Sleep in 1 year-old Children in Early Head Start: Implications for Development at age 2

• In Event: The Importance of Sleep Across the Perinatal Period: Implications for Maternal and Infant Well-being

Abstract

Background. Early Head Start (EHS) is a federally funded program for children and families from birth to age 3 who qualify as low income, are in foster care, without housing, or receive public assistance (Vogel & Boller, 2014). EHS resources are intended to promote positive development, health, and wellness. One major factor in early development is sleep, which is related to a host of important factors, including physical health (e.g., cardiovascular and brain health; Ramar et al., 2021), and cognitive and academic outcomes (e.g., language; Hernandez-Reif & Gongordu, 2022; Lin et al., 2020). While one-year-olds are recommended to have 11-14 hours (Schlieber & Han, 2021; WHO, 2019), a clear picture of sleep health at age 1 in an EHS sample has not been painted. The first aim of this study was to examine sleep at age 1 in children in the EHS, and variables associated with that sleep. Aim two examined how sleep at age 1 was associated with reported communication or cognitive skills at age 2.

Methods. Participants come from a nationally representative, longitudinal study of children in Early Head Start (Baby FACES, Vogel & Boller, 2014). Sociodemographics, parent-reported sleep, parental depression, and ASQ-3 scores (Squires et al., 2009) were collected from the parent in interviews at child ages 1 and 2. The ASQ-3 communication and problem-solving subscales were utilized at ages 1 and 2. All participants with age 1 sleep data (N= 652) were included in the study and longitudinal weighting was used in analyses.

Results. Aim 1. One-year-olds got, on average, 9.54 (1.89) hours of sleep per night, with an average nap of 1.51 (2.07) hours. Preterm infants, males, and children in rural area received less sleep (Table 1). More child sleep was associated with fewer maternal risk factors and less parental depression. Family childcare, home-based care, and center-based care all had similar sleep profiles, while “some other program” was associated with less sleep. Aim 2. Controlling for relevant covariates and ASQ-3 scores at age 1, linear regressions found that more total sleep at age 1 was associated with both the stronger reported communication and problem-solving skills (Table 2). While more parental depression at age 1 was related to poorer problem solving at age 2, it was not related to communication at age 2.

Discussion. This study found longitudinal associations between sleep and improved cognitive and language skills one year later, which research has suggested may be mutually informed by morning stress levels and HPA-Axis control of cortisol. These findings are in line with prior research connecting social determinants of health, such as living in urban areas or higher economic risk, to more sleep problems (Bottino et al., 2012; Singh & Kenney, 2013). These results suggest important connections between maternal depression and child sleep quality (Toffol et al., 2019), and future research should examine if EHS interventions for maternal depression may have spillover impact on sleep. Utilizing the EHS interventions to promote sleep education, and address risk factors such as parental depression, may be beneficial.

Authors

• Maire Claire Diemer, University of Missouri- St. Louis
  Presenting Author

• Haley Ringenary, University of Missouri - St. Louis

• Emily D. Gerstein, University of Missouri-St. Louis