Poverty, Bedtime Regularity Play a Role in Hispanic Children’s Sleep

There is an “urgent need” to address sleep health disparities experienced by U.S. Hispanic/Latinx children, Emily A. Schmied, Ph.D., assistant professor with the School of Public Health at San Diego State University, wrote in a new Sleep Health article.

Many children fail to meet sleep duration recommendations, but shorter durations and poorer quality sleep are frequently reported among U. S. Hispanic/Latinx children compared with children from several other racial/ethnic groups, Schmied noted.

For instance, the National Survey of Children’s Health (2016-2018) found that 42.4% of Hispanic children, ages 3 to 5, and 43.3%, ages 6 to 12, experienced short sleep versus 27.9% of non-Hispanic White children.

While previous studies have identified potential risk factors for poor sleep health among children generally, few have focused on the U.S. Hispanic/Latinx communities, Schmied said.

To that end, Schmied and her colleagues’ goal was to examine the association between sociodemographic, behavioral, and environmental factors and adherence to sleep duration recommendations among 1,165 US Hispanic/Latinx children.

Utilizing a convenience sample of baseline data from children and parents who were part of the California Childhood Obesity Research Demonstration (CA-CORD) study, the researchers looked at parent-reported variables correlating to whether children met age-appropriate nightly sleep duration recommendations .

The factors included caretaker and child demographics — gender, age, poverty level — presence of a television in child’s bedroom, child’s daily screen time and bedtime.

The children were ages 2-12 years, had a body mass of greater than the fifth percentile, and had no pre-existing medical conditions that would limit their ability to complete intervention activities.

After enrollment, caregivers completed a baseline interview with bilingual research staff regarding their child's health, health behaviors targeted in the intervention, factors hypothesized to be related to the four health behaviors of interest, and other characteristics. Children's height and weight were also measured at baseline.

Schmied and colleagues found that 61.4% of children met sleep duration guidelines. Theodds of meeting recommendations were significantly higher among children 6-12 years old living above the poverty threshold

The chances of meeting sleep recommendations were significantly higher among those with a regular bedtime some of the time and improved among those a regular bedtime and were better yet among those classified as always having a regular bedtime.

Both behavioral and social factors may play a role within certain age groups, Schmied and colleagues determined.

Of the factors examined, maintaining a regular weekday bedtime had the strongest association with meeting sleep duration recommendations, a finding that aligns with previous research conducted among young children and adolescents, Schmied wrote.

Emily Schmied

“As maintaining a regular bedtime is a potentially modifiable behavior, this strengthens the existing support for interventions designed to teach parents and children how to develop healthy bedtime routines,” Schmied wrote. "This strategy may be particularly important among Hispanic/Latinx families, as research has shown that they may be less likely to maintain a regular bedtime and/or bedtime routine than children from other racial/ethnic groups.”

Another major factor was poverty level. Participating children, ages 6 to 12, living below the poverty threshold faced nearly twice the odds of not meeting sleep duration recommendations.

“The link between poverty and poor sleep health has been observed previously but more research regarding influential mechanisms is needed, particularly among children,” Schmied wrote. “Some evidence suggests aspects of the home and physical environment related to living in poverty may mediate the relationship, including parental involvement, psychosocial factors (stress, for example), ambient sound and/or light, crowding, and poorer air quality.”

“It is important for researchers and healthcare providers to consider contextual factors that may influence sleep health among low-income Hispanic/Latinx children so that tailored, multi-level intervention strategies, including those designed for implementation within clinical settings, can be developed and successfully implemented,” Schmied added.

Overall, sleep health disparities must be addressed through culturally and contextually appropriate interventions that combine individual-level strategies with those that address social and environmental factors, Schmied said.

The article was published by Elsevier Inc. on behalf of National Sleep Foundation.