Erika J. Bagley

Economic Adversity and Children’s Sleep Problems: Multiple Indicators and Moderation of Effects

OBJECTIVE Toward explicating relations between economic adversity and childrens sleep, we examined associations between multiple indicators of socioeconomic status (SES)/adversity and childrens objectively and subjectively derived sleep parameters; ethnicity was examined as potential moderator. METHODS Participants were 276 third- and fourth-grade children and their families (133 girls; M age = 9.44 years; SD = .71): 66% European American (EA) and 34% African American (AA). Four SES indicators were used: income-to-needs ratio, perceived economic well-being, maternal education, and community poverty. Children wore actigraphs for 7 nights and completed a self-report measure to assess sleep problems. RESULTS Objectively and subjectively assessed sleep parameters were related to different SES indicators, and overall worse sleep was evident for children from lower SES homes. Specifically, children from homes with lower income-to-needs ratios had higher levels of reported sleep/wake problems. Parental perceived economic well-being was associated with shorter sleep minutes and greater variability in sleep onset for children. Lower mothers education was associated with lower sleep efficiency. Children who attended Title 1 schools had shorter sleep minutes. Ethnicity was a significant moderator of effects in the link between some SES indicators and childrens sleep. AA childrens sleep was more negatively affected by income-to-needs ratio and mothers education than was the sleep of EA children. CONCLUSIONS The results advocate for the importance of specifying particular SES and sleep variables used because they may affect the ability to detect associations between sleep and economic adversity.

Parental depressive symptoms and children’s sleep: the role of family conflict

BACKGROUND   We used a multi-method and multi-informant design to identify developmental pathways through which parental depressive symptoms contribute to childrens sleep problems. Environmental factors including adult inter-partner conflict and parent-child conflict were considered as process variables of this relation. METHODS   An ethnically and socioeconomically diverse sample of children (n = 268) participated (M age = 9.44 years, SD = 8.61 months). Children wore actigraphs for 7 consecutive nights and also reported on their sleep problems. RESULTS   Higher levels of maternal depressive symptoms were associated with childrens sleep/wake problems. Higher levels of paternal depressive symptoms were associated with shorter time in bed and fewer sleep minutes. Inter-partner conflict and parent-child conflict were mechanisms of effects in the associations between maternal depressive symptoms and childrens actigraphy-based and self-reported sleep problems. CONCLUSIONS   Findings build on this scant literature and highlight the importance of identifying pathways of risk and familial and environmental influences on childrens sleep problems.

What keeps low-SES children from sleeping well: the role of presleep worries and sleep environment.

OBJECTIVES Children in families of low socioeconomic status (SES) have been found to have poor sleep, yet the reasons for this finding are unclear. Two possible mediators, presleep worries and home environment conditions, were investigated as indirect pathways between SES and childrens sleep. PARTICIPANTS/METHODS The participants consisted of 271 children (M (age) = 11.33 years; standard deviation (SD) = 7.74 months) from families varying in SES as indexed by the income-to-needs ratio. Sleep was assessed with actigraphy (sleep minutes, night waking duration, and variability in sleep schedule) and child self-reported sleep/wake problems (e.g., oversleeping and trouble falling asleep) and sleepiness (e.g., sleeping in class and falling asleep while doing homework). Presleep worries and home environment conditions were assessed with questionnaires. RESULTS Lower SES was associated with more subjective sleep/wake problems and daytime sleepiness, and increased exposure to disruptive sleep conditions and greater presleep worries were mediators of these associations. In addition, environmental conditions served as an intervening variable linking SES to variability in an actigraphy-derived sleep schedule, and, similarly, presleep worry was an intervening variable linking SES to actigraphy-based night waking duration. Across sleep parameters, the model explained 5-29% of variance. CONCLUSIONS Sleep environment and psychological factors are associated with socioeconomic disparities, which affect childrens sleep.

Parasympathetic nervous system activity and children's sleep

We examined indices of childrens parasympathetic nervous system activity (PNS), including respiratory sinus arrhythmia during baseline (RSAB) and RSA reactivity (RSAR), to a laboratory challenge, and importantly the interaction between RSAB and RSAR as predictors of multiple parameters of childrens sleep. Lower RSAR denotes increased vagal withdrawal (reductions in RSA between baseline and task) and higher RSAR represents decreased vagal withdrawal or augmentation (increases in RSA between baseline and task). A community sample of school‐attending children (121 boys and 103 girls) participated [mean age = 10.41 years; standard deviation (SD) = 0.67]. Childrens sleep parameters were examined through actigraphy for 7 consecutive nights. Findings demonstrate that RSAB and RSAR interact to predict multiple sleep quality parameters (activity, minutes awake after sleep onset and long wake episodes). The overall pattern of effects illustrates that children who exhibit more disrupted sleep (increased activity, more minutes awake after sleep onset and more frequent long wake episodes) are those with lower RSAB in conjunction with lower RSAR. This combination of low RSAB and low RSAR probably reflects increased autonomic nervous system arousal, which interferes with sleep. Results illustrate the importance of individual differences in physiological regulation indexed by interactions between PNS baseline activity and PNS reactivity for a better understanding of childrens sleep quality.

Familial Risk Moderates the Association Between Sleep and zBMI in Children

OBJECTIVE A cumulative risk approach was used to examine the moderating effect of familial risk factors on relations between actigraphy-based sleep quantity (minutes) and quality (efficiency) and sex- and age-standardized body mass index (zBMI). METHODS The sample included 124 boys and 104 girls with a mean age of 10.41 years (SD = 0.67). Children wore actigraphs for 1 week, and their height and weight were assessed in the lab. RESULTS After controlling for potential confounds, multiple regression analyses indicated that sleep minutes predicted childrens zBMI and that both sleep minutes and efficiency interacted with family risk in the prediction of zBMI. The association between poor sleep and zBMI was especially evident for children exposed to higher levels of family risk. CONCLUSIONS Findings suggest that not all children who exhibit poor sleep are at equal risk for higher zBMI and that familial and contextual conditions need to be considered in this link.

Growth in Body Mass Index from Childhood into Adolescence: The Role of Sleep Duration and Quality.

This study examined longitudinal relations between sleep and body mass index (BMI) from late childhood ( X ¯ age = 9.44 at T1) to early adolescence ( X ¯ age = 11.36 at T3) with a relatively large (n = 273 at T1) and diverse (35% African Americans) sample. Sleep was assessed with actigraphy-based sleep minutes and self-reported sleep problems. Latent growth modeling revealed associations between sleep and BMI that varied based on the sleep parameter and sex of the child. In particular, although boys reported more sleep problems and had higher BMI than girls across time, self-reported sleep problems at age 9 predicted higher BMI at age 11 among girls (but not boys). Furthermore, more minutes of actigraph-assessed sleep at age 9 only predicted less growth in BMI among the girls. Possible mechanisms and intervention implications are discussed.

Longitudinal relations between children's sleep and body mass index: the moderating role of socioeconomic risk

Two separate meta-analyses concluded that across nonexperimental studies of children and adolescents, there was consistent evidence of a negative association between short sleep duration and body mass index (BMI). Since 2008, a number of studies have not only provided additional evidence on relations between sleep and BMI but have also pushed the field forward by documenting longitudinal relations and, therefore, direction of effects, between multiple sleep parameters and BMI. Findings from longitudinal work suggest that insufficient and poor-quality sleep may be a contributing factor to the epidemic of youth who are overweight and obese. In a prospective longitudinal study with nearly 2000 children, Seegers et al found that a 1-hour decrease in parent-reported time in bed at age 10 years was a significant risk factor for obesity at age 13 years. Other longitudinal research found that shorter parentand child-reported sleep duration at ages 8 to 11 years predicted higher zBMI, but only for boys in the sample. Most recently, ElSheikh et al included actigraphic-assessed and subjectively reported sleep and used latent growthmodeling to examine relations between sleep and BMI from late childhood into early adolescence. Contrary to the findings of Storfer-Isser et al, results of this study were significant only for girls in the sample and suggested that child-reported sleep problems at 9 predicted higher BMI at age 11 years, whereas shorter objectively assessed sleep minutes predicted more growth in BMI over those 2 years. However, it is also worth noting that not all prior investigations have found significant longitudinal relations between BMI and sleep. Araujo et al examined the association between self-reported sleep duration and zBMI in a sample of more than 1000 adolescents. After accounting for zBMI at age 13 years, sleep duration did not predict zBMI at age 17 years. It is possible that through a more nuanced examination of the conditions under which the influence of sleep on BMI is heightened or buffered, a better understanding of inconsistencies across samples and studies will be gained. One factor that may moderate the relations between sleep and BMI is socioeconomic and family-level risks. Several individual risk factors have been shown in prior studies to be associated with both

Neighborhood Economic Deprivation and Social Fragmentation: Associations With Children's Sleep.

ABSTRACT Background & Objective: A growing body of work indicates that experiences of neighborhood disadvantage place children at risk for poor sleep. This study aimed to examine how both neighborhood economic deprivation (a measure of poverty) and social fragmentation (an index of instability) are associated with objective measures of the length and quality of children’s sleep. Participants: Participants were 210 children (54.3% boys) living predominantly in small towns and semirural communities in Alabama. On average children were 11.3 years old (SD = .63); 66.7% of the children were European American and 33.3% were African American. The sample was socioeconomically diverse with 67.9% of the participants living at or below the poverty line and 32.1% from lower-middle-class or middle-class families. Methods: Indicators of neighborhood characteristics were derived from the 2012 American Community Survey and composited to create two variables representing neighborhood economic deprivation and social fragmentation. Child sleep period, actual sleep minutes, and efficiency were examined using actigraphy. Results: Higher levels of neighborhood economic deprivation were associated with fewer sleep minutes and poorer sleep efficiency. More neighborhood social fragmentation was also linked with poorer sleep efficiency. Analyses controlled for demographic characteristics, child health, and family socioeconomic status. Conclusions: Findings indicate that living in economically and socially disadvantaged neighborhoods predicts risk for shorter and lower-quality sleep in children. Examination of community context in addition to family and individual characteristics may provide a more comprehensive understanding of the factors shaping child sleep.

Relations between daytime pre-ejection period reactivity and sleep in late childhood.

The sympathetic nervous system and childrens sleep serve critical arousal regulation functions. Shortened pre‐ejection period, a reliable indirect index of greater sympathetic nervous system activity, has been associated with reduced sleep duration and quality in adults, but limited evidence exists in children regarding associations between pre‐ejection period and sleep. We examined relations between pre‐ejection period reactivity in response to a laboratory‐based stressor and multiple parameters of actigraphy‐based sleep duration and quality in children. The sample included 123 boys and 112 girls [mean age = 11.31 years, standard deviation (SD) = 0.63 years]. Controlling for body mass index, sex and pre‐ejection period baseline, increased sympathetic nervous system reactivity, indexed by a lower level of pre‐ejection period during the challenge than the baseline, was associated with worse sleep quality indicated by lower sleep efficiency, greater sleep activity and greater long wake episodes. The findings add to a small literature on relations between sympathetic nervous system functioning and childrens sleep, suggesting that poor sleep quality is related to dysregulation of this stress response system.

Socioeconomic Adversity and Women's Sleep: Stress and Chaos as Mediators

We examined income-to-needs ratio, perceived economic well-being, and education and their relations with European and African American womens sleep (n = 219). Sleep was examined through actigraphy and self-reports. Income-to-needs ratio was related to sleep minutes. Perceived economic well-being and education were associated with subjective sleep problems. Perceived stress mediated relations between both income-to-needs ratio and economic well-being and subjective sleep problems. Chaos emerged as a mediator linking income-to-needs ratio and subjective sleep problems. African American women had fewer sleep minutes and lower sleep efficiency than European Americans, and more robust relations between economic well-being and stress was observed for European Americans. Findings highlight the importance of economic adversity for womens sleep and explicate some pathways of risk.