Racial/Ethnic and Socio-Contextual Correlates of Chronic Sleep Curtailment in Childhood

• Published in: Sleep (New York, N.Y.) N.Y.), 2016-09, Vol.39 (9), p.1653-1661
• Main Authors: Peña, Michelle-Marie, Rifas-Shiman, Sheryl L, Gillman, Matthew W, Redline, Susan, Taveras, Elsie M
• Format: Article
• Language: English
• Subjects: African Americans; Asian Americans; Child; Child, Preschool; Chronic Disease; Ethnic Groups; European Continental Ancestry Group; Female; Health Status Disparities; Hispanic Americans; Humans; Infant; Longitudinal Studies; Male; Massachusetts - epidemiology; Pediatrics; Prevalence; Prospective Studies; Risk Factors; Sleep Deprivation - economics; Sleep Deprivation - ethnology; Sleep Deprivation - etiology; Social Class
• ISSN: 0161-8105; 1550-9109
• DOI: 10.5665/sleep.6086

To examine the association between race/ethnicity and sleep curtailment from infancy to mid-childhood, and to determine the extent to which socioeconomic and contextual factors both explain racial/ethnic differences and are independently associated with sleep curtailment. We studied 1,288 children longitudinally in Project Viva, a pre-birth cohort study, from 6 months to 7 years of age. The main exposure was the child's race/ethnicity. The main outcome was a sleep curtailment score from 6 months to 7 years. The score ranged from 0-13, where 0 indicated maximal sleep curtailment and 13 indicated never having curtailed sleep. The mean (standard deviation) sleep curtailment score was 10.2 (2.7) points. In adjusted models (β [95% CI]), black (-1.92, [-2.39, -1.45] points), Hispanic (-1.58, [-2.43, -0.72] points), and Asian (-1.71, [-2.55, -0.86] points) children had lower sleep scores than white children. Adjustment for sociodemographic covariates attenuated racial/ethnic differences in sleep scores for black (by 24%) and Hispanic children (by 32%) but strengthened the differences for Asian children by 14%. Further adjustment for environmental and behavioral variables did not substantially change these differences. Independently, low maternal education, living in households with incomes < $70,000, viewing more TV, and having a TV in the child's bedroom were associated with lower sleep scores. Chronic sleep curtailment from infancy to mid-childhood was more prevalent among black, Hispanic, and Asian children. These differences were partially but not entirely explained by socio-contextual variables. Independently, children from lower socioeconomic status and those with greater exposures to TV also had greater sleep curtailment.