603 Socioeconomic Status and Caregiver Perception of Young Children’s Sleep

Abstract

Abstract Introduction Socioeconomic status (SES) has been associated with variation in child sleep problems, but few studies have examined variation by SES in caregiver-reported early childhood sleep problems, patterns, and health behaviors. We hypothesized that, compared to higher-SES caregivers, lower-SES caregivers would report poorer sleep outcomes and sleep health behaviors, but lower rates of caregiver-perceived sleep problems. Methods A total of 309 caregivers (97% parents) of young children (M child age=3.59 years; 53.1% girls; 15% non-Hispanic/Latinx White, 57% non-Hispanic/Latinx Black, 20% Hispanic/Latinx White, 8% Hispanic/Latinx Black) completed the Brief Child Sleep Questionnaire. SES was measured via income level (lowest=$0-$20,000; middle= $20,001-$50,000; highest= $50,001 or greater). Results The prevalence of a caregiver-reported child sleep problem was similar across SES (17.6% of lowest SES group, 8.8% of middle, and 15.5% of highest, p>.05). However, ANCOVA models covarying for child race/ethnicity, age, caregiver age and education indicated sleep outcomes varied by SES. Caregivers in the lowest SES group reported significantly longer child sleep onset latency (SOL) than the middle or highest groups (p=.008), more frequent night wakings than those of middle SES (p=.009), and longer night waking duration than those of the highest SES, (p=.047). There were no significant differences by SES for child bedtime, total nighttime sleep, and total (24-hour) sleep duration. Logistic regression models with the same covariates showed no variation by SES for sleep behaviors, including caffeine consumption, presence of bedroom electronics, and bedtime resistance. Within each SES group, logistic regression models indicated that increased night wakings were uniquely associated with greater likelihood of endorsing a child sleep problem in the middle SES (p=.045) and highest SES groups (p=.040), but not in the lowest SES group. Conclusion Although caregiver-reported child sleep problems did not significantly differ across SES, lower-SES caregivers reported longer child sleep onset latency and increased number and duration of night wakings. Furthermore, night wakings were associated with perceived sleep problems, but only in middle and highest SES families. Clinicians should consider specific sleep parameters, such as SOL and night wakings, in addition to caregiver-reported child sleep problems when assessing and addressing child sleep problems, especially in lower-SES families. Support (if any) Funding: NIH K23HD094905 (AAW)