1. In this cross-sectional study, household food insecurity and daily servings of sugar-sweetened beverages were associated with sleeping less than the recommended sleep duration in children 4-60 months old who were supported by the Special Supplemental Nutrition Program for Women, Infants, and Children.
2. Furthermore, each additional serving of sugar-sweetened beverages was associated with increased odds of sleeping less than the daily recommended sleep duration.
Evidence Rating Level: 3 (Average)
Child development is dependent on several factors, including optimal sleep duration. Although prior studies have investigated the role of sleep duration on health outcomes in children, few studies have looked at this association in young children under the age of 5. Given that approximately one-third of children ages 4-60 months have insufficient sleep, this represents an opportunity for exploration. Furthermore, social determinants, such as food insecurity and socioeconomic status, may impact sleep quality in young children. Therefore, the present study aimed to investigate the household and social factors that may impact sleep duration in children under the age of 5.
This cross-sectional study included 9,547 children ages 4-60 months who lived in households supported by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Los Angeles County (LAC). Data from the 2017 and 2020 WIC LAC WIC survey was obtained from the child’s caregiver. Caregivers were included if they were 18 years or older, were receiving WIC for themselves or their child, and lived in LAC. The WIC survey included questions regarding the household environment, health insurance coverage, food intake, sleep duration, and more. Participants were asked how many hours the child slept in a typical day, and this was compared to the sleep recommendations set by the National Sleep Foundation (NSF) and the American Academy of Sleep Medicine (AASM). The primary outcome was the classification of participants into one of three groups based on their sleep duration relative to the sleep recommendations: sleeping less than the recommended sleep duration (LTR), being in the recommended range of sleep duration, or sleeping more than the recommended sleep duration (MTR).
The results demonstrated that food insecurity and daily servings of sugar-sweetened beverages were associated with LTR sleep in children 4-60 months old. Furthermore, there was a direct association between sugar-sweetened beverages and sleep, whereby each additional serving of these beverages resulted in an increased risk of LTR sleep. Other social factors also influenced sleep. Caregivers without practical or social support, or children of caregivers with a high school education or less were more likely to get LTR sleep. However, the study was limited by the caregiver’s reports of sleep duration, which may have introduced bias and inaccuracies in the reported sleep durations. Nonetheless, the present study demonstrated that several social factors may contribute to sleep duration in young children.
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