Racial/Ethnic and Socio-Contextual Correlates of Chronic Sleep Curtailment in Childhood.
To examine the association between race/ethnicity and sleep curtailment from infancy to mid-childhood, and to determine the extent to which socioeconomic and contextual factors both explain racial/ethnic differences and are independently associated with sleep curtailment.



We studied 1,288 children longitudinally in Project Viva, a pre-birth cohort study, from 6 months to 7 years of age. The main exposure was the child's race/ethnicity. The main outcome was a sleep curtailment score from 6 months to 7 years. The score ranged from 0-13, where 0 indicated maximal sleep curtailment and 13 indicated never having curtailed sleep.



The mean (standard deviation) sleep curtailment score was 10.2 (2.7) points. In adjusted models (β [95% CI]), black (-1.92, [-2.39, -1.45] points), Hispanic (-1.58, [-2.43, -0.72] points), and Asian (-1.71, [-2.55, -0.86] points) children had lower sleep scores than white children. Adjustment for sociodemographic covariates attenuated racial/ethnic differences in sleep scores for black (by 24%) and Hispanic children (by 32%) but strengthened the differences for Asian children by 14%. Further adjustment for environmental and behavioral variables did not substantially change these differences. Independently, low maternal education, living in households with incomes < $70,000, viewing more TV, and having a TV in the child's bedroom were associated with lower sleep scores.



Chronic sleep curtailment from infancy to mid-childhood was more prevalent among black, Hispanic, and Asian children. These differences were partially but not entirely explained by socio-contextual variables. Independently, children from lower socioeconomic status and those with greater exposures to TV also had greater sleep curtailment.
Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA.|Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA.
Michelle-Marie
MM
Peña
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
Sheryl L
SL
Rifas-Shiman
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.|Department of Nutrition, Harvard School of Public Health, Boston, MA.
Matthew W
MW
Gillman
Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.
Susan
S
Redline
Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA.|Department of Nutrition, Harvard School of Public Health, Boston, MA.
Elsie M
EM
Taveras
D001741:Black or African American; D001213:Asian; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005006:Ethnicity; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012892:Sleep Deprivation / Q000191:economics / Q000208:ethnology / Q000209:etiology*; D012923:Social Class; D044465:White People
ethnicity; health disparities; race; sleep curtailment; socioeconomic status