Sleep Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Johnson & Johnson Consumer Health, Skillman, New Jersey, USA.
Sleep Health. 2021 Apr;7(2):143-152. doi: 10.1016/j.sleh.2021.01.002. Epub 2021 Mar 4.
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).
Cross-sectional.
Data were collected using the free, publicly available Johnson's Bedtime© baby sleep app.
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.
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).
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).
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.
使用社区困境指数（一种衡量社会经济劣势的指标），检验在一个大型美国样本中，社会经济劣势的增加是否与使用移动健康应用程序（app）的照顾者报告的幼儿睡眠模式和问题的变化有关。
横断面研究。
数据是通过免费的、公开可用的 Johnson's Bedtime© 婴儿睡眠应用程序收集的。
共有 14980 名照顾者（85.1%为母亲）参与了这项研究，他们的孩子年龄在 6-35.9 个月之间（M=13.88 个月；52.6%为男孩）。
照顾者使用经过修订的简短婴儿睡眠问卷（Brief Infant Sleep Questionnaire-Revised）报告儿童睡眠情况。社会经济劣势通过邮政编码使用困境社区指数（Distressed Communities Index，DCI）来衡量，该指数结合了七种美国人口普查中衡量社会经济劣势的指标。DCI 得分范围从繁荣（最低五分位数）到困境（最高五分位数）。
社会经济劣势与较晚的就寝时间、较长的入睡潜伏期以及较短的夜间和 24 小时（总）睡眠时间显著相关，生活在困境社区的儿童睡眠质量最差。然而，生活在困境社区的照顾者报告的整体儿童睡眠问题的比例明显较低（繁荣社区为 43%，困境社区为 58%），并且对管理儿童睡眠的信心更高（繁荣社区为 42%，困境社区为 34%）。
生活在最困难社区的儿童报告的睡眠模式和就寝时间最差；然而，他们的照顾者不太可能报告儿童睡眠有问题。这些发现强调了需要开展社区层面的睡眠健康促进干预措施，以及进一步调查生活在社会经济劣势环境中的家庭中照顾者对儿童睡眠和睡眠健康促进的看法。
