Poster #31 - Parental Socioeconomic Status and Childhood Sleep: A Systematic Review and Meta-Analysis

• In Event: Poster Session 11

Abstract

Background: Socioeconomic status (SES) is increasingly understood to be key to sleep health, which is a foundational requirement for healthy growth and development. Several aspects of childhood sleep are associated with long-term consequences across health and development, including obesity, mood, cognitive development, academic performance, and social adjustment. Unfortunately, sleep problems and inadequate sleep duration are common, often begin early in life, and show moderate stability from infancy through to adolescence. Optimizing sleep in children and adolescents is an urgent public health priority to promote positive outcomes across the lifespan. To advance policy, health literacy, and treatment, more comprehensive information is needed about the variables that contribute to childhood sleep disparities. The current study aimed to examine the associations between indicators of child SES and child sleep (≤18 years old) through a systematic review and meta-analyses.

Methods: Four databases (i.e., CINAHL with Full Text, PsycINFO, MEDLINE/PubMed, Embase) were searched using terms to define SES and childhood to ascertain all relevant, peer-reviewed articles from database inception to 27 December 2019. Eligible studies were required to be empirical studies written in English that included children (≤ 18 years of age) without diagnosed medical or psychological disorders, a subjective or objective measure of sleep duration, problems, and/or quality, and a measure of parental SES. Studies must have reported a relationship between cSES and sleep. Abstract and full-text reviews were conducted by independent reviewers. Meta-analysis and meta-regression were conducted using established software.

Results: Data were extracted from 46 studies (N=72,915). Across these studies, the total sample size included in the meta-estimate was N=69,373. Higher parental education was associated with longer childhood sleep duration (stronger in samples with a higher proportion of White children) (OR=1.302, 95% CI [1.111, 1.526], Z-value = 3.259, p = .001) and better sleep quality (OR=1.332, 95% CI [1.014, 1.751], Z-value = 2.059, p = .040). Parental education was not directly associated with child sleep problems (OR=1.191, 95% CI [0.733, 1.935], Z-value = 0.707, p = .479); moderation occurred by continent and the relationship was more pronounced in the Asian meta-estimate. Higher household income was not directly associated with longer childhood sleep duration (OR=0.570, 95% CI [0.167, 1.943], Z-value = -0.898, p = 0.369), but moderation occurred by higher quality studies and the proportion of White children in the sample. Higher household income was associated with fewer sleep problems (moderated by continent) (OR=0.764 (95% CI [0.689, 0.848], Z-value = -5.097, p < .001) and higher sleep quality (OR=1.558, 95% CI [1.036, 2.342], Z-value = 2.132, p = .033).

Conclusions: Restorative processes such as sleep are often overlooked contributors to more downstream socioeconomic disparities in health. Based on what is known about the influence of sleep on mental and physical outcomes, the sleep disparities identified in this review have wide-reaching implications for child physical, cognitive, and emotional development. Early intervention efforts to address systematic SES disparities, in addition to targeted sleep interventions in childhood, hold promise for preventing the onset and severity of later health problems.

Authors

• Emily E Cameron, University of Manitoba
  Presenting Author

• Dana Watts

• Katherine Silang

• Ashley Dhillon

• Pooja Sohal

• Anna MacKinnon, University of Montreal

• Leslie E. Roos, University of Manitoba

• Lianne M Tomfohr-Madsen, The University of Calgary