Sleep Problems, Cumulative Risks, and Psychological Functioning in Early Childhood

Author:

Williamson Ariel A12ORCID,Davenport Mattina13,Cicalese Olivia1,Mindell Jodi A124

Affiliation:

1. Children’s Hospital of Philadelphia

2. University of Pennsylvania Perelman School of Medicine

3. University of Missouri School of Medicine

4. Department of Psychology, Saint Joseph’s University

Abstract

Abstract Background Sleep problems and cumulative risk factors (e.g., caregiver depression, socioeconomic disadvantage) have independently been linked to adverse child development, but few studies have examined the interplay of these factors. We examined whether cumulative risk exposure moderated the link between sleep problems, including insomnia and poor sleep health, and child psychological outcomes. Methods 205 caregiver-child dyads (child Mage = 3.3 years; 53.7% girls; 62.9% Black, 22.4% non-Latinx White, and 4.4% Latinx; 85.4% maternal caregiver reporter) completed child sleep, family sociodemographic, and child psychological functioning (internalizing, externalizing, and executive functioning) questionnaires. Indexes of cumulative risk exposure, insomnia symptoms, and poor sleep health were created. Results Ninety percent of children had ≥1 cumulative risks, 62.9% had ≥1 insomnia symptom, and 84.5% had ≥1 poor sleep health behavior. Increased insomnia symptoms were significantly associated with increased child internalizing, externalizing, and global executive functioning impairments controlling for child age, race/ethnicity, and sex. Poor sleep health behaviors were associated with internalizing concerns. Cumulative risk exposure was not associated with outcomes but moderated the association between insomnia symptoms and all psychological outcomes, such that children with higher cumulative risk exposure and insomnia symptoms had the greatest impairments. Children with the poorest sleep health behaviors and highest cumulative risks had the greatest internalizing concerns. Conclusions Insomnia symptoms in particular are associated with poor child outcomes, which are exacerbated when accompanied by greater cumulative risk exposure. Clinicians should assess sleep when treating early psychological concerns, especially within the context of increased cumulative risks.

Funder

National Heart, Lung, and Blood Institute

Sleep Research Society Foundation

Eunice Kennedy Shriver National Institute of Child Health and Human Development

Publisher

Oxford University Press (OUP)

Subject

Developmental and Educational Psychology,Pediatrics, Perinatology, and Child Health

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