title: Nighttime Sleep Duration and Sleep Behaviors among Toddlers from Low-Income Families: Associations with Obesogenic Behaviors and Obesity and the Role of Parenting.
abstract: Shortened sleep duration is associated with poor health and obesity among young children. Little is known about relationships among nighttime sleep duration, sleep behaviors, and obesogenic behaviors/obesity among toddlers. This study characterizes sleep behaviors/duration and examines relationships with obesogenic behaviors/obesity among toddlers from low-income families.
  
  
  
  Mothers of toddlers (age 12-32 months) were recruited from urban/suburban sites serving low-income families. Mothers provided demographic information and completed the Brief Infant Sleep Questionnaire (BISQ); a 6-item Toddler Sleep Behavior Scale was derived (TSBS-BISQ, higher score reflects more recommended behaviors). Toddler weight/length were measured; obesity defined as ≥95th percentile weight-for-length. Measures of obesogenic behaviors: physical activity [accelerometry, minutes/day in Moderate-to-Vigorous Physical Activity (MVPA)] and diet quality [24-hour recall, Healthy Eating Index 2005 (HEI-2005)]. Bivariate and adjusted multivariable models examined associations between nighttime sleep behaviors/duration and obesogenic behaviors/obesity.
  
  
  
  Sample included 240 toddlers (mean age = 20.2 months), 55% male, 69% black, 59% urban. Toddlers spent 55.4 minutes/day in MVPA, mean HEI-2005 score was 55.4, 13% were obese. Mean sleep duration was 9.1 hours, with 35% endorsing 5-6 recommended sleep behaviors (TSBS-BISQ). In multivariable models, MVPA was positively related to sleep duration; obese toddlers had a shorter nighttime sleep duration than healthy weight toddlers [odds ratio = 0.69, p = 0.014]. Nighttime sleep duration was associated with high TSBS-BISQ scores, F = 6.1, p = 0.003.
  
  
  
  Toddlers with a shorter nighttime sleep duration are at higher risk for obesity and inactivity. Interventions to promote healthy sleep behaviors among toddlers from low-income families may improve nighttime sleep duration and reduce obesogenic behaviors/obesity.
authors.affiliation: 1 Department of Pediatrics, University of Maryland School of Medicine , Baltimore, MD.
authors.forename: Erin R
authors.initials: ER
authors.lastname: Hager
authors.affiliation: 2 Nemours/A.I. duPont Hospital for Children , Wilmington, DE.
authors.forename: Christina J
authors.initials: CJ
authors.lastname: Calamaro
authors.affiliation: 3 University of Maryland School of Nursing , Baltimore, MD.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Bentley
authors.affiliation: 4 Department of International Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Hurley
authors.affiliation: 1 Department of Pediatrics, University of Maryland School of Medicine , Baltimore, MD.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: 1 Department of Pediatrics, University of Maryland School of Medicine , Baltimore, MD.
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Black
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D015444:Exercise; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D009034:Mother-Child Relations; D009035:Mothers / Q000193:education / Q000523:psychology; D016487:Parenting / Q000523:psychology; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D011203:Poverty / Q000706:statistics & numerical data*; D012890:Sleep / Q000502:physiology*; D012892:Sleep Deprivation / Q000453:epidemiology / Q000523:psychology*; D014505:Urban Population; D055815:Young Adult