Parental social capital and children's sleep disturbances

Social Capital and Sleep Outcomes Across Childhood in United States Families

OBJECTIVE

To examine whether aspects of social capital, or benefits received from social relationships, are associated with regular bedtime and sleep duration across childhood in US families with lower income.

METHODS

Cross-sectional study using the 2018-19 National Survey of Children's Health in participants with incomes <400% federal poverty level. Separately for early childhood (0-5 years), school-age (6-12 years), and adolescence (13-17 years), we used weighted logistic regression to examine associations between social capital (measured by family social cohesion, parent social support, child social support) and sleep (measured by regular bedtime, sleep duration, adequate sleep per American of Academy of Sleep guidelines). Path analysis tested whether regular bedtime mediated associations between social capital and sleep duration.

RESULTS

In our sample (N = 35,438), 84.9% had a regular bedtime, 60.2% had adequate sleep. Family social cohesion was associated with sleep duration and adequate sleep (infancy: adjusted odds ratio [aOR] 2.18 [95% confidence interval [CI], 1.32, 3.60]; school age: aOR 2.03 [95% CI, 1.57, 2.63]; adolescence: aOR 2.44 [95% CI, 1.94, 3.09]). In toddlerhood, parent social support was associated with adequate sleep (aOR 1.44 [95% CI, 1.06, 1.96]). In adolescence, child social support was associated with regular bedtime (aOR 1.70 [95% CI, 1.25, 2.32]. Across childhood, associations between family social cohesion and sleep duration were partially mediated by regular bedtime.

CONCLUSIONS

Family social cohesion was associated with adequate sleep across childhood, this was partially mediated by regular bedtime. Associations between social support and sleep outcomes varied by development stage. Future work should consider how supportive relationships may influence child sleep outcomes.

Towards A Socioeconomic Model of Sleep Health among the Canadian Population: A Systematic Review of the Relationship between Age, Income, Employment, Education, Social Class, Socioeconomic Status and Sleep Disparities

A better understanding of the contribution of the socioeconomic status (SES) in sleep health could guide the development of population-based interventions aiming to reduce “the silent public health issue” that are sleep disturbances. PRISMA was employed to identify relevant studies having examined the association between social class, social capital, education, income/assets, occupation/employment status, neighborhood deprivation and sleep health. Sixteen cross-sectional and three longitudinal studies were selected, having sampled 226,029 participants aged from 2 months to 85 years old. Findings showed that: (1) sleep health disparities among children and adolescent are strongly correlated to parental socioeconomic indicators; (2) poor parental income, poor family SES and poor parental education are associated with higher sleep disturbances among children and adolescents; (3) lower education is a predictor of increased sleep disturbances for adults; (4) low SES is associated with high sleep disturbances in adults and old people and; (5) low income and full-time employment was significantly associated with short sleep among adults and old people. In conclusion, sleep health should be an important public health target. Such intervention would be beneficial for populational health, for all taxpayers and public administrations, which would see a reduction in absenteeism and productivity losses attributable to sleep-related health problems in the global economy.

Genetically-predicted prefrontal DRD4 gene expression modulates differentiated brain responses to food cues in adolescent girls and boys

The dopamine receptor 4 (DRD4) in the prefrontal cortex (PFC) acts to modulate behaviours including cognitive control and motivation, and has been implicated in behavioral inhibition and responsivity to food cues. Adolescence is a sensitive period for the development of habitual eating behaviors and obesity risk, with potential mediation by development of the PFC. We previously found that genetic variations influencing DRD4 function or expression were associated with measures of laboratory and real-world eating behavior in girls and boys. Here we investigated brain responses to high energy–density (ED) and low-ED food cues using an fMRI task conducted in the satiated state. We used the gene-based association method PrediXcan to estimate tissue-specific DRD4 gene expression in prefrontal brain areas from individual genotypes. Among girls, those with lower vs. higher predicted prefrontal DRD4 expression showed lesser activation to high-ED and low-ED vs. non-food cues in a distributed network of regions implicated in attention and sensorimotor processing including middle frontal gyrus, and lesser activation to low-ED vs non-food cues in key regions implicated in valuation including orbitofrontal cortex and ventromedial PFC. In contrast, males with lower vs. higher predicted prefrontal DRD4 expression showed minimal differences in food cue response, namely relatively greater activation to high-ED and low-ED vs. non-food cues in the inferior parietal lobule. Our data suggest sex-specific effects of prefrontal DRD4 on brain food responsiveness in adolescence, with modulation of distributed regions relevant to cognitive control and motivation observable in female adolescents.

Family Social Capital: Links to Weight-Related and Parenting Behaviors of Mothers with Young Children

Family social capital includes the social relationships, values, and norms shared by a family and is positively linked with children’s mental and physical health status. This cross-sectional study addresses a gap in the literature related to family social capital vis-à-vis weight-related behaviors and home environments of 557 mothers and their young children (ages 2 to 9 years). Mothers completed an online survey comprised of valid, reliable questionnaires assessing family relationships and weight-related behavioral and home environment measures. The measures that determined family social capital (i.e., supportive, engaged parenting behaviors; family cohesion; family conflict; and family meal frequency) yielded distinct tertile groups that differed significantly (p < 0.001) on every family social capital measure with large effect sizes. Analysis of variance with Tukey post-hoc test revealed greater family social capital was linked to significantly better maternal health, dietary intake, physical activity, and sleep behavior. Additionally, maternal modeling of healthy eating and physical activity, child feeding practices, and home environments was higher in groups with greater family social capital. Child mental and physical health, physical activity, and sleep quality were better in families with greater family social capital. Findings suggest greater family social capital is linked to healthier weight-related behaviors and home environments. Future intervention studies should incorporate strategies to build family social capital and compare longitudinal outcomes to traditional interventions to determine the relative value of family social capital on health behaviors.

Socioeconomic disadvantage and sleep in early childhood: Real-world data from a mobile health application

OBJECTIVES

To examine whether increased socioeconomic disadvantage, indexed using a measure of community distress, was associated with variation in caregiver-reported early childhood sleep patterns and problems in a large US sample using a mobile health application (app).

DESIGN

Cross-sectional.

SETTING

Data were collected using the free, publicly available Johnson's Bedtime© baby sleep app.

PARTICIPANTS

A total of 14,980 caregivers (85.1% mothers) of children ages 6-35.9 months (M = 13.88 months; 52.6% boys) participated in this study.

MEASURES

Caregivers reported on child sleep using the Brief Infant Sleep Questionnaire-Revised. Socioeconomic disadvantage was indexed by zip code using the Distressed Communities Index (DCI), which combines seven US census indicators of socioeconomic disadvantage. DCI scores range from prosperous (lowest quintile) to distressed (highest quintile).

RESULTS

Socioeconomic disadvantage was significantly associated with later bedtimes, longer sleep onset latency, and shorter nighttime and 24-hour (total) sleep duration, with children living in distressed communities showing the poorest sleep. However, caregivers living in distressed communities reported a significantly lower prevalence of overall child sleep problems (43% vs 58% in prosperous communities), and more confidence in managing child sleep (42% vs 34% in prosperous communities).

CONCLUSIONS

Children living in the most distressed communities have the poorest reported sleep patterns and bedtime behaviors; however, their caregivers are less likely to report problematic child sleep. These findings highlight the need for community-level sleep health promotion interventions, as well as further investigation of caregiver perceptions about child sleep and sleep health promotion among families living in socioeconomically disadvantaged contexts.

Development of sleep patterns in children with obese and normal-weight parents

AIM

To study the sleep development and sleep characteristics in children at different obesity risks, based on parental weight, and also to explore their weekday-weekend sleep variations and associated family factors.

METHODS

A total of 145 children participating in a longitudinal obesity prevention project were included, of which 37 had normal-weight parents (low obesity risk), and 108 had overweight/obese parents (high obesity risk). Sleep diaries at ages 1 and 2 years were used to study sleep development in children at different obesity risks. Objectively assessed sleep using an accelerometer at 2 years of age was used to analyse weekday-weekend sleep variations.

RESULTS

There was no difference in sleep development from age 1 to age 2 among children at different obesity risks, but more children in the high-risk group had prolonged sleep onset latency and low sleep efficiency. At 2 years of age, children in the high-risk group had more weekday-weekend variation in sleep offset (mean difference 18 min, 95% confidence interval (CI) 4-33 min), midpoint of sleep (mean difference 14 min, 95% CI 3-25 min) and nap onset (mean difference 42 min, 95% CI 10-74 min) than children in the low-risk group, after adjusting for other family factors. However, no difference could be detected between groups in weekday-weekend variation in sleep duration.

CONCLUSIONS

Unfavourable sleep characteristics, as well as more variation in sleep schedules, have been observed in children at high obesity risk. While the differences were relatively small, they may reflect the unfavourable sleep hygiene in families at high obesity risk.

Does social capital moderate the association between children's emotional overeating and parental stress? A cross-sectional study of the stress-buffering hypothesis in a sample of mother-child dyads

Parental stress has been shown associated with children's eating behaviors. The stress-buffering hypothesis suggests that social resources, i.e., resources accessed via one's social networks, may prevent or attenuate the impact of stress on health. Prior research on the stress-buffering hypothesis has found evidence for the protective effects of social support (emotional, instrumental, or informational resources available in a person's life); less is known about social capital (resources available through one's social networks) as a stress buffer. Further, these studies have often examined the association between a person's direct access to social resources and their health; less research has examined whether the benefits of social resources may extend two degrees from parents to their children. Using data from a community-based birth cohort of mother-child dyads, this study examined whether mother's social capital moderated the association between maternal stress and children's emotional overeating (EO). Mothers completed health questionnaires on an annual basis and a one-time social network questionnaire in 2011-2012. EO was measured using the Children's Eating Behavior Questionnaire. Maternal stress was measured using the 18-item Parental Stress Scale. Social capital was measured using a position generator and based on the number of occupations to which a mother had access. Poisson regression analysis was used. Results showed that mother's social capital moderated the positive association between greater maternal stress and children's EO, such that maternal stress was associated with children's EO in only those mothers with low social capital. This study suggests that social capital may disrupt the transmission of maternal stress from parent to child, thereby playing a potential role in the production and reproduction of health inequalities.

Environmental Determinants of Insufficient Sleep and Sleep Disorders: Implications for Population Health

PURPOSE OF REVIEW

Sleep is important for overall health and well-being. Insufficient sleep and sleep disorders are highly prevalent among adults and children and therefore a public health burden, particularly because poor sleep is associated with adverse health outcomes. Emerging evidence has demonstrated that environmental factors at the household- and neighborhood-level can alter healthy sleep. This paper will (1) review recent literature on the environmental determinants of sleep among adults as well as children and adolescents; and (2) discuss the opportunities and challenges for advancing research on the environment and sleep.

RECENT FINDINGS

Epidemiologic research has shown that social features of environments, family, social cohesion, safety, noise, and neighborhood disorder can shape and/or impact sleep patterns; and physical features such as light, noise, traffic, pollution, and walkability can also influence sleep and is related to sleep disorders among adults and children. Prior research has mainly measured one aspect of the environment, relied on self-reported sleep, which does not correlate well with objective measures, and investigated cross-sectional associations. Although most studies are conducted among non-Hispanic white populations, there is growing evidence that indicates that minority populations are particularly vulnerable to the effects of the environment on insufficient sleep and sleep disorders.

SUMMARY

There is clear evidence that environmental factors are associated with insufficient sleep and sleep disorders. However, more research is warranted to evaluate how and which environmental factors contribute to sleep health. Interventions that target changes in the environment to promote healthy sleep should be developed, tested, and evaluated as a possible pathway for ameliorating sleep health disparities and subsequently health disparities.