Objectively Measured Sleep Duration and Body-Mass Index in Young Children: Nativity and Ethnicity Differences

• In Event: 1-149 - Sleep in High-Risk Young Children: Disparities, Behavioral Correlates, and Intervention Results

Integrative Statement

Introduction
Quality sleep is increasingly recognized as a crucial part of health beginning in early childhood. Racial/ethnic disparities have been observed in sleep quality and in the prevalence of childhood overweight and obesity. Sleep has been linked with obesity (Chen et al., 2008) and may be one important mechanism contributing to increased obesity rates among racial/ethnic minority children. It is crucial to consider contextual factors when examining biobehavioral processes affecting physical health for people of color, as there is significant heterogeneity within racial/ethnic minority groups, for example, nativity, acculturation, and reasons for migration.
Recent immigrants are more likely to show better health behaviors than their more acculturated counterparts, a finding known as the immigrant paradox (Garcia Coll & Marks, 2012). However, it is less clear how this may impact children of immigrants, who may enjoy some benefits (e.g., healthy birthweight; Acevedo-Garcia et al., 2005) but other risks (e.g., food insecurity; Chilton et al., 2009). Here we explore the relation between sleep quality and body-mass index (BMI) in children with immigrant mothers as compared to children with non-immigrant mothers.
Methods
Data were derived from a larger study that examined sleep and stress physiology among children recruited from early childcare settings. Participants included 82 children (56% female) who were fitted with a wrist actigraph to record sleep data across 4 days during which parents also completed sleep diaries. Ages ranged from two to five years (M= 4.04, SD=0.70). Maternal ethnicity (Latina/non-Latina), nativity (U.S. vs. foreign born) and family language preference were used to determine group-based comparisons. We compared families who did (23%) and did not complete the study in Spanish, as well as children of Latina immigrants (COLI; 22%), children of Latina Americans (COLA; 10%) and children of non-Latina Americans (ConLA; 68%). Actigraphy data was used to calculate sleep duration, percentage of wake during the night, and mid sleep point (MSP). Children’s height and weight was measured using standardized protocols, and BMI percentiles were calculated using World Health Organization age- and sex-adjusted norms.
Results
ANOVAs revealed significant differences between groups for average sleep duration, F(2, 79)=8.22, p<0.05, where COLIs and COLAs had shorter average sleep durations as compared to ConLIs. Similarly, COLIs, COLAs, and ConLAs differed in weight classification X¬¬² (4, N=70)=10.36, p<0.05, with 30%, 35% and 20% obese/overweight, respectively (see Figure 1). Longer average sleep duration was predictive of lower BMI for ConLAs, r(57)= -0.30, p<0.05, and those who completed the study in English (vs. Spanish), r(59)=-0.26, p<0.05, but not other groups (see Figure 2). These null effects did not appear to be due to low power, (p’s > 0.49).
Discussion
Despite sleeping less and having higher BMI, associations between sleep duration and BMI were only evident in children of non-Latina immigrants. These results extend prior work (Mendoza et al., 2017) suggesting that well-replicated risk associations may not universally apply to children of Latina immigrants and require more nuanced investigation. Findings suggest that considering the family context may be critical for understanding associations between sleep quality and physical health outcomes.

Authors

• Tiffany Phu, Department of Psychology, University of Denver
  Presenting Author

• Neda Senehi, University of Colorado Denver Anschutz Medical Campus
  Non-Presenting Author

• Lisa Badanes, Metropolitan State University of Denver
  Non-Presenting Author

• Marina Mendoza, Denver Preschool Program
  Non-Presenting Author

• Sarah Enos Watamura, UNIVERSITY OF DENVER
  Non-Presenting Author