First name
Jon
Last name
Quach

Title

Sleep problems, internalizing and externalizing symptoms, and domains of health-related quality of life: bidirectional associations from early childhood to early adolescence.

Year of Publication

2020

Date Published

2020 Jul 21

ISSN Number

1550-9109

Abstract

<p><strong>STUDY OBJECTIVE: </strong>To examine longitudinal, bidirectional associations among behavioral sleep problems, internalizing and externalizing symptoms, and domains of health-related quality of life (HRQoL) from early childhood to adolescence in a population sample of Australian children.</p>

<p><strong>METHOD: </strong>Data were drawn from the Longitudinal Study of Australian Children (LSAC), a national prospective cohort study with 4,983 children participating in the Kindergarten cohort. Data were collected when children were ages 4-5, 6-7, 8-9, 10-11, 12-13 years. At each study wave, the primary parent (97% mothers) reported on behavioral child sleep problems, internalizing and externalizing symptoms, and HRQoL domains (psychosocial and physical). Cross-lagged structural equation models were used to evaluate bidirectional associations.</p>

<p><strong>RESULTS: </strong>At nearly every age, behavioral sleep problems were associated with worse subsequent psychosocial and physical HRQoL. Despite bidirectional associations between mental health and HRQoL at many waves, HRQoL domains more strongly predicted later internalizing symptoms, while externalizing symptoms more strongly predicted later HRQoL. Many of the bidirectional associations among sleep, mental health, and HRQoL were found earlier in childhood.</p>

<p><strong>CONCLUSION: </strong>Behavioral sleep problems may forecast later HRQoL psychosocial and physical impairments. Attending to both sleep problems and HRQoL could prevent the progression of internalizing conditions, while a focus on externalizing concerns could prevent the worsening of these symptoms, sleep problems and HRQoL, particularly during the transition to school.</p>

DOI

10.1093/sleep/zsaa139

Alternate Title

Sleep

PMID

32691073

Title

Longitudinal sleep problem trajectories are associated with multiple impairments in child well-being.

Year of Publication

2020

Date Published

2020 Jul 26

ISSN Number

1469-7610

Abstract

<p><strong>BACKGROUND: </strong>This study examined whether distinct sleep problem trajectories from infancy through middle childhood were associated with multiple aspects of child well-being at ages 10-11&nbsp;years.</p>

<p><strong>METHODS: </strong>Data were from the first six waves of the Longitudinal Study of Australian Children - Birth Cohort (5,107 children recruited at birth). Caregivers reported on child sleep problems at each time point. A combination of caregiver-reported, teacher-reported and child-completed tasks were used to index child well-being outcomes at ages 10-11&nbsp;years including emotional/behavioural functioning (internalizing and externalizing symptoms; self-control), health-related quality of life, cognitive skills and academic achievement.</p>

<p><strong>RESULTS: </strong>Latent class analysis identified five distinct sleep problem trajectories over time: persistent sleep problems through middle childhood (7.7% of the sample), limited infant/preschool sleep problems (9.0%), increased middle childhood sleep problems (17.0%), mild sleep problems over time (14.4%) and no sleep problems (51.9%). Compared to those with no sleep problems, children with persistent sleep problems had the greatest impairments across all outcomes except cognitive skills (perceptual reasoning), with moderate to large effect sizes. Children with increased middle childhood sleep problems similarly experienced greater internalizing and externalizing symptoms and worse quality of life, but few academic impairments. Both the limited infant/preschool sleep problems and mild increases over time trajectories also showed internalizing concerns and worse caregiver-reported quality of life, although effects were smaller than the other sleep trajectories.</p>

<p><strong>CONCLUSIONS: </strong>The linkages between sleep problems and negative child outcomes across domains underscore the importance of early identification and targeted intervention to address sleep problems and promote child well-being.</p>

DOI

10.1111/jcpp.13303

Alternate Title

J Child Psychol Psychiatry

PMID

32713013

Title

Child sleep behaviors and sleep problems from infancy to school-age.

Year of Publication

2019

Number of Pages

5-8

Date Published

2019 Nov

ISSN Number

1878-5506

Abstract

<p><strong>OBJECTIVE: </strong>Few studies have examined the sleep behaviors associated with a caregiver-reported sleep problem beyond early childhood and across different age groups. This study examined sleep behaviors associated with a caregiver-reported sleep problem from birth to middle childhood.</p>

<p><strong>METHODS: </strong>Participants were 5107 children from the Longitudinal Study of Australian Children-Birth Cohort. Caregiver-reported child sleep problems and sleep behaviors were assessed biennially from ages 0-1 to 10-11 years. Logistic regressions were used to examine associations between three child sleep behaviors (waking overnight, difficulty falling asleep, and difficulty sleeping alone) and the odds of having a caregiver-reported sleep problem at each age.</p>

<p><strong>RESULTS: </strong>Caregiver-reported child sleep problems were most prevalent in infancy (17.1%) and decreased through middle childhood (7.7%). All three sleep behaviors were associated with a sleep problem at each age. Whereas waking overnight was the most common sleep behavior and was associated with the highest odds of having a sleep problem from infancy to age 6-7 years (ORs&nbsp;=&nbsp;5.78-8.29), difficulty falling asleep was the most common sleep behavior and was associated with the highest odds of having a sleep problem at ages 8-9 and 10-11 years (ORs&nbsp;=&nbsp;10.65 and 17.78, respectively).</p>

<p><strong>CONCLUSION: </strong>Caregivers' endorsement of a child sleep problem was associated with developmentally-relevant sleep behaviors, with night awakenings most relevant during infancy and difficulty falling asleep most relevant in middle childhood. Study findings have implications for targeted and developmentally-focused sleep problem screening questions in child healthcare settings. Future research examining additional indicators of caregiver-defined sleep problems is required.</p>

DOI

10.1016/j.sleep.2019.05.003

Alternate Title

Sleep Med.

PMID

31600659

Title

Sleep Problem Trajectories and Cumulative Socio-Ecological Risks: Birth to School-Age.

Year of Publication

2019

Number of Pages

229-237.e4

Date Published

2019 Dec

ISSN Number

1097-6833

Abstract

<p><strong>OBJECTIVES: </strong>To evaluate whether there are distinct childhood sleep problem trajectories from birth to 10-11&nbsp;years and to assess associations with cumulative socio-ecological risks (child, family, context).</p>

<p><strong>STUDY DESIGN: </strong>Participants were 5107 children from the Longitudinal Study of Australian Children-Birth Cohort. At birth, cumulative risk indexes were generated for birth, parenting, family, socioeconomic, and neighborhood risks. Parent-reported child sleep problems were assessed biennially from ages 0-1 to 10-11&nbsp;years. Sleep problem trajectories were derived using latent class&nbsp;analysis. Multivariable logistic regression was used to examine associations with risk indexes.</p>

<p><strong>RESULTS: </strong>Five distinct trajectories emerged: persistent sleep problems through middle childhood (7.7%), limited infant/preschool sleep problems (9.0%), increased middle childhood sleep problems (17.0%), mild sleep problems over time (14.4%), and no sleep problems (51.9%). Cumulative mother- and father-reported family risks (distress; marital/relational hostility) were linked to nearly all of the trajectories, whereas father- and mother-reported parenting risks were associated with fewer trajectories. Birth risks were associated with increased middle childhood sleep problems. Neighborhood risks were not associated with any trajectories. Socioeconomic risks were linked to mild and persistent sleep problem trajectories. Cumulative risk indexes were most associated with increased middle childhood sleep problems.</p>

<p><strong>CONCLUSIONS: </strong>This study identified distinct longitudinal sleep problem trajectories, suggesting the need for continuous sleep screening over development. Cumulative risks assessed at birth-primarily maternal and paternal family risks-predicted these trajectories, especially for the sleep problems in middle childhood trajectory. Preventive interventions targeting modifiable factors, particularly caregiver distress and marital/relational hostility, could benefit child sleep.</p>

DOI

10.1016/j.jpeds.2019.07.055

Alternate Title

J. Pediatr.

PMID

31564429

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