Mansolf Maxwell, Blackwell Courtney K, Chandran Aruna, Colicino Elena, Geiger Sarah, Harold Gordon, McEvoy Cindy, Santos Hudson P, Sherlock Phillip R, Bose Sonali, Wright Rosalind J
Northwestern University, Chicago, IL, USA.
Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
J Child Fam Stud. 2023 Aug;32(8):2558-2572. doi: 10.1007/s10826-023-02624-x. Epub 2023 Jul 15.
Up to 50% of children and adolescents in the United States (U.S.) experience sleep problems. While existing research suggests that perceived stress in caregivers is associated with poorer sleep outcomes in children, research on this relationship is often limited to infant and early childhood populations; therefore, we investigated this association in school-age children and adolescents. We used cross-sectional caregiver-reported surveys and applied item response theory (IRT) followed by meta-analysis to assess the relationship between caregiver perceived stress and child sleep disturbance, and moderation of this relationship by child age and the presence of a child mental or physical health condition. We analyzed data from the National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) Program, a collaboration of existing pediatric longitudinal cohort studies that collectively contribute a diverse and large sample size ideal for addressing questions related to children's health and consolidating results across population studies. Participants included caregivers of children ages 8 to 16 years from four ECHO cohorts. Caregiver perceived stress was measured using the Perceived Stress Scale (PSS), and child sleep disturbance was assessed using five sleep-related items from the School-Age version of the Child Behavior Checklist (CBCL). Increases in caregiver perceived stress and child mental or physical health condition were independently associated with greater sleep disturbance among children. The findings reinforce the importance of accounting for, and potentially intervening on, the broader family context and children's mental and physical health in the interest of improving sleep health.
在美国，高达50%的儿童和青少年存在睡眠问题。虽然现有研究表明，照顾者感知到的压力与儿童较差的睡眠结果有关，但关于这种关系的研究通常仅限于婴儿和幼儿群体；因此，我们在学龄儿童和青少年中调查了这种关联。我们使用了照顾者报告的横断面调查，并应用项目反应理论（IRT），随后进行荟萃分析，以评估照顾者感知到的压力与儿童睡眠障碍之间的关系，以及儿童年龄和儿童是否存在心理或身体健康状况对这种关系的调节作用。我们分析了美国国立卫生研究院（NIH）儿童健康结果的环境影响（ECHO）项目的数据，该项目是现有儿科纵向队列研究的合作项目，共同提供了一个多样且样本量大的理想样本，适合解决与儿童健康相关的问题并整合不同人群研究的结果。参与者包括来自四个ECHO队列的8至16岁儿童的照顾者。照顾者感知到的压力使用感知压力量表（PSS）进行测量，儿童睡眠障碍使用儿童行为检查表（CBCL）学龄版中的五个与睡眠相关的项目进行评估。照顾者感知到的压力增加以及儿童存在心理或身体健康状况，均与儿童更大的睡眠障碍独立相关。这些发现强化了考虑并可能干预更广泛的家庭环境以及儿童的心理和身体健康对于改善睡眠健康的重要性。
