0829 Cumulative Risk is Associated with Preschoolers' Sleep Patterns and Problems. (27th April 2018) - Williamson, A A
Abstract: Introduction: Psychosocial risk factors, such as parental depression and family poverty, have been associated with pediatric sleep patterns and problems. However, studies rarely examine risk factors in relation to sleep in a cumulative risk model, which indexes exposure to multiple risks. The purpose of this study was to examine associations between cumulative risk and preschoolers' sleep outcomes. Methods: Caregivers (87.3% mothers) of 205 children ages 2–5 years ( M = 3.3 years; 53.7% females; 62.9% African American; 22.4% non-Hispanic/Latino White; 4.4% Hispanic/Latino) reported on family demographics, child sleep (Brief Child Sleep Questionnaire; obstructive sleep apnea [OSA] checklist), and caregiver depression (Center for Epidemiological Studies Depression Scale [CES-D]). Poverty level was calculated using US guidelines. A cumulative risk index was created by dichotomously coding (1 = risk) and summing 7 risk factors: family living at or below 125% of the poverty level (42.4%); single caregiver household (49.8%); parental unemployment (11.7%); caregiver education ≤ high school (36.1%); clinically significant caregiver depression (19.5%; based on CES-D cutoff); child prematurity or developmental delays (11.7%); and moving homes ≥ 1 times in the last year (34.1%). Results: Forty-one percent of families reported 0–1 risks, with 19.5% reporting 2 risks, 21% reporting 3 risks, 13.7% reporting 4 risks, and 4.8% reporting ≥ 5 risks. Separate linear and logistic regression models examined associations between cumulative risks and child sleep, controlling for child age, racial/ethnic background, and sex. Children with increased cumulative risks were less likely to follow a consistent bedtime routine, and had later bedtimes, more frequent night awakenings, and increased OSA symptoms ( p <.05). Cumulative risk was not associated with caregiver-reported sleep problems, sleep onset latency, or 24-hour sleep duration. Conclusion: Exposure to cumulative psychosocial risks is associated with poor sleep habits, including an inconsistent bedtime routine and a later bedtime. Risk exposure was also associated with frequent night awakenings and increased OSA symptoms, but not caregiver-reported sleep problems. Findings suggest that healthcare providers should assess sleep disturbances by asking caregivers about child sleep patterns in addition to their perceptions of sleep problems. Support (If Any): T32HL007953-17