0955 Does Primary Caregiver Influence Sleep in Preschoolers? Evidence from a Large-Scale Longitudinal Study in China

Abstract

Abstract Introduction The aim of the study is to characterize sleep disturbances and sleep patterns in preschoolers, and to examine the potential role of primary caregivers and particularly its transition on children’s sleep in a large-scale cohort study in China. Methods A representative sample of 20324 newly enrolled preschoolers(age 3-4 years) were recruited in Shanghai,China at 2016.11. Sleep disturbances were examined at 3 timepoints from age 3-4 years to 5-6 years by the Children’s Sleep Habits Questionnaire(CSHQ). Data on bedtime, onset time and offset time were included, along with primary caregivers derived from each follow-up. Prevalence and trend estimates of sleep disturbances and sleep patterns were presented. Multivariable logistic regression and propensity score-adjusted models for sleep disturbances at wave3 on different caregiving models were analysed adjusting for demographics, socioeconomic status, family characteristics, maternal mental health and CSHQ total score at baseline. Results Prevalence of global sleep disturbances (CSHQ total score>41) steadily fell from 84.2% to 73.8%. Specifically, behavioral sleep problem domains of “Bedtime besistance”and “Sleep anxiety” decreased from 66.4% to 47.3% and 53.4% to 37.8%, respectively. Meanwhile, Bedtime gradually delayed from 21:04(SD=0:37) to 21:20(SD=0:33) while offset time changed slightly from 7:13(SD=0:29) to 7:17(SD=0:27). Compared with counterparts in western countries, children slept for a shorter nocturnal sleep duration (NSD) with 9.51(SD=0.57) hours at wave1, 9.42(SD=0.57) hours at wave2 and 9.42(SD=0.52) hours at wave3. Different caregiving models were independently associated with sleep disturbances at wave3. Taking “Predominant parental care” as reference, “Predominant grandparental care” and “Transition from parental to grandparental care” were associated with higher odds of sleep disturbances (OR=1.32, 95% CI [1.17, 1.48], p<0.001 and OR=1.25, 95% CI [1.03, 1.52], p=0.020, respectively). While “Transition from grandparental to parental care” has no significant effect(OR=1.04, 95%CI [0.94, 1.15], p=0.436). Conclusion Grandparental care is associated with increased risk of sleep disturbances among preschoolers in China. Parenting and Grandparenting factors should be considered when assessing and treating sleep disturbances and optimizeing sleep health in preschoolers. Support Supported by the Chinese National Natural Science Foundation of China (81773443, 81728017, 81728017); Ministry of Science and Technology (2016YFC1305203); Shanghai Science and Technology Commission (17XD1402800, 18695840200, 2018SHZDZX05, 18JC1420305);