Portrait of sleep in preschoolers involved with Child Protective Services and from the community

Actigraphy Estimated Night Sleep Duration in Preschool Children: Comparison of an Automated Algorithm and Sleep Diary Against the Sadeh Algorithm

OBJECTIVES

This study aims to compare amongst preschoolers, night sleep duration derived using the automated van Hees algorithm in GGIR (GGIR_VH) against the reference Sadeh algorithm (Actilife_SD), and subjective caregiver-reported sleep diaries against Actilife_SD.

METHODS

Participants were 142 preschoolers (52.1% males), age 5.5 years, from the Growing Up in Singapore Toward healthy Outcomes (GUSTO) birth cohort study. Weeklong actigraphy data was collected via the wGT3X-BT accelerometer (worn on the non-dominant wrist) with concurrent caregiver-reported sleep diaries. Analyses were conducted to compare the automated GGIR_VH and sleep diaries against the reference Actilife_SD. Intraclass correlations were calculated to compare the agreement levels. Bland-Altman plots were used to investigate the bias in the mean differences and limits of agreement (LoA). Repeated measures of ANOVAs were used to compare mean differences.

RESULTS

For the intraclass correlation between automated GGIR_VH and reference Actilife_SD, there was moderate agreement for the nighttime total sleep duration (r = 0.66) and poor agreement between diary and Actilife_SD (r = 0.04). Bland-Altman plots revealed a positive bias when comparing diaries against Actilife_SD, where diaries reported longer sleep duration. In contrast, there was almost no bias and smaller LoAs for the comparison between GGIR_VH and Actilife_SD. ANOVAs showed that comparisons between diary (M = 9.36, SD = 1.16) and Actilife_SD (M = 6.93, SD = 1.12); and GGIR_VH (M = 6.76, SD = 1.30) and Actilife_SD both yielded significant differences.

CONCLUSIONS

Overall, the automated GGIR_VH algorithm showed moderate agreement compared to the reference Actilife_SD. In contrast, sleep diaries overestimated sleep duration when compared to Actilife_SD.

Longitudinal study of childhood sleep trajectories and adolescent mental health problems

Study Objective

To investigate whether childhood sleep trajectories are associated with mental health symptoms such as social phobia, generalized anxiety, depression, attention deficit hyperactivity disorder (ADHD), conduct problems, and opposition at age 15.

Methods

A total of 2120 children took part in the Quebec Longitudinal Study of Child Development. Childhood sleep trajectories were computed from maternal reports at 2.5, 3.5, 4, 6, 8, 10, and/or 12 years. At age 15, 1446 adolescents filled out mental health and sleep questions. A path analysis model was assessed in the full sample.

Results

Four childhood nocturnal sleep duration trajectories were identified: (1) a short pattern (7.5%), (2) a short-increasing pattern (5.8%), (3) a 10 hours pattern (50.7%), and (4) an 11 hours pattern (36.0%). Three childhood sleep latency trajectories were found: (1) a short pattern (31.7%), (2) an intermediate pattern (59.9%), and (3) a long pattern (8.4%). Finally, two childhood wakefulness after sleep-onset trajectories were found: (1) a normative pattern (73.0%) and (2) a long pattern (27.0%). The path analysis model indicated that children following a long childhood sleep latency trajectory were more likely to experience symptoms of depression (β = 0.06, 95% CI: 0.01 to 0.12), ADHD (β = 0.07, 95% CI: 0.02 to 0.13), conduct problems (β = 0.05, 95% CI: 0.00 to 0.10) and opposition (β = 0.08, 95% CI: 0.02 to 0.13) at age 15.

Conclusions

This longitudinal study revealed that children presenting a long sleep latency throughout childhood are at greater risk of symptoms of depression, ADHD, conduct problems, and opposition in adolescence.