Abstract
ObjectiveSleep is an important marker of healthy development and has been associated with emotional, behavioral, and cognitive development. There is limited longitudinal data on children's sleep with only a few reports from low- and middle-income countries (LMICs). We investigate sleep parameters and associated sociodemographic characteristics in a population-based longitudinal study in Pelotas, Brazil. MethodsData from the Pelotas 2004 Birth Cohort were used (N = 3842). Infant sleep was collected through maternal report at 3, 12, 24, and 48 months: sleep duration, bed and wake time, nighttime awakenings, co-sleeping and sleep disturbances (24 and 48 months). ResultsCompared to children in high-income countries (HICs), children in Brazil showed a substantial shift in rhythms with later bed and wake times by approximately 2 hours. These remain stable throughout the first 4 years of life. This population also shows high levels of co-sleeping which remain stable throughout (49.0–52.2%). Later bedtime was associated with higher maternal education and family income. Higher rates of co-sleeping were seen in families with lower income and maternal education and for children who were breastfed. All other sleep parameters were broadly similar to data previously reported from HICs. ConclusionThe shift in biological rhythms in this representative community sample of children in Brazil challenges our understanding of optimal sleep routine and recommendations.
Highlights
Sleep is an important indicator of healthy development and one of the earliest markers of bio-behavioral organization
We examine a range of sleep parameters to allow for comparability to previously published research, to present normative patterns on parameters known to be predictive of later child development and to present normative data on culture-specific factors which are less common in high-income countries (HICs)
This study describes normative sleep parameters and associated sociodemographic characteristics in a large prospective cohort in Brazil
Summary
Sleep is an important indicator of healthy development and one of the earliest markers of bio-behavioral organization. Sleep problems, has been associated both with current and future symptoms of emotional and behavioral problems, as well as cognitive development [1e3]. Better sleep consolidation and sleep duration are associated with higher language achievement [7], cognition function (executive function, school performance, and multiple domain cognitive functioning), better future performance on executive function tasks [8], fewer current internalizing, and externalizing symptoms [9]. In identifying normative patterns of sleep in children and in proposing sleep recommendations which may relate to sleep duration or hygiene, data from low- and middle-income country (LMIC) cohorts have an important part to play due to the specific cultural and socioeconomic factors that influence sleep and parental perceptions of sleep
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