Establishing a consistent sleep schedule for a toddler can be one of the most challenging aspects of child rearing, but it also may be one of the most important.
Research findings from a team
including Lauren Covington, an assistant professor in the University of
Delaware School of Nursing, suggest that children with inconsistent sleep
schedules have higher body mass index (BMI) percentiles. Their findings,
published in the Annals of Behavioral Medicine,
suggest sleep could help explain the association between household poverty and
BMI.
“We’ve known for a while that
physical activity and diet quality are very strong predictors of weight and
BMI,” said Covington, the lead author of the article. “I think it’s really
highlighting that sleep may be playing a bigger role here than it’s been given
credit for.”
The study used data from an
obesity prevention trial for mothers and their children living in Baltimore.
All of the families were eligible for the Special Supplemental Nutrition
Program for Women, Infants, and Children (WIC) and 70% were living at or below
the poverty line. As part of the trial, 207 toddlers wore accelerometers that
measured their sleep and physical activity for up to a week at a time. Mothers
also completed a food diary that was compared with the Healthy Eating Index, a
measure of diet quality based on the recommendations from the Dietary
Guidelines for Americans.
Researchers wanted to examine
the relationship between poverty and BMI, specifically looking at whether the
consistency of when toddlers went to bed, their level of physical activity and
diet quality could explain the association. They found that children from
households with greater poverty had more overall inconsistent sleep onset
times. And those with more inconsistent bedtimes had higher BMI percentages.
Covington said it is likely a
bidirectional relationship. “There’s a lot of teasing out the relationships of
the mechanisms that are at play here, which is really difficult to do because I
think they’re all influencing each other,” she said.
Sleep recommendations suggest
children go to bed within an hour of their usual bedtime on a nightly basis.
But for families living in poverty, such scheduling may not be so easily done,
Covington said, especially if a caregiver is the only parent, juggling multiple
jobs, parenting multiple children or dealing with a tenuous housing situation.
“There’s so many factors that
are at play and not necessarily controllable, especially in disadvantaged
communities,” said Covington, who hopes in the future to develop interventions
for families that support healthy routines.
Covington, who joined the UD
faculty in 2018, became interested in sleep research while working as a
pediatric intensive care nurse. She encountered several families who lost a
baby to sudden infant death syndrome (SIDS) as a result of their sleep
environment.
“There’s so much stigma and
stereotypes out there and people are just so quick to judge,” she said. “These
families just want to do what’s right for their child. They just either don’t
personally know how to or they don’t have the resources to do it.”
Covington is currently
working on a study comparing the sleep similarities between children and their
caregivers. She and other researchers, including Associate Professor Freda
Patterson from the Department of Behavioral Health and Nutrition, School of
Nursing professor Emily Hauenstein and UD graduate students Angeni Cordova and
Shannon Mayberry, also completed a systematic review of the existing research
literature looking at the influence of the family context in early childhood
health sleep health.
Their findings, published in
the peer-reviewed journal Sleep Health, found that the
presence of household chaos and poor-quality marital relationships were
directly associated with early childhood sleep problems and variable sleep
timing.
For families who have been
struggling during the coronavirus (COVID-19) pandemic, creating a regular
evening routine may be a doable way to make a difference in a child’s health,
despite the other upheaval going on at this time.
“Implementing a consistent
bedtime could be one behavioral change that a family could potentially do,”
said Covington, who came to UD because of the opportunity to work with other
sleep and disparity researchers. “It’s more attainable than maybe getting
healthy food at the grocery store or playing outside on the playground,
especially now with the cold weather. Just having a consistent bedtime can help
provide some sense of structure, but then maybe have better implications for
health and BMI as well.”
Source: https://www.udel.edu/
Journal article: https://academic.oup.com/abm/advance-article-abstract/doi/10.1093/abm/kaaa100/5983318?redirectedFrom=fulltext
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