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Preschool-aged Children’s Problematic Sleep Habits are Related to Irritability, Anxiety, and Parental Psychopathology

Thu, April 8, 3:15 to 4:15pm EDT (3:15 to 4:15pm EDT), Virtual

Abstract

Irritability and anxiety can emerge early in childhood and impair functioning, and problematic sleep may contribute to these difficulties. Child irritability, a facet of mood, and anxiety are associated with risk for a range of psychological difficulties (Brotman et al., 2017; Dougherty et al., 2015; Krieger et al., 2013; Pine et al., 1998). Associations between sleep and internalizing difficulties have been identified in school-aged children (Alfano et al., 2009; 2010), and researchers have identified prospective links between preschool-aged sleep problems and later internalizing difficulties (Gregory et al., 2005; Quach et al., 2018). Parental psychopathology may be related to children’s sleep as well (Gregory et al, 2005; Seifer, 2011). Despite growing knowledge in the relation between child sleep and psychopathology, the relationship between child irritability and anxiety, parental psychopathology, and child sleep in preschool-aged children has been largely understudied. This study assessed associations between these constructs in a large community sample of 3-5-year-old children. It was hypothesized that children’s problematic sleep habits would be positively correlated with parent-reported and laboratory-observed child irritability and anxiety and parental psychopathology. In total, 592 primary caregivers of preschool-aged (M=3.75, SD=.75) children (356(60%) White, 83(14%) Mixed Race, 61(10.3%) Hispanic, 50(8.4%) African American, 28(4.7%) Asian, 7(1.2%) Other, and 3(.5%) American Indian) participated. Parents completed the Affective Reactivity Index (ARI; child irritability), Preschool Anxiety Scale (PAS), Center for Epidemiologic Studies Depression Scale (CES-D; parental depression), Patient-Reported Outcomes Measurement Information System-Anxiety (PROMIS-A; parental anxiety), and Children’s Sleep Habits Questionnaire (CSHQ). In addition, a subsample of children (n=202) completed a distressing laboratory task in which they were mildly criticized while being asked to draw a “perfect” circle; children’s facial/bodily/vocal expressions of anger, sadness, and fear were coded using a standardized scheme. Pearson’s correlation analyses supported the hypotheses: children’s problematic sleep habits were positively related to parent-reported child irritability (r=.35, p<.001) and anxiety (r=.38, p<.001), laboratory-observed child anger (r=.21, p=.003), and parental depression (r=.33, p<.001) and anxiety (r=.30, p<.001); child sleep was not related to laboratory-observed child sadness or fear. These variables with significant associations with child sleep were entered into a multiple linear regression model; each remained significantly associated with child sleep except for parental anxiety. Finally, we examined whether parental psychopathology moderated the association between child variables and child sleep; there was a significant interaction between laboratory-observed child anger and parental depression (B=.08,SE=.03,t=3.46,p<.001,95%CI:.04-.14) such that the association between child anger and sleep difficulties was stronger for parents with more depressive symptoms (B=1.28,SE=.27,t=4.66,p<.001,95%CI:.74-1.82) compared to parents with fewer depressive symptoms (B=.07,SE=.25,t=.26,p=.80,95%CI:-.43-.57) (Figure 1). These results highlight the important and unique relationships between child sleep and child irritability and anxiety and parental psychopathology during the preschool period. The findings suggest that recognizing and addressing problematic sleep behaviors in young children may reduce risk for psychopathology (Hoyniak et al., 2020). Future research should examine demographic differences and investigate causal relationships between child and parental psychopathology and child sleep.

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