Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Sleep. 2022 May 12;45(5). doi: 10.1093/sleep/zsac037. Epub 2022 Feb 15.
To investigate trajectories of early childhood sleep in the first 3 years and their association with maternal depressive symptoms.
Data were from 243 Chinese mother-child dyads. Children's sleep duration and night-waking were assessed using the Brief Infant Sleep Questionnaire (BISQ) at 42 days, 3, 6, 9, 12, 18, 24, and 36 months postpartum. The Center for Epidemiological Survey-Depression Scale (CES-D), Edinburgh Postnatal Depression Scale (EPDS), and Profile of Mood States (POMS) were used to assess maternal depressive symptoms at late pregnancy, 42 days, and 36 months postpartum, respectively. Early childhood sleep trajectories were estimated with group-based trajectory models. The association between early childhood sleep trajectories and maternal depressive symptoms was examined with binary and multinomial logistic regression models and linear regression models.
Three trajectories of daytime sleep duration ("short", 14.4%; "medium", 60.4%; "long", 25.2%), nighttime sleep duration ("increasing", 17.6%; "stable", 76.3%; "decreasing", 6.1%), and total sleep duration ("short", 21.5%; "medium", 59.9%; "long",18.6%), and two trajectories of night-waking ("resolving", 22.9%; "persistent", 77.1%) were identified. Controlling for confounding factors, maternal depression at 42 days postpartum was associated with higher risks for short daytime sleep duration and persistent night-waking in children. Persistent night-waking in children was associated with increased maternal depressive symptoms at 36 months postpartum.
Early childhood sleep follows distinct trajectories in the first 3 years of life. The trajectories of short daytime sleep duration and persistent night-waking are associated with maternal depression. The findings indicate tailored interventions should target both unfavorable early childhood sleep trajectories and maternal depression.
探究儿童在生命最初 3 年的早期睡眠轨迹及其与产妇抑郁症状的关系。
本研究的数据来源于 243 对中国母婴对子。在产后 42 天、3、6、9、12、18、24 和 36 个月时，采用婴儿睡眠问卷（BISQ）评估儿童的睡眠持续时间和夜间醒来次数。采用中心流行病学调查抑郁量表（CES-D）、爱丁堡产后抑郁量表（EPDS）和心境状态问卷（POMS）分别在妊娠晚期、产后 42 天和 36 个月评估产妇的抑郁症状。采用基于群组的轨迹模型估计儿童早期睡眠轨迹。采用二项和多项逻辑回归模型以及线性回归模型检验早期儿童睡眠轨迹与产妇抑郁症状之间的关系。
确定了儿童日间睡眠时间（“短”，14.4%；“中”，60.4%；“长”，25.2%）、夜间睡眠时间（“增加”，17.6%；“稳定”，76.3%；“减少”，6.1%）和总睡眠时间（“短”，21.5%；“中”，59.9%；“长”，18.6%）以及夜间醒来次数（“解决”，22.9%；“持续”，77.1%）的 3 种轨迹和 2 种轨迹。控制混杂因素后，产后 42 天的产妇抑郁与儿童日间睡眠时间较短和夜间醒来持续时间较长的风险增加有关。儿童夜间醒来持续时间较长与产妇产后 36 个月的抑郁症状增加有关。
儿童在生命最初 3 年的早期睡眠呈现出不同的轨迹。日间睡眠时间较短和夜间醒来持续时间较长的轨迹与产妇抑郁有关。这些发现表明，有针对性的干预措施应同时针对不良的儿童早期睡眠轨迹和产妇抑郁。
