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Abstract

Purpose: Child and caregiver sleep occurs in a family system, with socioeconomically disadvantaged families experiencing disproportionately worse sleep health than more advantaged families. The extent to which objectively measured sleep health metrics (i.e., sleep duration, midpoint, regularity, efficiency) are concordant within disadvantaged family systems, including caregiver-child dyads, is not clear. To address this gap, this study aimed to: (1) characterize sleep health metrics and (2) identify levels of sleep health concordance among caregiver-child dyads living in families experiencing socioeconomic disadvantage.

Design and methods: We enrolled 20 caregivers and 26 children in this micro-longitudinal study. Eligible primary caregivers slept in the same house as the child β‰₯4 nights/week and had no sleep disorders. Eligible children were aged 6-14 years and reported no medical problems. Dyads wore an actigraphy device continuously for 14 consecutive days. Sleep duration, bedtime, midpoint, and efficiency were estimated, and concordance evaluated using linear mixed modeling (R v.3.5.2).

Results: Most caregivers were female (85%), Non-Hispanic Black (80%), and aged 40.45 years (SD=11.82). On average, caregivers were not meeting national recommendations for sleep duration and efficiency. Similarly, sleep duration recommendations were not met by child participants. Bivariate results showed that bedtime π‘Ÿ=0.19, p<.001), sleep efficiency (π‘Ÿ=0.24, p<.001), and sleep midpoint (π‘Ÿ=0.39, p<.001), were concordant between child and caregiver. Multivariable models showed that caregiver bedtime was predictive of child sleep midpoint (b=0.16, p<.05), and caregiver sleep midpoint was predictive of child bedtime (b=0.29, p<.01) and child sleep midpoint (b=0.31, p<.001).

Conclusion: Objectively estimated caregiver sleep may be connected to the sleep timing of their children. Improving child sleep may require addressing caregiver sleep habits too.

Practice Implications: Results highlight the importance of providers considering caregiver sleep health when assessing child sleep health during well child visits.

Key Take Away Points

  • In this sample of caregiver-child dyads living in families experiencing socioeconomic disadvantage, on average, caregivers were not meeting national recommendations for sleep duration (7-9 hours per night) and sleep efficiency (>85%), and children were not obtaining 9-11 hours of sleep per night.
  • Bedtime, sleep efficiency, and sleep midpoint were significantly concordant in caregivers and children, with the strongest association observed with sleep midpoint.
  • In multivariable models, caregiver bedtime predicted child sleep midpoint, and caregiver midpoint predicted child bedtime and midpoint; highlighting the necessity of addressing poor sleep health at the family versus individual level among families experiencing socioeconomic disadvantage.

Author Biography

LBC is a nurse scientist and Assistant Professor at University of Delaware School of Nursing. AS is a Pulmonologist and Professor of Thoracic Medicine and Surgery at Temple University Lewis Katz School of Medicine. BB is a data analyst for the Sleep and Health Research Program at University of Delaware College of Health Sciences. RB is the former Research Project Manager of the Temple Lung Health Cohort Study at the Temple University Lewis Katz School of Medicine. ID is a pediatrician and Associate Professor of Clinical Pediatrics at Temple University Lewis Katz School of Medicine. JL is the Unidel A. Gilchrist Sparks III Chair in the Social Sciences and Professor of Psychological and Brain Sciences at University of Delaware. SM is the current project manager for the Temple Lung Health Cohort Study at the Temple University Lewis Katz School of Medicine. AC was a research assistant for the Family Sleep Study at University of Delaware College of Health Sciences during the data collection period. EH is a postdoctoral researcher at the Sleep and Health Research Program at the University of Delaware College of Health Sciences. FP is an Associate Professor of Behavioral Health and Nutrition and Director of the Sleep and Health Research Program at University of Delaware College of Health Sciences.

Acknowledgements

This work was supported by National Institutes of Health [R01MD012734] (Patterson and Satti); University of Delaware General University Research Grant (Covington); University of Delaware School of Nursing SEED funding (Covington).

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