Mediating Effects of Executive Function on the Relationship between Sleep Problems and Emotional and Behavioral Problems among Preschoolers: Physical Activity as a Protective Factor.

This study investigated three waves of data from the Anhui Preschool Children Cohort study, with a total of 1,987 mother-child dyads participating. The questionnaires on sleep problems (Wave 1), executive function (EF) (Wave 2), physical activity (PA) (Wave 2), and emotional and behavioral problems (EBPs) (Wave 1 & Wave 3) were assessed by the mothers of the children. Results showed that sleep problems, GEC (total executive dysfunction scores), and PA are all positively related to EBPs. After controlling for covariates, GEC partially mediated the association between sleep problems and EBPs (β = 0.015, 95%CI: 0.002-0.028). PA moderated the relationship between sleep problems and preschoolers' GEC (β = -0.06, P<0.05). These findings reveal the mediating role of executive dysfunction in the association between sleep problems and EBPs. It also highlights that targeted interventions to reduce sleep problems and increase PA could help reduce the risk of EBPs in preschoolers.