School of Nursing, College of Health Sciences, University of Delaware, 100 Discovery Boulevard, Newark, DE 19713, USA.
Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, 100 Discovery Boulevard, Newark, DE 19713, USA.
Sleep Health. 2021 Apr;7(2):254-265. doi: 10.1016/j.sleh.2020.11.010. Epub 2021 Jan 10.
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.
睡眠-觉醒调节是在儿童早期建立的，对终身健康至关重要。家庭环境对儿童睡眠-觉醒调节的发展至关重要。本系统综述的主要目的是阐明有助于儿童（0-5 岁）睡眠健康的家庭层面的结构（除了睡前育儿）。我们通过系统地搜索 PubMed、Web of Science 和 PsycINFO 数据库，确定了调查这些关系的实证研究文章。睡眠-觉醒调节的交互模型指导了家庭层面搜索术语的选择，包括社会经济地位（SES）、家庭结构、家庭混乱、婚姻、共同育儿和社会关系。睡眠搜索术语包括睡眠问题、持续时间、时间和可变性。我们将睡眠和家庭术语与婴儿、幼儿或学龄前的发育年龄相结合进行搜索。符合纳入标准的研究有 16 项。结果表明，家庭混乱的存在和不良的婚姻关系与儿童早期的睡眠问题和可变的睡眠时间直接相关。较高的婚姻满意度和家庭常规的存在与睡眠时间延长呈正相关。一些研究表明 SES 较低与儿童睡眠健康状况较差有关，但并非所有研究都表明家庭结构存在直接关联，而感知社会支持和共同育儿关系质量的作用的研究发现则较为有限。总体而言，研究之间家庭和睡眠结构的操作和测量存在差异，这降低了我们进行比较和得出可靠结论的能力。未来的研究应确定可改变的家庭层面因素，除了睡前育儿外，还可以针对这些因素来改善睡眠-觉醒调节的发展。
