Sleep and Self-Regulation Among Young Children Experiencing Homelessness

• In Event: 3-085 - Sleep in the Context of Risk and Adversity: A Lifespan Perspective

Integrative Statement

Sleep represents an important foundation for healthy development. Inadequate sleep has been repeatedly linked to poorer cognitive and emotional self-regulation (Astill et al., 2012; Talbot et al., 2010), believed to reflect disrupted activity in the prefrontal cortex (Dahl, 1996). Because sleep is known to be disrupted in the context of poverty and associated stressors (Bagley et al., 2015), inadequate sleep may contribute to difficulty self-regulating in the context of poverty-related risk, undermining cognitive control processes implicated in resilience (Blair & Raver, 2012). Sleep-related challenges are particularly salient for families experiencing homelessness, who report extremely high levels of poverty-related risk and unique challenges associated with maintaining sleep hygiene in shelter (Perlman et al., 2012). Limited research has documented elevated parent-reported and self-reported sleep problems among homeless children and adolescents (Bassuk, 1990; Stewart et al., 2004). We are not aware of prior research that assesses multiple dimensions of sleep using objective and subjective measurement with children experiencing homelessness.
The current study addresses gaps in the literature by a) evaluating parent-reported sleep problems and actigraphy-measured sleep duration and quality among young children in emergency housing, and b) assessing links with poverty-related risks and child self-regulation. Participants were 144 three- to six-year old children (63.9% African American, 21.5% Multiracial, 5.6% American Indian, 5.6% European American, 3.5% missing/other) and their primary caregivers (88.2% biological mothers, 7.6% biological fathers, 4.2% other) recruited from emergency family housing in a Midwestern city.
Caregivers reported on demographics and well-established poverty-related risk factors, summed to create a five-item risk index. Caregivers also rated children’s sleep problems using an abbreviated Children’s Sleep Habits Questionnaire (Owens et al., 2000) and emotion dysregulation using the Emotion Regulation Checklist (ERC; Shields & Cicchetti, 1997). Executive function (EF) was assessed using Dimensional Change Card Sort (DCCS) and Flanker from the NIH Toolbox (Zelazo et al., 2013). A subset of children participated in objective measurement of sleep, wearing actigraphers on non-dominant wrists for seven days (Actigraph Corporation, 2014). Actigraphy data was available for 73 children with at least 4 days of useable sleep data; they did not differ from children without actigraphy data on study variables. Full-information maximum likelihood was used to account for missing data.
Results revealed inadequate sleep duration and low sleep quality among young children experiencing homelessness (Table 1). Poverty-related risk was associated with worse sleep quality. Regarding self-regulation, all three sleep measures predicted Flanker performance. Sleep quality and duration additionally predicted better DCCS performance, and sleep problems predicted more emotion dysregulation. A series of path analyses was conducted predicting to multiple self-regulatory outcomes (Figure 1). Associations between self-regulation and parent-reported (but not actigraphy-measured) sleep were robust to demographic controls. Separate models testing indirect associations between risk and self-regulation through sleep quality were non-significant.
Overall, results confirmed inadequate sleep among young children experiencing homelessness, and identified variations in sleep quality related to poverty-related risk, even in this very high-risk sample. Sleep measures in turn predicted children’s self-regulation, suggesting that improving sleep may be one pathway for enhancing self-regulatory outcomes among children experiencing homelessness.

Authors

• Madelyn H. Labella, University of Delaware
  Presenting Author

• Rebecca Linnea Distefano, University of Minnesota Twin Cities
  Non-Presenting Author

• Andrew J. Barnes, University of Minnesota
  Non-Presenting Author

• Ann S. Masten, University of Minnesota Twin Cities
  Non-Presenting Author