Eng Derric Z H, Tham Elaine K H, Jafar Nur K, Tan Jael S Y, Goh Daniel Y T, Lee Yung Seng, Shek Lynette P, Teoh Oon-Hoe, Yap Fabian, Tan Kok Hian, Eriksson Johan G, Chong Yap Seng, Meaney Michael J, Cai Shirong, Broekman Birit F P
Institute for Human Development and Potential, Agency for Science, Technology and Research (A∗STAR), 30 Medical Drive, Brenner Centre for Molecular Medicine, 117609, Singapore.
Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
Sleep Med. 2024 Dec;124:174-186. doi: 10.1016/j.sleep.2024.09.003. Epub 2024 Sep 14.
Evening-chronotype is associated with increased socioemotional problems among school-aged children. Inadequate sleep and increased sleep problems are also prevalent among evening-chronotype children and may underlie the relationship between chronotype and socioemotional problems. However, it is unclear whether the association between chronotype and socioemotional problems at school-age may be mediated by poorer sleep during late preschool.
Our study utilized cross-sectional data to examine the relations between chronotype, sleep duration, sleep problems and socioemotional problems in preschoolers. We subsequently performed longitudinal mediation analyses to examine how the association between chronotype at preschool-age and later socioemotional problems at school-age may be mediated by sleep problems and sleep duration during late preschool. 399 children from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study were included for analyses. Children's chronotype were identified with the Children's Chronotype Questionnaire at 4.5 years old. Sleep duration and problems were measured with the Children's Sleep Habits Questionnaire at 4.5 and 6 years old. Socioemotional problems were evaluated using the Child Behavioral Checklist at 4 and 7 years of age. All questionnaires were caregiver-reported.
Linear regressions demonstrated that eveningness was associated with concurrent sleep problems and internalizing, externalizing and total behavioral problems at 4-4.5 years old, but not sleep duration. Mediation analyses supported that sleep problems (and not sleep duration) at 6 years old mediated the relationship between chronotype and socioemotional problems at 7 years old.
Our findings suggest addressing sleep problems during early development may reduce socioemotional problems at school-age, especially among evening-chronotype children.
晚睡型与学龄儿童社会情绪问题增加有关。睡眠不足和睡眠问题增加在晚睡型儿童中也很普遍，这可能是昼夜节律类型与社会情绪问题之间关系的基础。然而，尚不清楚学龄期昼夜节律类型与社会情绪问题之间的关联是否可能由学龄前晚期较差的睡眠所介导。
我们的研究利用横断面数据来检验学龄前儿童的昼夜节律类型、睡眠时间、睡眠问题和社会情绪问题之间的关系。随后，我们进行了纵向中介分析，以检验学龄前昼夜节律类型与学龄期后期社会情绪问题之间的关联如何由学龄前晚期的睡眠问题和睡眠时间所介导。纳入了来自新加坡成长为健康结果（GUSTO）出生队列研究的399名儿童进行分析。在4.5岁时用儿童昼夜节律问卷确定儿童的昼夜节律类型。在4.5岁和6岁时用儿童睡眠习惯问卷测量睡眠时间和问题。在4岁和7岁时使用儿童行为清单评估社会情绪问题。所有问卷均由照顾者报告。
线性回归表明，在4至4.5岁时，晚睡与同时存在的睡眠问题、内化、外化和总行为问题相关，但与睡眠时间无关。中介分析支持，6岁时的睡眠问题（而非睡眠时间）介导了7岁时昼夜节律类型与社会情绪问题之间的关系。
我们的研究结果表明，解决早期发育过程中的睡眠问题可能会减少学龄期的社会情绪问题，尤其是在晚睡型儿童中。
