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Associations Between Children’s Sleep and Externalizing Behavior: The Moderating Role of Executive Functioning

Wed, April 7, 3:15 to 4:15pm EDT (3:15 to 4:15pm EDT), Virtual

Abstract

Sleep problems have been linked to increased externalizing behaviors (Bayes & Bullock, 2019). However, inconsistent findings suggest variability among youth. Executive functioning (EF) influences behaviors through a top-down process, allowing children at higher levels of EF to exhibit better self-control by inhibiting problematic behavior. As such, children with higher EF may be better equipped to handle the deleterious effects of poor quality sleep when compared to their peers with lower EF, thus serving to moderate this relationship (Kidwell, 2016). The current study investigated the main effects of sleep and EF on externalizing problems, as well as the moderating effect of EF on associations between sleep and externalizing behaviors in middle childhood. It was hypothesized that poor quality sleep would have a positive relation and EF would have a negative relation to externalizing behaviors. Also, children with lower EF would demonstrate significant associations between sleep problems and externalizing behaviors but children with higher EF would not.

The current study included 710 children from a socioeconomically and racially diverse twin study (Mage=8.43, SD=0.68; 51.5% female; 55.6% non-Hispanic White, 22.5% Hispanic; 26.3% living at/below the poverty line). Primary caregivers reported on children’s externalizing behaviors (HBQ; Armstrong & Goldstein, 2003), subjective sleep problems (CSHQ; Owens et al., 2000), and family income-to-needs and parents’ education levels (used to calculate socioeconomic status (SES)). Actigraphy across one week was used to measure sleep duration (Mnights=6.83, SD=0.62). Children also completed the Continuous Performance Task (CPT; Conners et al., 2003), Flanker Task (Mueller & Piper, 2014), and Digit Span Backwards (Wechsler, 2003), which were used to compute an EF principal component. Multilevel regression models were run to account for twin interdependence and to examine each sleep measure (sleep problems, duration), EF principal component, and their interactions in predicting externalizing behaviors. Covariates included child sex, age, race, and SES.

The EF principal component was not significantly associated with externalizing behaviors, therefore analyses were run with individual EF tasks, see Table 1. Sleep problems were positively associated with externalizing behaviors (b=.14, p<.001). Neither objective sleep duration nor individual EF tasks predicted externalizing behaviors. Further, sleep duration did not interact with any EF measure to predict externalizing behaviors. There was a significant interaction between sleep problems and CPT (b= .04, p<.01; see Figure 1). Children higher in EF exhibited the strongest associations between sleep problems and externalizing as compared to children at average and low levels, although slopes were significant at all levels.

These findings suggest that sleep problems are a risk factor for externalizing behaviors at all levels of EF. Further, high EF serves as a protective factor for children who experience fewer sleep problems, but is less protective at high levels of sleep problems. Therefore, sleep may be a crucial point of intervention on externalizing behaviors. Future research should investigate internalizing behaviors, other sleep parameters, and the longitudinal effects of sleep problems and EF on externalizing behaviors, given such a relationship is evident with ADHD (Kidwell, 2016).

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