Oral Session 2
Saturday, April 28, 2018 | 4:00pm-5:30pm | Room 342B
DOES CUMULATIVE SOCIO-ECOLOGICAL RISK IN INFANCY PREDICT PERSISTENT SLEEP PROBLEM TRAJECTORIES?
Jon Quach (Australia)*
Ariel Williamson (USA)
Jodi A. Mindell (USA)
Harriet Hiscock (Australia)
Although research indicates that sleep problems tend to persist from infancy through early childhood, few studies have examined trajectories from infancy through middle childhood. In addition, studies rarely examine whether multiple risks at different socio-ecological levels (child, family, context) contribute to the persistence of sleep problems. The purpose of this study was to examine sleep problem trajectories and the impact of cumulative socio-ecological risks at multiple levels in a large sample of Australian children.
Materials and methods
Longitudinal data were drawn from 5,107 children who participated in the first 6 waves of the Longitudinal Study of Australian Children –Birth Cohort. Data were collected every 2 years from ages 0-1 years to 10-11 years. Mothers and fathers reported on psychosocial risk factors at birth, and the presence of child sleep problems at each wave. We generated 5 cumulative risk indexes reflecting risk exposure at different socio-ecological levels: birth risks (prenatal teratogen exposure; prematurity; birth weight), parenting risks (warmth; hostility; self-efficacy; co-parenting), family risks (marital hostility; parental psychosocial distress; depression; stressful life events), socio-economic risks (financial hardship; socio-economic position), and neighborhood risks (neighborhood income; facilities; cleanliness; noise). Exposure to risks were coded dichotomously (1 = risk) and summed within each index. We created separate mother- and father-reported indexes for family and parenting risks. Latent profile analysis was used to identify sleep problem trajectories from ages 0-1 years to 10-11 years and cumulative risk indexes were calculated to predict sleep problem trajectories in regression models. Univariate regressions were conducted to examine the association between each risk index and trajectory. Indexes with an association that had a p<0.1 were included in a multivariate model.
Five distinct sleep problem trajectories emerged: mild persistent sleep problems (59.7% of the sample), limited infant sleep problems (12.9%), limited infant through preschool sleep problems (8.8%), mild increases in middle childhood sleep problems (12.4%), and persistent increases through middle childhood (6.1%). In the final multivariate model, the mother-reported family risk index was significantly associated with all sleep problem trajectories except mild persistent sleep problems. Father-reported family risks were only associated with the limited infant trajectory. Mother-reported parenting risks were associated with the limited infant and limited infant-preschool trajectories, whereas father-reported parenting risks were not significant predictors of any trajectory. Socioeconomic risks predicted the trajectory with persistent sleep problems through middle childhood. There were no significant findings for the birth and neighborhood risk indexes.
Findings suggest that there are distinct sleep problem trajectories from infancy through middle childhood, which has implications for developmentally-tailored preventive interventions. Cumulative mother-reported family risks during infancy emerged as a significant predictor across the majority of the sleep problem trajectories, whereas father-reported family and parenting risks, birth risks, and socioeconomic and neighborhood-level risks did not. While additional research is needed to examine the interplay of cumulative risks and sleep problems over time, finding underscore the importance of targeting modifiable maternal perceptions and behaviors in pediatric sleep interventions.