Morales-Muñoz Isabel, Lemola Sakari, Saarenpää-Heikkilä Outi, Kylliäinen Anneli, Pölkki Pirjo, Paunio Tiina, Broome Matthew R, Paavonen E Juulia
Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.
Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom.
BMJ Paediatr Open. 2020 Mar 10;4(1):e000622. doi: 10.1136/bmjpo-2019-000622. eCollection 2020.
The concurrence of sleep and socio-emotional development in children is well accepted. However, the predictive role of sleep problems in infancy and the development of emotional and behavioural problems later in childhood remain still unclear. Therefore, in this study we examined the associations between sleep problems in early childhood and internalising, externalising and dysregulation symptoms in toddlers.
1679 families entered the study during pregnancy and 936 children participated at 24 months. Parent-reported sleep duration, sleep-onset latency, night wakings, proportion of daytime sleep and bedtime at 3, 8, 18 and 24 months were assessed with two sleep questionnaires. Externalising, internalising and dysregulation problems at 24 months were examined with the Brief Infant-Toddler Social and Emotional Assessment.
Short sleep duration at 3 and 8 months, more night wakings at 3, 8, 18 and 24 months and greater proportion of daytime sleep at 24 months were associated with internalising symptoms. Shorter sleep duration at 8, 18 and 24 months and longer sleep-onset latency and more night wakings at all time points, in addition to earlier bedtime at 8 months and greater proportion of daytime sleep at 24 months, were related to dysregulation. Finally, more night wakings at 3 and 24 months, and longer sleep-onset latency at 24 months were associated with externalising problems.
Shorter sleep and poorer sleep quality in infancy were prospectively related to emotional and behavioural symptoms in toddlers, and these associations were strongest for internalising and dysregulation symptoms. This study contributes to the recent research on the role of early sleep problems in socio-emotional development, suggesting that shorter sleep duration, longer sleep-onset latency and higher waking frequency are related to internalising, externalising and dysregulation symptoms in toddlers, and thus it might be beneficial to provide early interventions for those infants reporting these sleep problems.
儿童睡眠与社会情感发展的同时存在已被广泛接受。然而，婴儿期睡眠问题的预测作用以及儿童后期情绪和行为问题的发展仍不明确。因此，在本研究中，我们探讨了幼儿期睡眠问题与幼儿内化、外化和失调症状之间的关联。
1679个家庭在孕期进入研究，936名儿童在24个月时参与研究。使用两份睡眠问卷评估家长报告的3、8、18和24个月时的睡眠时间、入睡潜伏期、夜间醒来次数、白天睡眠时间比例和就寝时间。使用简短婴幼儿社会和情感评估量表检查24个月时的外化、内化和失调问题。
3个月和8个月时睡眠时间短、3个月、8个月、18个月和24个月时夜间醒来次数多以及24个月时白天睡眠时间比例高与内化症状相关。8个月、18个月和24个月时睡眠时间短、所有时间点入睡潜伏期长和夜间醒来次数多，此外8个月时就寝时间早以及24个月时白天睡眠时间比例高与失调相关。最后，3个月和24个月时夜间醒来次数多以及24个月时入睡潜伏期长与外化问题相关。
婴儿期睡眠时间短和睡眠质量差与幼儿的情绪和行为症状存在前瞻性关联，这些关联在内化和失调症状方面最为明显。本研究为近期关于早期睡眠问题在社会情感发展中的作用的研究做出了贡献，表明睡眠时间短、入睡潜伏期长和醒来频率高与幼儿的内化、外化和失调症状相关，因此对报告这些睡眠问题的婴儿进行早期干预可能有益。
