Abstract
Objective
To examine racial and ethnic disparities and associated factors of insufficient sleep
among children from infancy to preschool-aged.
Methods
We analyzed parent-reported data on US children ages 4 months-5 years (n = 13,975)
from the 2018 and 2019 National Survey of Children's Health. Children who slept less
than the age-specific minimum hours recommended by the American Academy of Sleep Medicine
were classified as having insufficient sleep. Logistic regression was used to estimate
unadjusted and adjusted odds ratios (AOR).
Results
An estimated 34.3% of children from infancy to preschool-aged experienced insufficient
sleep. Socioeconomic factors (poverty [AOR] = 1.5, parents’ education level [AORs]
from 1.3 to 1.5); parent-child interaction variables (AORs from 1.4 to 1.6); breast
feeding status (AOR = 1.5); family structure (AORs from 1.5 to 4.4); and weeknight
bedtime regularity (AORs from 1.3 to 3.0) were significantly associated with having
insufficient sleep. Non-Hispanic Black (OR = 3.2) and Hispanic children (OR = 1.6)
had significantly higher odds of insufficient sleep compared to non-Hispanic White
children. Racial and ethnic disparities in insufficient sleep between non-Hispanic
White children and Hispanic children were largely attenuated by adjusting for social
economic factors. However, the difference in insufficient sleep between non-Hispanic
Black and non-Hispanic White children remains (AOR = 1.6) after adjusting socioeconomic
and other factors.
Conclusions
More than one-third of the sample reported insufficient sleep. After adjusting for
socio-demographic variables, racial disparities in insufficient sleep decreased but
persistent disparities existed. Further research is warranted to examine other factors
and develop interventions to address multilevel factors and improve sleep health among
racial and ethnic minority group children.
Keywords
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Article info
Publication history
Published online: February 20, 2023
Accepted:
November 13,
2022
Received in revised form:
October 28,
2022
Received:
April 8,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Published by Elsevier Inc. on behalf of National Sleep Foundation.
