socioeconomic Disadvantage Is Associated With Later Sleep Ti...supporting

confidence: 93%

Section: Socioeconomic Disparities In Sleep Duration and Timingmentioning

confidence: 99%

Socioeconomic factors, sleep timing and duration, and amygdala resting-state functional connectivity in children

Hansen,

Simon,

et al. 2024

Front. Psychiatry

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“…Research in preschool children (approximately 2.5-5 years of age) has prioritized home-based interventions, or interventions targeting obesity rather than sleep as a primary outcome . Despite sleep health disparities, population samples have lacked racial, ethnic, and socioeconomic diversity . Half of the nation’s preschoolers attend early childhood programs, in which promoting sleep health is endorsed by parents and staff .…”

Section: Introductionmentioning

confidence: 99%

Effects of a Sleep Health Education Program for Children and Parents on Child Sleep Duration and Difficulties

et al. 2022

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IMPORTANCE Preschool-aged children often lack sufficient sleep and experience sleep difficulties. A consistent bedtime routine, falling asleep alone, and other sleep practices reduce difficulties and increase sleep duration. OBJECTIVE To evaluate the effects of a preschool-based sleep health literacy program on children's sleep duration and difficulties and on parent sleep knowledge, attitudes, self-efficacy, and beliefs 9 and 12 months after the program. DESIGN, SETTING, AND PARTICIPANTS This stepped-wedge cluster randomized clinical trial was implemented across the 2018-2019 school year. Head Start preschool personnel delivered interventions and collected outcomes data at baseline and 4 follow-ups. Seven Head Start agencies across New York State were randomized to implement interventions in either fall 2018 or winter and spring 2019. Outcomes were ascertained at 9-and 12-month follow-up. From March 19 through September 28, 2018, Head Start staff recruited (a) English-or Spanish-speaking parents (b) of children 3 years of age on or about September 2018 (c) who planned to remain at the site through the school year. Altogether, 519 parent-child (aged 3 years) dyads completed baseline and (any) followup data. INTERVENTIONS A 2-week classroom curriculum for children, a 1-hour parent workshop, and 1-on-1 parent discussions at home or school. MAIN OUTCOMES AND MEASURESOutcomes were the pre-vs postintervention differences measured at baseline and 9-month follow-up for parent-reported child school-night sleep duration per sleep logs, mild or moderate sleep difficulties per a validated questionnaire, and the total and domain scores for parent sleep knowledge, attitudes, self-efficacy, and beliefs. A modified intentionto-treat analysis excluding participants with only baseline data was used. RESULTSThe mean (SD) age at enrollment of 519 children was 2.7 (0.1) years, 264 (50.9%) were girls, 196 (37.8%) lived in Spanish-speaking households, and 5 (0.9%) identified as Alaskan Native or American Indian, 17 (3.2%) as Asian American or Pacific Islander, 57 (10.8%) as Black, 199 (37.8%) as White, and 63 (12.0%) as other. Mean sleep durations increased nonsignificantly from baseline by 5.6 minutes (95% CI, −2.3 to 13.6 minutes; P = .17) at 9-month follow-up and by 6.8 minutes (95% CI, 0.2-13.7 minutes; P = .06) at 12-month follow-up. There was a slight improvement in parental knowledge (1.13 unit increase from baseline; 95% CI, 0.13-2.12 units), but no significant outcomes for parent sleep attitudes (0.16 unit increase from baseline; 95% CI, −0.46 to 0.77 units), self-efficacy (−0.13 unit decrease from baseline; 95% CI, −1.02 to 0.76 units) and beliefs (−0.20 unit decrease from baseline; 95% CI, −0.56 to 0.16 units). Intervention effects for child sleep difficulties were not (continued) Key Points Question Does a sleep health education program for children and parents in Head Start improve childhood sleep and related outcomes? Findings This stepped-wedge cluster randomized clinical trial of 519 parentchild (aged 3 years at enroll...

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“…Disparities in sleep behaviours of young children based on ethnicity, income, and mother's level of education have been noted (75). Recent research has shown that parents of Hispanic children were more accurate at estimating their child's sleep duration and wake time than parents of White children (76).…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

The Validity, Reliability, and Feasibility of Measurement Tools Used to Assess Sleep of Pre-school Aged Children: A Systematic Rapid Review

et al. 2021

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Background: Sleep of pre-school aged children is important for their health and development, but there are currently no standards for measuring sleep in this age group. We aimed to examine the validity, reliability and feasibility of tools used to assess sleep of pre-school aged children.Methods: Studies were eligible for inclusion if they examined the validity and/or reliability and/or feasibility of a measurement tool used to examine sleep of pre-school aged children (aged 3–7 years). We systematically searched six electronic databases, grey literature and trial registries. We manually searched topic specific journals, reference and citations of included studies, and reference lists of existing reviews. We extracted data and conducted a risk of bias assessment on the included studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist. We used a narrative synthesis to present the results.Results: Sixteen studies met the inclusion criteria: these explored accelerometers (n = 3) and parental reported tools (n = 13; nine questionnaires, six diaries). Studies assessed construct validity (n = 3), criterion validity (n = 1), convergent validity (n = 13), test-retest reliability (n = 2), internal consistency (n = 4) and feasibility (n = 12). Most studies assessed the convergent validity of questionnaires and diaries compared with accelerometers, but the validity of accelerometers for sleep in this age group is unknown. Of studies with a low risk of bias, one sleep diary was shown to be valid for measuring sleep duration. No measurement tools were appropriate for determining sleep quality. Reporting of reliability and feasibility was minimal.Discussion: The evidence base in this field is limited, and most studies had high risk of bias. Future research on sleep in pre-school aged children should focus on assessing the validity, reliability and feasibility of accelerometers, which in turn will improve the quality of studies that assess questionnaires and diaries against accelerometers.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021230900; PROSPERO: CRD42021230900.

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Does context matter? A multilevel analysis of neighborhood disadvantage and children's sleep health

Cited by 12 publications

References 53 publications

Socioeconomic factors, sleep timing and duration, and amygdala resting-state functional connectivity in children

Socioeconomic factors, sleep timing and duration, and amygdala resting-state functional connectivity in children

Effects of a Sleep Health Education Program for Children and Parents on Child Sleep Duration and Difficulties

The Validity, Reliability, and Feasibility of Measurement Tools Used to Assess Sleep of Pre-school Aged Children: A Systematic Rapid Review

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