NIGHT-WAKING AND BEHAVIOR IN PRESCHOOLERS: A DEVELOPMENTAL TRAJECTORY APPROACH

Oral Session 1
Saturday, April 28, 2018 | 2:15pm-3:45pm | Room 342B

3:00pm-3:15pm
NIGHT-WAKING AND BEHAVIOR IN PRESCHOOLERS: A DEVELOPMENTAL TRAJECTORY APPROACH

Authors:
Eve Reynaud (France)*
Anne Forhan (France)
Barbara Heude (France)
Marie-Aline Charles (France)
Sabine Plancoulaine (France)

Introduction

There is increasing evidence that short sleep duration is associated with more behavioral difficulties in children. However, there are very few studies investigating the role of night-waking, despite the fact that it is very common in young children. It is one of the causes of shorter sleep and indicates less restorative sleep for the child. The aim was to study with a developmental approach, the longitudinal association between night-waking from age 2 to 6 and behavior at age 6.

Materials and methods

Our study was based on the longitudinal French birth-cohort study EDEN, which recruited 2 002 pregnant women in two French cities between 2003 and 2006. Repeated measures of children’s night-waking were collected at age 2, 3 and 5-6 through parental questionnaires, and were used to model night-waking trajectories. Behavior was assessed with the “Strengths and Difficulties Questionnaire” which provides 5 subscales measuring a child’s conduct problems, emotional symptoms, peer relation problems, antisocial behavior and hyperactivity/attention problems. The behavioral subscales were dichotomized at the 10th percentile. Multivariable logistic regressions, adjusted for parents’ socio-economic factors, parental characteristics, children’s characteristics and sleep habits, allowed us to study the independent association between night-waking trajectories from 2 to 6 and behavior at age 6.

Results

Two distinct night-waking trajectories were identified. The “2 to 6 rare night-waking” trajectory represented 78% of the included population (N=896), and the “2 to 6 common night-waking” 22% (N=247%). The trajectories did not cross, indicating a perseverance of night-waking difficulties throughout preschool-years. Children belonging to the “2 to 6 common night-waking trajectory” had, at age 6, increased risk of presenting emotional symptoms (OR 2.17, 95% CI [1.27-3.70], p=0.004), conduct problems (OR 1.63 95% CI [1.00-2.65], p=0.050) and hyperactivity/attention problems (OR 1.61, 95% CI [1.00-2.57], p=0.049). After adjusting for baseline behavior at age 2, only the association with emotional symptoms remained significant (OR 2.02, 95% CI [1.15-3.55], p=0.015).

Conclusions

Results did not differ according to gender Results suggest that there is a persistence of night-waking difficulties in early childhood and that they are associated with behavioral difficulties. Children may thus benefit from systematic investigation of sleep quality to prevent the settling of sleep difficulties and prevent subsequent behavioral problems.

Acknowledgements

We thank the EDEN mother-child cohort study group and all funding sources for the EDEN study