Abstract
Abstract Introduction Poor sleep quality is associated with many adverse health outcomes for children and adolescents. Recently, increasing knowledge has been gained for understanding risk factors for poor sleep, but there is little knowledge about early protective factors for sleep quality in young people. The purpose of this study was to investigate whether prenatal obstetric and psychosocial factors, and happiness during childhood would predict child sleep quality across time. Methods A total of 290/454 children aged 11–12 years in the Healthy Brain and Behavior Study were included in analysis. Prenatal obstetric and psychosocial factors were recalled by mothers through structured interviews. Childhood happiness and child sleep quality across 1, 3, 5, 11, and 12 years of age were reported by mothers through questionnaires. Two-level linear mixed-effects modeling was conducted. Results Overall, children’s average sleep quality increased from 1 to 5 years, followed by a decrease during 5 to 12 years. Prenatal care (β = 0.376, SE = 0.169, p = 0.027), better maternal psychosocial support during pregnancy (β = 0.045, SE = 0.016, p = 0.007), and higher childhood happiness (β = 1.333, SE = 0.274, p < 0.001) were associated with better sleep quality across childhood. Childhood happiness during previous developmental age predicts better sleep quality at later age (β = 1.526, SE = 0.350, p < 0.001). Other prenatal factors including prenatal gestation and parturition history, substance use during pregnancy, maternal labor and delivery complications, and neonatal conditions were not associated with child sleep quality trajectory. Conclusion Prenatal care, prenatal psychosocial support, and childhood happiness are protective factors of child sleep quality across 1–12 years of age. Future prospective longitudinal studies are needed to understand the causal relationship between early protective factors and sleep quality in childhood and adolescence. Support (if any) This study is supported by the Pennsylvania Department of Health (SAP# 4100043366), the Clinical & Translational Research Center, Perelman School of Medicine, University of Pennsylvania (grant number UL1-RR-024134).
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