Household chaos and family sleep during infants' first year

Parent-Child Relationships: A Shield Against Maternal Depression in the Midst of Household Chaos

Background

Depression, a severe mental disorder, not only jeopardizes the health of mothers but also significantly negative impacts on families and their children. This study investigates the correlation between household chaos and maternal depression.

Methods

This study adopted a cross-sectional design and used the Confusion, Hubbub, and Order Scale, Dyadic Adjustment Scale, Parent-Child Relationship Scale, and Beck Depression Inventory to assess 1947 mothers of children in seven kindergartens in Shanghai, China.

Results

The findings revealed a significant positive correlation between household chaos, marital conflict, and maternal depression. Marital conflict also showed a significantly positively correlated with maternal depression. Marital conflict mediates the relationship between household chaos and maternal depression. Parent-child relationships moderated the direct effect of household chaos on maternal depression. When parent-child relationships were low, household chaos had a greater predictive effect on maternal depression. Conversely, when parent-child relationships were high, the predictive effect of household chaos on maternal depression was reduced.

Conclusion

This study reveals that parent-child relationships play a protective role in the impact of household chaos on maternal depression. This study significantly contributes to enriching the social support buffering model.

Auditory chaos classification in real-world environments

Background & motivation

Household chaos is an established risk factor for child development. However, current methods for measuring household chaos rely on parent surveys, meaning existing research efforts cannot disentangle potentially dynamic bidirectional relations between high chaos environments and child behavior problems.

Proposed approach

We train and make publicly available a classifier to provide objective, high-resolution predictions of household chaos from real-world child-worn audio recordings. To do so, we collect and annotate a novel dataset of ground-truth auditory chaos labels compiled from over 411 h of daylong recordings collected via audio recorders worn by N = 22 infants in their homes. We leverage an existing sound event classifier to identify candidate high chaos segments, increasing annotation efficiency 8.32× relative to random sampling.

Result

Our best-performing model successfully classifies four levels of real-world household auditory chaos with a macro F1 score of 0.701 (Precision: 0.705, Recall: 0.702) and a weighted F1 score of 0.679 (Precision: 0.685, Recall: 0.680).

Significance

In future work, high-resolution objective chaos predictions from our model can be leveraged for basic science and intervention, including testing theorized mechanisms by which chaos affects children's cognition and behavior. Additionally, to facilitate further model development we make publicly available the first and largest balanced annotated audio dataset of real-world household chaos.

Maternal depression and anxiety symptoms across pregnancy and the postnatal period: Modest associations between depression symptoms and infant sleep outcomes

Maternal depression and anxiety symptoms are common across the perinatal period and are associated with a raised risk for adverse child outcomes. While substantial evidence exists for child outcomes such as behaviour, language and cognition, infant sleep has been less studied. In this longitudinal study, we examined the association between maternal symptoms of depression and anxiety and mother-reported infant sleep at 6 and 12 months. Across the four infant sleep outcomes, total sleep time, sleep onset latency, number of awakenings and a maternal perception variable, we found modest effects for concomitant depression symptoms. There were almost no additional effects for anxiety symptoms beyond that already accounted for by depression. Using trajectory modelling of maternal symptoms at five time points, we found more robust effects for maternal groups with postnatally emerging symptoms over prenatally present symptoms across all four sleep outcomes. Our strongest finding was that mothers with postnatal depression symptoms were more likely to perceive their infant's sleep as problematic compared with all other mothers. Where we found effects on duration-based infant sleep outcomes overall, these were small and clearest for depressive symptoms over anxiety symptoms. For both nighttime awakenings and perception of sleep as a problem, effects were apparent only for mothers in the postnatal symptom groups, and not for prenatal symptoms, at both infant ages six and 12 months. Our sample was a relatively high-socioeconomic group with low symptoms overall, and findings may not generalize to more vulnerable populations.

Contextual considerations in infant sleep: Offering alternative interventions to families

Infant sleep problems are one of the commonly reported reasons parents seek professional help, yet what constitutes a "sleep problem" depends on the models used to explain the development of infant sleep. The current models are based on research conducted in the western context where infant solitary sleeping is the norm. Parent-child co-sleeping is the norm in many cultures around the world. We argue that the primary focus of current research on parent-child interactions as the mediating context for the development of infant sleep problems has inherently made these models and ensuing interventions less sensitive and applicable to infant sleep problems in the context of co-sleeping families. When families present for help with infant sleep difficulties, extinction based behavioral interventions or interventions focused on reducing parental presence at bedtime are commonly recommended. These recommendations may not always align with cultural values and parenting practices of all families, therefore precluding these families from getting necessary help. In attempting to provide families with choices that depart from behavioral based interventions, this paper draws on research and adapts current models to propose an alternative to conceptualize perceptions of infant sleep problems that may be sensitive to and applied across various cultural and personal contexts. We attempt to provide a rationale for interventions that are inclusive and sensitive to families where reduced parental nighttime responsiveness may not be a preferred choice.

Co-Rooming Accounts for Socioeconomic Disparities in Infant Sleep Quality among Families Living in Urban Environments

Poor infant sleep quality is associated with negative maternal and infant health outcomes. This study measures socioeconomic disparities in infant sleep quality, and assesses whether child sleep location and maternal stress mediate associations between socioeconomic status (SES) and infant sleep quality. The study includes 86 socioeconomically diverse, mother-infant dyads living in an urban area with infants aged 6–12 months. Mothers reported socioeconomic demographics, infant sleep quality (Brief Infant Sleep Questionnaire) and maternal subjective stress (Perceived Stress Scale). Maternal objective stress was measured via hair cortisol concentration (HCC). The associations among SES, infant sleep quality, infant co-rooming, and maternal stress were assessed. Infants from families with lower income-to-needs (ITN) ratios had poorer infant sleep quality. The association between familial ITN and infant sleep quality was mediated by whether the child co-rooms with parents. Maternal perceived stress was independently associated with infant sleep quality, but HCC was not associated with infant sleep quality.

Sleeping through COVID-19: a longitudinal comparison of 2019 and 2020 infant auto-videosomnography metrics

BACKGROUND

With the outbreak of the COVID-19 pandemic, pediatric experts called attention to the potential adverse effects of living restrictions (e.g., lockdown) on child well-being, but at the same time- acknowledged their possible benefits. To date, only few data-driven reports have been published on child sleep during COVID-19, and all have been based on parent- or self-reports. This study used auto-videosomnography to capture the effects of COVID-19 stay-at-home orders imposed in the USA on objectively measured infant sleep.

METHODS

Auto-videosomnography metrics of infants assessed nightly between January and May 2020 were compared with metrics of an equivalent infant cohort, assessed in the corresponding 2019 period. A total of 610 infants (50.7% girls) aged 6-18 months (M = 11.8, SD = 3.6) were included, with 71,472 analyzed nights. Multilevel models were applied to assess differences between 2019 and 2020 infant sleep pre- and during-lockdown.

RESULTS

Whereas infant cohorts were equivalent in demographic and January-March/April sleep characteristics, during the 2020 lockdown infants had longer nighttime sleep durations (M_difference  = 11.0 min, p = .01), later morning rise times (M_difference  = 9.5 min, p = .008), and later out-of-crib times (M_difference  = 12.3 min, p < .0001), compared to the equivalent 2019 period. In addition, weekday-weekend differences in sleep onset and midpoint times were diminished during 2020 home-confinement compared to the equivalent 2019 period (2019: M_difference  = 5.5 min, p < .0001; M_difference  = 4.5 min, p < .0001; 2020: M_difference  = 2.3 min, p = .01; M_difference  = 3.1 min, p < .0001, respectively).

CONCLUSIONS

Notwithstanding the negative implications of COVID-19 living restrictions in other domains, our findings indicate that there might be a silver lining-in promoting longer and more consistent infant sleep. These benefits should be considered in determining policy for the current and future pandemics.

Family Health Development: A Theoretical Framework

In recognition of the family as central to health, the concept of family, rather than individual, health has been an important area of research and, increasingly, clinical practice. There is a need to leverage existing theories of family health to align with our evolving understanding of Life Course Health Development, including the opportunities and constraints of the family context for promoting lifelong individual and population health. The purpose of this article is to propose an integrative model of family health development within a Life Course Health Development lens to facilitate conceptualization, research, and clinical practice. This model provides an organizing heuristic model for understanding the dynamic interactions between family structures, processes, cognitions, and behaviors across development. Potential applications of this model are discussed.

Household Chaos and Caregivers' and Young Children's Mental Health during the COVID-19 Pandemic: A Mediation Model

Based on 764 households with young children in Wuhan, China, where the COVID-19 pandemic started, this study investigated how household chaos during the pandemic was associated with the mental health problems of children and their caregivers. It also examined the familial correlates of household chaos. The results showed that household chaos was associated with caregiver-rated symptoms of anxiety/withdrawal, fearfulness and acting out exhibited by young children and the symptoms of anxiety and depression in their caregivers. Moreover, caregivers' depression and anxiety mediated the relations between household chaos and caregiver-rated child mental health problems. Additionally, caregivers living in families with a single caregiver, a larger family size, poorer physical health, and more significant income loss reported greater levels of household chaos during the pandemic. These findings highlight the importance of reducing household chaos to promote the mental health of young children and their caregivers during the pandemic. They also underscore the need to identify families with high levels of chaos based on key background variables.

The role of household chaos on levels and trajectories of socioemotional behavior in the second year

The second year of life is a time of formative developmental change as basic behavioral systems undergo rapid integration and expansion. This study examined the developmental trajectories of social-emotional (SoE) outcomes and the effects of infant sex and household chaos (HC) on the development of SoE outcomes across the second year of life. The participating families (N = 143) were ethnically homogenous (88% Caucasian) but economically diverse (31% low-to-very-low income). Mothers reported on their children's SoE outcomes including externalizing, internalizing, dysregulating problem behaviors as well as SoE competence when infants (54% girls) were 12, 18, and 24 months old. At each age point, HC was assessed through observations during home visits and compliance to the study protocols. Multilevel modeling revealed increasing developmental trajectories in all of the domains of SoE outcomes across the second year of life, reflecting the premise that these behavioral systems continue to form and become increasingly part of the infant's behavioral repertoire as development unfolds. However, compared to infants in less chaotic homes, infants in more chaotic households experienced steeper increases in both externalizing and internalizing problem behaviors across the second year, and girls showed higher levels of internalizing problem behaviors compared to boys. Results emphasize the increasing trajectories of problem behaviors in relation to ongoing chaotic caregiving environment among infants as young as 2 years of age. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Household chaos mediates the link between family resources and child sleep

PURPOSE

This study examined the mediational role of household chaos in the link between family resources and child sleep outcomes during the transition to kindergarten.

PROCEDURES

Participants included 230 families of children entering kindergarten (50% female) who participated in an 8-day measurement burst at pre-kindergarten (July-August), early kindergarten (September/October), and mid-kindergarten (November/December). At pre-kindergarten, mothers completFed the Family Resources Scale-Revised (FRS-R), while at pre- and early-kindergarten, trained observers assessed household chaos using the Descriptive In-Home Survey of Chaos-Observer ReporteD (DISCORD). To better understand perturbations in child sleep during this transition, actiwatches (AW Spectrum Plus, Philips/Respironics, Murrysville, PA) were used to measure both child sleep duration and proportion of recommended sleep duration (9+ hours per night) at early- and mid-kindergarten.

MAIN FINDINGS

Results found that family resources were more clearly predictive of child sleep outcomes than household income. Controlling for quality of coparenting and maternal depressive symptoms, household chaos mediated the link between family resources and child sleep duration at both early and mid-kindergarten, the link between family resources and the proportion of recommended sleep duration in mid-kindergarten, and the change in proportion of recommended sleep from pre-kindergarten to early-kindergarten.

CONCLUSIONS

Findings highlight household chaos as a mechanism by which family resources, a metric of socioeconomic risk, influences child sleep during the transition to kindergarten.

Exploring Associations of Household Chaos and Child Health Behaviors in Rural Families

Objectives: Regular physical activity (PA) and limited sedentary behavior (SB) and screen-time are essential for children's health, and rural children are more likely to have overweight and obesity. Household chaos (HHchaos), defined as disorganization characterized by noise and crowding, is associated with negative behavioral outcomes in children. In this study, we examined associations between HHchaos and PA, SB, and screen-time among rural children. Methods: Parent/child dyads (N=105) were enrolled in NU-HOME, a family-based, obesity prevention randomized-controlled trial. We used hierarchical regression analyses of baseline data to examine unadjusted and adjusted (child age, sex, BMI z-scores and economic assistance) associations between HHchaos and outcomes. Results: Children were 8.96 ± 1.06 years old; 58% were female; and 53% were categorized as normal weight. Total daily PA, SB, and weekday screen-time were 259.1 ± 58.22 minutes, 499.9 ± 77.46 minutes, and 1.79 ± 1.48 hours, respectively. Unadjusted HHchaos scores (mean = 5.04 ± 3.6; range = 0-15 with higher score indicating more chaos) were not associated with child PA or SB. HHchaos was positively associated with child screen-time in all models (p<.05), except the fully adjusted model for weekday screen-time. Conclusions: Our findings suggest that decreasing household chaos may be useful in reducing child screen-time. Our findings align with current literature in viewing household chaos as a risk factor for children's health.

Daily concordance between ecological stressors and sleep in young minority children during the pre-COVID-19 outbreak period

OBJECTIVE

As the COVID-19 pandemic brings widespread changes in families, the sociology of sleep becomes noticeable. Yet, the socio-contextual determinants of a biopsychosocial phenomenon as sleep are poorly investigated. We examine changes concomitantly occurring in the child's sleep per familial and community stressors.

METHODS

During the pre-COVID-19 outbreak period, in 24 minority children (5.4 ± 1.7 years old, 54.2% girls), sleep was objectively measured 24 h for two consecutive weeks, and this was repeated three times over the study period of three months. The caregiver filled out questionnaires surveying sociodemographic, community and family aspects.

RESULTS

Children went to bed at 22:26 and woke up at 07:04, with each a variability of about 50 min. Money and time were revealed as related key stressors to sleep. Five dimensions best fitted their association. In general, concurrent changes within the individual child indicate that mean sleep variables seem to relate to predominantly features of the stressors (explained variance of 34.7 to 56.7%), while variability of sleep tends to associate to situational aspects of the stressors (explained variance of 30.4 to 61.8%). Associations were best explained in terms of the 24 h dimension, particularly exposing sleep variability.

CONCLUSION

Individual variabilities in a child's sleep are associated with familial resources, such as caregiver's time to self, money and basic needs. Time spent in bed, a modifiable factor by society and shaper of sleep quantity and quality, plays a key role in stressor-sleep associations. Insights from biopsychosocial perspectives may be valuable for understanding COVID-19 sleep studies, and the development of (post-) COVID-19 sleep recommendations.

Sleep ecology, sleep characteristics and behavior problems in young maltreated children: A scoping review

BACKGROUND

Behavior problems are highly prevalent in young maltreated children. Their etiology is multifactorial and has been widely documented. Lately, researchers paid increased attention to the role of sleep in non-maltreated children's behavior problems. They showed that poor sleep (e.g., short sleep duration, nocturnal awakenings) increased behavior problems. In addition, an inadequate sleep ecology (e.g., lack of sleep hygiene or bedtime routine) may lead to sleep problems.

OBJECTIVE

As maltreated children often live in disorganized environments, this study aims to map knowledge about sleep ecology and sleep characteristics, as well as their associations with behavior problems in young maltreated children from one to five years old.

METHOD

A scoping review was performed according to the PRISMA-SR checklist. Bibliographic databases were searched from 1993 to May 2020.

RESULTS

From the 650 studies screened, nine reported results about sleep ecology or sleep characteristics or their associations with behavior problems in young maltreated children. Only one study described their sleep ecology. Eight studies documented or compared sleep characteristics, showing slight differences between maltreated and non-maltreated children (e.g., longer nighttime sleep duration or shorter naps in maltreated children). Four studies revealed associations between sleep characteristics and behavior problems in young maltreated children (e.g., shorter sleep duration was associated with more externalizing behaviors).

CONCLUSION

Literature about sleep ecology, sleep characteristics, as well as with their associations with behavior problems in young maltreated children is scarce. Their sleep ecology especially deserves to be investigated. Longitudinal studies, studies with comparison groups, combining objective and subjective validated sleep measures, and taking into account maltreatment characteristics and children's developmental stage should be pursued.

Infant Regulation: Associations with Child Language Development in a Longitudinal Cohort

OBJECTIVE

To determine whether infants who have regulatory problems (eg, sleeping, crying, and feeding problems) at 1 year of age are at increased risk of experiencing language difficulties at ages 5 and 11 years, compared with settled infants.

STUDY DESIGN

Parent survey and child assessment data (n = 1131) were drawn from a longitudinal community cohort study. Latent Class Analysis identified 5 profiles of infant regulation including those who were settled (37%), had tantrums (21%), had sleep problems (25%), were moderately unsettled (13%), and severely unsettled (3%) at 12 months of age. Adjusted regression analyses examined associations between infant regulatory profiles and language ability (Clinical Evaluation of Language Fundamentals-fourth edition) at ages 5 and 11 years.

RESULTS

Infants who were moderately unsettled had lower language scores at age 5 (adjusted mean difference, -3.89; 95% CI, -6.92 to -0.86) and were more likely to have language difficulties (aOR, 2.71; 95% CI, 1.28-5.75), than infants who were settled. Infants who were severely unsettled at 12 months of age, had lower language scores at ages 5 (adjusted mean difference, -7.71; 95% CI, -13.07 to -2.36) and 11 (adjusted mean difference, -6.50; 95% CI, -11.60 to -1.39), than infants who were settled. Severely unsettled infants were 5 times more likely to have language difficulties at age 5 than their settled counterparts (aOR, 5.01; 95% CI, 1.72-14.63).

CONCLUSIONS

Children at 1 year of age with multiple regulatory problems are at an increased risk for poorer language skills at ages 5 and 11 years.

Household chaos, family routines, and young child movement behaviors in the U.S. during the COVID-19 outbreak: a cross-sectional study

BACKGROUND

The home environment is an important facilitator of young child movement behaviors, including physical activity (PA), sleep, and screen-time. Household chaos, characterized by crowding, noise, and disorder in the home, may hinder efforts to obtain adequate amounts of movement behaviors. The COVID-19 outbreak impacted many families, and social distancing during this time may create conditions for more household chaos. Family routines can help establish order in the home and encourage an appropriate balance of movement behaviors, such as less screen-time and more sleep. The purpose of this study was to evaluate the association between household chaos and young child movement behaviors during the COVID-19 outbreak in the United States, and the role of family routines in this relationship.

METHODS

A national online survey including 1836 mothers of preschoolers (3.0-5.9 years) was conducted during May 2020. Mothers reported demographic characteristics, household chaos, family routines, and the preschooler's movement behaviors during the outbreak. Mothers completed a household chaos questionnaire and were grouped into chaos categories (low, moderate/low, moderate/high, and high) for analysis. Linear regression was used to assess the association between chaos category, family routines, and movement behaviors with adjustment for covariates.

RESULTS

Mothers were 35.9 ± 4.1 years of age, middle income (47.8%), and preschoolers were 3.8 ± 0.8 years of age. Most mothers reported their preschooler was less physically active (38.9%), slept the same amount of time (52.1%), and increased their screen-time (74.0%) after the COVID-19 outbreak. Preschoolers in the high chaos households performed less total PA (β = - 0.36 days/week, 95% CI:-0.62 to - 0.09, p = 0.008), slept less (β = - 0.42 h, 95% CI:-0.59 to - 0.25, p = 0.001) and had more screen-time (β = 0.69 h, 95% CI:0.45 to 0.92, p = 0.001) compared to those in low chaos households. In most chaos categories, having a bed-time ritual was related to more child sleep, and mothers who viewed routines as "less/not important" reported more preschooler screen-time compared to mothers who viewed routines as "very important".

CONCLUSION

Promoting bed-time rituals and prioritizing routines, even somewhat, may be related to an improved balance of child movement behaviors. Innovative measures are needed to support families during periods of disruption such as that experienced in the COVID-19 pandemic.

Correlates of Sleep Duration in Early Childhood: A Systematic Review

OBJECTIVE

This systematic review aimed to summarize correlates of sleep duration in children under 5 years of age.

METHODS

Six electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, SPORTDiscus, and Scopus) were searched from inception to May 2019. Observational studies and intervention studies reporting cross-sectional results from baseline data were considered. Data were extracted using a predesigned form and potential correlates were categorized following a sociological framework.

RESULTS

One-hundred and sixteen studies, representing 329,166 children, met the inclusion criteria, with a high risk of bias in 62 included studies. A total of 83 correlates of sleep duration were identified. Among the associations studied four or more times, correlates of nap duration were child's age and nighttime sleep onset/bedtime; correlates of nighttime sleep duration were household income, parent marital status, parental adiposity level, nighttime sleep duration at younger age, nighttime sleep onset/bedtime, nighttime sleep wakeup time, and frequency of current bedtime routine; correlate of total sleep duration was screen time.

CONCLUSIONS

Young children from low-income households, single families, or having overweight parents may be at risk for short sleep duration. Promoting healthy sleep duration from an early age appears essential. Effective practices may include encouraging an earlier bedtime, limiting screen time, and establishing a regular bedtime routine. The absence of consistent evidence in the psychological, cognitive, and emotional domain as well as the physical environmental domain warrants further research.

Profiles and Predictors of Infant Sleep Problems Across the First Year

OBJECTIVE

To identify profiles and predictors of maternal-reported infant sleep problems across the first postnatal year.

METHODS

Survey data examining maternal mental and physical health, intimate partner violence (IPV), and infant sleep problems and night waking were gathered from a cohort of 1,460 nulliparous women at 15 weeks' gestation and when their infants were 3, 6, 9, and 12 months old.

RESULTS

Latent class analysis revealed 5 profiles of infant sleep problems, including those who had few problems (24.7%), persistent moderate problems (27.3%), increased problems at 6 months (10.8%), increased problems at 9 months (17.8%), and persistent severe problems (19.4%). Persistent severe infant sleep problems were associated with prepartum and postpartum maternal depression (adjusted odds ratio [AOR] 2.13, 95% confidence interval [CI] 1.35-3.34, p < 0.01; AOR 2.52, 95% CI 1.64-3.87, p < 0.001, respectively), poorer prepartum and postpartum perception of health (adjusted mean difference [AMD] 23.48, 95% CI 24.9 to 22.1, p < 0.01; AMD 23.78, 95% CI 25.2 to 22.4, p < 0.001, respectively), increased postpartum anxiety (AOR 2.22, 95% CI 1.26-3.90, p < 0.01), and increased prevalence of IPV in the first year postpartum (AOR 1.86, 95% CI 1.20-2.87, p < 0.01).

CONCLUSION

Poorer prepartum and postpartum maternal mental and physical health, and IPV, were associated with maternal report of persistent severe infant sleep problems. Women experiencing prenatal physical and mental health difficulties may benefit from advice on managing infant sleep and settling. Health professionals working with unsettled infants must be equipped to enquire about and respond appropriately to disclosures of IPV.

The contributory role of the family context in early childhood sleep health: A systematic review

Sleep-wake regulation is established during early childhood and contributes to life-long health. The family context is critical to the development of child sleep-wake regulation. The primary aim of this systematic review was to elucidate family-level constructs (outside of bedtime parenting) that contribute to early childhood (age 0-5 years) sleep health. We identified empirical research articles that investigate these relationships through systematically searching PubMed, Web of Science, and PsycINFO databases. The transactional model of sleep-wake regulation guided the selection of family-level search terms, including socioeconomic status (SES), family structure, household chaos, marital, co-parenting, and social relationships. Sleep search terms included sleep problems, duration, timing, and variability. We searched sleep and family terms in combination with infant, toddler, or preschool developmental age. Sixteen studies satisfied criteria for inclusion. Results indicated that the presence of household chaos and poor quality marital relationships were directly associated with early childhood sleep problems and variable sleep timing. Higher marital satisfaction and the presence of household routines were positively associated with sleep duration. Several, but not all, studies showed an association between lower SES and poor child sleep health. There were no significant direct associations for family structure and limited findings for the role of perceived social support and co-parenting relationship quality. Overall, operationalization and measurement of family and sleep constructs varied across studies, decreasing our ability to make comparisons and draw robust conclusions. Future research should identify modifiable family-level factors that can be targeted, in addition to bedtime parenting, to improve sleep-wake regulation development.

An investigation of the link between prenatal alcohol exposure and sleep problems across childhood

OBJECTIVE

To investigate the association between dose and frequency of prenatal alcohol exposure (PAE) and sleep problems in children, after controlling for established risk factors for sleep problems.

METHODS

Data from the birth cohort of the Longitudinal Study of Australian Children (LSAC) was used. Mothers of 3447 children provided information on alcohol consumption during pregnancy, children's sleep problems from 2- to 9-years, and potential confounders associated with sleep problems. Children were classified into PAE groups based on distinct patterns of maternal drinking during pregnancy: abstinent, occasional, low, moderate, and heavy. The effect of PAE on the number and persistence of sleep problems across childhood (2-9 years) was examined.

RESULTS

After controlling for multiple covariates that impact sleep, children with heavy PAE had 1.13 more sleep problems across childhood (2-9 years) relative to children whose mothers were abstainers, in particular 0.37 more at 2- to 3-years (0.504, 95 % CI 0.053, 0.956), and 0.34 more at 6- to 7-years (0.847, 95 % CI 0.299, 1.396). Compared to children of abstainers, heavy PAE increases the probability of having persistent sleep problems from 2- to 9-years by 22.57 %. No negative associations between moderate or low PAE and sleep were observed. Parenting, family, economic, and child health factors also significantly affected child sleep.

CONCLUSION

Heavy PAE was associated with significantly more sleep problems across childhood and a higher probability of reporting persistent sleep problems, relative to children with no PAE. Implications for the understanding and management of sleep in young children with PAE and FASD are discussed.

Infant sleep during COVID-19: Longitudinal analysis of infants of US mothers in home confinement versus working as usual

OBJECTIVES

This study longitudinally compared the sleep of infants in the United States whose mothers were in home confinement to those whose mothers were working as usual throughout the COVID-19 pandemic.

METHODS

Mothers of 572 infants (46% girls) aged 1-12 months (M = 5.9, standard deviation = 2.9) participated. Assessments were conducted on 4 occasions from late March to May 2020. Infant sleep was measured objectively using auto-videosomnography. Mothers reported their sheltering status, demographic characteristics, and infant sleep.

RESULTS

Infants of mothers in home confinement had later sleep offset times and longer nighttime sleep durations, compared to infants of mothers who were working as usual. At the end of March, these infants also had earlier bedtimes, more nighttime awakenings, and more parental nighttime visits, but differences were not apparent during April and May.

CONCLUSIONS

Living restrictions issued in the United States may have led to longer sleep durations and temporary delays in sleep consolidation for infants of mothers in home confinement.

Socioeconomic status and sleep in adolescence: The role of family chaos

Low socioeconomic status (SES) has been associated with poor sleep in youth, yet mechanisms underlying this association are not well-understood. The present study examined greater chaos as a mediator of associations between low SES and 2 indices of poor sleep. Two hundred fifty-two adolescents (53% girls; 66% White/European American, 34% Black/African American) participated in the 3-wave longitudinal study. The sample was socioeconomically diverse. At age 16, parents reported on 2 indices of SES: family income and perceived economic well-being. Adolescents reported on chaos within their family at age 17 and on 2 key sleep-wake processes-sleep quality and daytime sleepiness-at age 18. Family chaos functioned as a mediating or intervening variable in longitudinal associations between lower SES and both poorer sleep quality and greater daytime sleepiness. The findings suggest the potential utility of targeting family level processes that exemplify chaos, such as unpredictability, noise, and interruptions, to improve sleep among adolescents. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Sex Differences in the Association between Household Chaos and Body Mass Index z-Score in Low-Income Toddlers

Background: Associations between household chaos and childhood overweight have been identified, but the mechanisms of association are not clearly established in young children, with some studies linking higher chaos to increased obesity risk, whereas other studies link higher chaos to lower obesity risk. Given the lack of consistent findings and early sex differences in vulnerability to chaos, we examined child sex as a moderator of the chaos-child overweight association. We also tested these associations with self-regulation, as self-regulation has been implicated in understanding the chaos-obesity risk association in low-income toddlers. Methods: Parent-reported household chaos and observed child self-regulation were collected at baseline [n = 132; M age 23.0 months (standard deviation 2.8)]. Children's body mass index z-score (BMIz) was measured at 33 months. Multivariate linear regression models were used to assess whether child sex moderated the chaos-BMIz association. A three-way interaction between chaos, child sex, and self-regulation was also tested. Results: Child sex moderated the chaos-BMIz association (b = -0.11, p = 0.04) such that chaos was positively associated with BMIz among boys (b = 0.12, p = 0.003), but unrelated in girls (b = 0.01, p = 0.78). A three-way interaction with self-regulation indicated that a positive chaos-BMIz association existed only for boys with average (b = 0.12, p = 0.004) and low (b = 0.22, p < 0.001) self-regulation. Conclusions: Boys with poor self-regulation may be particularly vulnerable to obesogenic effects of chaotic households.

The relationship between household chaos and child, parent, and family outcomes: a systematic scoping review

BACKGROUND

Household chaos, represented by the level of disorganisation or environmental confusion in the home, has been associated with a range of adverse child and family outcomes. This review aims to (1) identify how household chaos is measured, (2) chart study details of household chaos literature, and (3) map the existing literature with respect to the relationship between household chaos and child, parent, and family outcomes. We expect that this review will highlight the need to consider the importance of household chaos in child well-being research, particularly in those families where children may be more vulnerable to the adverse effects of household chaos.

METHODS

We searched five electronic databases (last updated September 1st 2018) in addition to Google Scholar, and identified publications via a 3-stage screening process, which was conducted by two researchers. Published studies were included if they investigated the association between household chaos and child, parent, or family outcomes. Research that investigated household chaos as a mediator or moderator, or that investigated how the relationship between household chaos and the outcome of interest was mediated or moderated, were also included.

RESULTS

One hundred twelve studies in 111 publications were included. The majority were conducted in the United States (n = 71), and used either cross-sectional (n = 60) or longitudinal (n = 49) study designs. Outcomes of interest were categorised into seven categories: (1) cognitive and academic (n = 16), (2) socio-emotional and behavioural (n = 60), (3) communication (n = 6), (4) parenting, family, and household functioning (n = 21), (5) parent outcomes (n = 6), (6) hormone (n = 8), and (7) physical health and health behaviours (n = 19). There was consistent evidence for significant correlations between household chaos and adverse outcomes across all seven categories in diverse populations with respect to age, disease status, and socio-economic status (SES).

CONCLUSION

There is consistent evidence for associations between household chaos and a number of adverse child, parent, and family-level outcomes. Household chaos may also help describe variations in outcomes between low SES and child development.