Rising Prevalence and Neighborhood, Social, and Behavioral Determinants of Sleep Problems in US Children and Adolescents, 2003–2012

Abstract

We examined trends and neighborhood and sociobehavioral determinants of sleep problems in US children aged 6–17 between 2003 and 2012. The 2003, 2007, and 2011-2012 rounds of the National Survey of Children's Health were used to estimate trends and differentials in sleep problems using logistic regression. Prevalence of sleep problems increased significantly over time. The proportion of children with <7 days/week of adequate sleep increased from 31.2% in 2003 to 41.9% in 2011-2012, whereas the prevalence of adequate sleep <5 days/week rose from 12.6% in 2003 to 13.6% in 2011-2012. Prevalence of sleep problems varied in relation to neighborhood socioeconomic and built-environmental characteristics (e.g., safety concerns, poor housing, garbage/litter, vandalism, sidewalks, and parks/playgrounds). Approximately 10% of children in neighborhoods with the most-favorable social environment had serious sleep problems, compared with 16.2% of children in neighborhoods with the least-favorable social environment. Children in neighborhoods with the fewest health-promoting amenities or the greatest social disadvantage had 37%–43% higher adjusted odds of serious sleep problems than children in the most-favorable neighborhoods. Higher levels of screen time, physical inactivity, and secondhand smoke exposure were associated with 20%–47% higher adjusted odds of sleep problems. Neighborhood conditions and behavioral factors are important determinants of sleep problems in children.

A Child’s View: Social and Physical Environmental Features Differentially Predict Parent and Child Perceived Neighborhood Safety

“…Among adults, feeling unsafe is associated with adopting poorer health habits (e.g., increases in sedentary behavior, decreased physical activity, and active transportation), and experiencing poorer mental (e.g., anxiety, deteriorated psychological wellbeing, and social withdrawal) and physical (e.g., poorer self-reported health, stressrelated diseases, and chronic conditions) health. [7][8][9][10] With respect to child health, parent perceived unsafety is associated with asthma, 11 sleep problems, 12 psychological distress, 13 and weight-related behaviors (e.g., physical activity). 14 Parents' perceptions of safety may influence child health by impacting the household environment and parenting decisions (e.g., restricting children's outdoor activities).…”

Factors associated with shorter night-time sleep in toddlers: The Survey of Young Canadians

“…5 Studies have found higher rates of sleep problems in children from lowincome families as well as those who live in lower-income neighbourhoods. [34][35][36] Lower SES was correlated with lower sleep duration in children. Using the Panel Survey of Income Dynamics, family income was related to shorter sleep duration.…”

Difficult to Bed and Difficult to Rise: Complex Interplay Among ADHD, Sleep, and Adolescence

“…In the United States, data from the National Survey of Children's Health show that the prevalence of sleep problems has increased significantly over the past 15 years, with 10-16% of youth currently exhibiting serious sleep problems (Singh & Kenney, 2013). Frequently occurring problems include poor sleep quality (e.g., waking up multiple times during the night), inadequate sleep duration (i.e., fewer hours slept), and daytime sleepiness (i.e., feelings of tiredness during the day).…”