OBJECTIVE
To examine associations between insufficient sleep and neurobehavioral functioning in childhood as reported by mothers and teachers.
METHODS
Participants were 1046 children in a pre-birth cohort study. Main exposures were insufficient sleep durations at three time points: 6 months to 2 years, defined as sleep < 11 hours/day, 11-<12 hours/day (v. ≥ 12); 3 to 4 years, defined as sleep < 10 hours/day, 10-<11 hours/day (v. ≥11); and 5 to 7 years, sleep < 9 hours/day, 9-<10 hours/day (v. ≥ 10). Outcomes at age 7 were executive function, behavior, and social-emotional functioning, assessed by the Behavior Rating Inventory of Executive Function (BRIEF) and the Strengths and Difficulties Questionnaire (SDQ). Higher scores indicate poorer functioning. Mothers and teachers completed both instruments independently.
RESULTS
At age 7, mean (SD) mother and teacher report of the BRIEF global executive composite scale were 48.3 (7.9) and 50.7 (9.4) points, respectively, and of the SDQ total difficulties score was 6.5 (4.7) and 6.2 (5.7). In multivariable models, children who slept <10 hours/day at 3-4 years had worse maternal-reported scores for the BRIEF (2.11 points; 95% CI: 0.17, 4.05) and SDQ (1.91 points; 95% CI: 0.78, 3.05) than those with age-appropriate sleep. Children who slept <9 hours/day at 5-7 years also had worse scores. At both ages, associations with teacher-reported results were consistent with mothers'. Infants who slept 11-<12 hours/day had higher teacher- but not mother-reported scores.
CONCLUSIONS
Insufficient sleep in the preschool and early school years is associated with poorer mother- and teacher-reported neurobehavioral processes in mid-childhood.