Abstract
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.
Keywords
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Article info
Publication history
Published online: March 04, 2021
Accepted:
January 12,
2021
Received in revised form:
January 5,
2021
Received:
May 19,
2020
Identification
Copyright
© 2021 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
