0105 INSIGHT Study associations between sleep health and child behavior at age 6 years

Abstract

Abstract Introduction Sub-optimal sleep duration, quality and timing are associated with the presence of disruptive behaviors in childhood. Previous studies have largely utilized parent-/teacher-report of children’s behaviors and focused on mean sleep duration and quality measures, ignoring sleep variability. This analysis uses actigraphy and standardized laboratory behavioral tasks to examine the associations of average levels and variability (SD) of sleep duration, timing, and quality with child behavior. Methods The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Study randomized families with firstborn newborns to a responsive parenting intervention or a safety control shortly after delivery. At age 6 years, children wore a wrist actigraphy device (Spectrum Plus) for 7 days to measure sleep and completed frustration (Transparent Box) and parent-child interaction (Picture Frame) tasks. Tasks were recorded and coded using global behavioral coding schemes; inter-rater reliability was sufficient (Transparent Box ICCs=.83-.97; Picture Frame=.83-1). Children with data on sleep (≥3 valid days) and both behavioral tasks were included in this secondary data analysis (n=143). Separate linear regression models examined associations between 10 sleep variables (M/SD of onset, offset, and midpoint of sleep timing, sleep maintenance efficiency, and total sleep time) and 4 behavioral variables (Transparent Box: emotion regulation, impulsivity; Picture Frame: prosocial and antisocial behavior). Models controlled for child sex and age, household income, and study group. Results Children were aged 6.7 ± 0.3 years and predominantly White, non-Hispanic (95%). Sleep onset (timing) variability was positively associated with impulsivity (B=.85, p=.004) and negatively associated with emotion regulation (B=-.65, p=.01). Sleep midpoint (timing) variability was positively associated with impulsivity (B=.80, p=.03). Mean sleep timing, sleep duration, and sleep maintenance efficiency were not associated with any of the behavioral variables. Conclusion The regularity of sleep timing (onset and midpoint) at age 6 had a greater role in behavioral and emotional regulation than duration and quality of sleep. These findings support existing literature that highlight the importance of parents implementing consistent routines (e.g., consistent bedtime) and how such routines play a key role in socioemotional outcomes among children. Support (if any) R01DK088244