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Pre-School Family Irregularity Disturbs the Development of Sleep in Children

Sat, March 23, 2:30 to 4:00pm, Baltimore Convention Center, Floor: Level 3, Room 318

Integrative Statement

Introduction: Previous research points to the importance of the family environment in relation to sleep; stressful family environments, a lack of parental rules, and family conflict have all been associated with sleep problems in children and adolescents (Gregory, Caspi, Moffitt, & Poulton, 2006). These negative family influences all occur more often in the context of an unpredictable and irregular family life (Gregory et al., 2006).
The literature is characterized by several gaps. First, studies have been primarily cross-sectional, thus it has not yet been possible to examine how family irregularity prospectively associates with the development of sleep problems in childhood. Second, the effects of family irregularity on objective indices of sleep have yet to be characterized. Third, no study to date has investigated whether child psychopathology mediates the association between family irregularity in early life and later sleep problems.

Hypotheses: We examined whether family irregularity is prospectively associated with sleep problems rated by both parents and children and assessed by objective measures of sleep, using data from a large population-based study. Moreover, we tested whether the association between family irregularity and child sleep problems is mediated by child psychopathology.
Study population: This population-based study comprises 5443 children from Generation R, a prospective population-based cohort from fetal life onward in Rotterdam, the Netherlands. Methods: Family irregularity was measured with seven maternal reported questions on family routines when children were 2 and 4 years old. Mothers reported on sleep problems at child age 3, 6, and 10 years, whereas children completed questionnaires on sleep problems at age 10. Additionally, we used tri-axial wrist accelerometers for five nights in 851 children (mean age 11.7 years) to assess sleep objectively.

Results: Family irregularity was associated with more mother- and self-reported sleep problems at ages 3, 6, and 10 years (Mother-reported age 3, β =0.21, 95% CI: 0.17 – 0.25), age 6, β =0.16, 95% CI: 0.12 – 0.20), age 10, β =0.10, 95% CI: 0.06 – 0.14) (figure 1); self-reported β =0.08, 95% CI: 0.04 – 0.13, p<0.01)) as well as with a shorter sleep duration (β = -0.09, 95% CI: -0.16 – -0.01, p<0.01) and a later sleep onset (β =0.11, 95% CI: 0.04 –0.17, p<0.01), but not with sleep efficiency or sleep onset latency. The association between family irregularity and multi-informant subjective sleep problems at age 10 years was mediated by mother-reported child psychopathology at age 6 years (mother-reported sleep problems: adjusted β: 0.14; 95% CI: 0.04 – 0.33 for [Ratio of indirect to direct effect 40%]; child-reported sleep problems: adjusted beta: 0.05; 95% CI: 0.00 – 0.16 [Ratio of indirect to direct effect 13%]).

Conclusions: Our findings show that pre-school family irregularity is associated with more sleep problems during childhood, and with a shorter sleep duration and a later sleep onset. In part, these sleep problems were associated with family irregularity by way of child psychopathology. These findings suggest that interventions improving pre-school family irregularity, which are targeted to reduce child psychopathology, may also impact the development of sleep problems beneficially.

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