Sleep Problem Trajectories and Cumulative Socio-Ecological Risks: Birth to School-Age.
Sleep Problem Trajectories and Cumulative Socio-Ecological Risks: Birth to School-Age.
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睡眠问题轨迹和累积社会生态风险：出生到学龄期。
DOI：
10.1016/j.jpeds.2019.07.055
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Quach,Jon
中科院分区：
文献类型：
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作者：
Williamson,ArielA;Mindell,JodiA;Hiscock,Harriet;Quach,Jon
目标评估从出生到 10-11 岁是否存在明显的儿童睡眠问题轨迹，并评估与累积社会生态风险（儿童、家庭、环境）的关联。研究设计参与者是来自澳大利亚儿童出生队列纵向研究的 5107 名儿童。出生时，针对出生、养育、家庭、社会经济和邻里风险生成累积风险指数。从 0-1 岁到 10-11 岁，每两年评估一次家长报告的儿童睡眠问题。睡眠问题轨迹是使用潜在类别分析得出的。使用多变量逻辑回归来检查与风险指数的关联。结果出现了五种不同的轨迹：儿童中期持续存在睡眠问题（7.7%）、婴儿/学龄前睡眠问题有限（9.0%）、儿童中期睡眠问题增加（17.0%）、随着时间的推移出现轻度睡眠问题（14.4%）和无睡眠问题（51.9%）。母亲和父亲报告的累积家庭风险（痛苦；婚姻/关系敌意）与几乎所有轨迹相关，而父亲和母亲报告的养育风险与较少的轨迹相关。出生风险与儿童中期睡眠问题的增加有关。邻里风险与任何轨迹无关。社会经济风险与轻度和持续的睡眠问题轨迹有关。累积风险指数与儿童中期睡眠问题的增加最为相关。结论这项研究确定了不同的纵向睡眠问题轨迹，表明需要在发育过程中进行持续的睡眠筛查。出生时评估的累积风险（主要是母亲和父亲的家庭风险）预测了这些轨迹，尤其是童年中期轨迹的睡眠问题。针对可改变因素的预防性干预措施，特别是照顾者的痛苦和婚姻/关系敌意，可能有益于儿童睡眠。
ObjectivesTo evaluate whether there are distinct childhood sleep problem trajectories from birth to 10-11 years and to assess associations with cumulative socio-ecological risks (child, family, context).Study designParticipants were 5107 children from the Longitudinal Study of Australian Children—Birth Cohort. At birth, cumulative risk indexes were generated for birth, parenting, family, socioeconomic, and neighborhood risks. Parent-reported child sleep problems were assessed biennially from ages 0-1 to 10-11 years. Sleep problem trajectories were derived using latent class analysis. Multivariable logistic regression was used to examine associations with risk indexes.ResultsFive distinct trajectories emerged: persistent sleep problems through middle childhood (7.7%), limited infant/preschool sleep problems (9.0%), increased middle childhood sleep problems (17.0%), mild sleep problems over time (14.4%), and no sleep problems (51.9%). Cumulative mother- and father-reported family risks (distress; marital/relational hostility) were linked to nearly all of the trajectories, whereas father- and mother-reported parenting risks were associated with fewer trajectories. Birth risks were associated with increased middle childhood sleep problems. Neighborhood risks were not associated with any trajectories. Socioeconomic risks were linked to mild and persistent sleep problem trajectories. Cumulative risk indexes were most associated with increased middle childhood sleep problems.ConclusionsThis study identified distinct longitudinal sleep problem trajectories, suggesting the need for continuous sleep screening over development. Cumulative risks assessed at birth—primarily maternal and paternal family risks—predicted these trajectories, especially for the sleep problems in middle childhood trajectory. Preventive interventions targeting modifiable factors, particularly caregiver distress and marital/relational hostility, could benefit child sleep.