Neighborhood Deprivation and Infant Sleep

• In Event: 3-085 - Sleep in the Context of Risk and Adversity: A Lifespan Perspective

Integrative Statement

Introduction
While links between neighborhood deprivation and sleep have been established in older children and adolescents (Bagley et al., 2016; Pabayo et al., 2014), we know less about these links early in the life course. However, many studies have found associations between family-level factors and infant sleep, including emotional availability (Philbrook & Teti, 2016), maternal depression (Teti & Crosby, 2012), and bedtime practices (Sadeh et al., 2010). Given that infancy is a period of heightened dependence on caregivers, the current study tests whether the neighborhood context predicts infant sleep quality through its interaction with maternal emotional availability.
Methods
The current study utilizes data from the Neonatal and Pediatric Sleep (NAPS) Study, a longitudinal study of sleep development in African-American infants. 68 parent-child dyads (61% male) are included in the current analyses. Participants’ addresses were used to identify the census tracts in which they reside, and a neighborhood deprivation score was calculated from four census variables: percent below poverty, percent receiving food stamps or SNAP, percent with less than a high school diploma, and percent of families with a female head-of-household and children under the age of 18. These four indicators are consistent with prior literature examining the association between neighborhood characteristics and health behaviors (e.g., Bagley et al., 2016; Pampalon & Raymond, 2000). At 3 and 6 months of age, infant sleep was measured via actigraphy throughout the nighttime period for 7 nights. For our analyses we examined the average number of night wakings (>5 minutes) as an indicator of infant sleep quality. At 3 months of age, maternal emotional availability (EA) was coded from videorecordings at bedtime using the Emotional Availability Scales (Biringen, Robinson, & Emde, 1998). Four subscales (sensitivity, structuring, nonintrusiveness, nonhostility) were standardized and averaged to create a composite EA score.
Results
Our findings reveal that neighborhood deprivation and maternal EA interact to predict infant sleep quality. At 3 months of age, infants who reside in more disadvantaged neighborhoods and have mothers who are higher in EA wake up more frequently throughout the night (p < .05) (Figure 1). At 6 months of age, we again see this interaction between neighborhood deprivation and high maternal EA, but it is only marginally significant (p < .10) (Figure 2).
Conclusion
Contrary to our hypotheses, we found that greater maternal emotional availability does not predict better sleep quality for infants living in higher risk neighborhoods, but instead predicts greater wakings during the night. Our findings differ from prior studies that have shown that higher levels of maternal emotional availability are beneficial to infant sleep (e.g., Philbrook & Teti, 2016), possibly due to the different developmental period and context. Mothers provide infants with nutrition, comfort, and security, as well as help to regulate their sleep patterns. This may be even more important for those living in stressful contexts, and thus, night waking may be adaptive. Future analyses will aim to further elucidate these findings, by focusing on parenting behaviors that may be driving these association, such as breastfeeding or bed-sharing.

Authors

• Melissa Grimes, University of North Carolina-Chapel Hill
  Presenting Author

• Marie Camerota, UNC-Chapel Hill
  Non-Presenting Author

• Cathi Propper, University of North Carolina at Chapel Hill
  Non-Presenting Author