Night-waking and behavior in preschoolers: A developmental trajectory approach

Publication date: Available online 14 November 2017
Source:Sleep Medicine
Author(s): Eve Reynaud, Anne Forhan, Barbara Heude, Marie-Aline Charles, Sabine Plancoulaine
ObjectiveThe aim was to study, with a developmental approach, the longitudinal association between night-waking from age 2 to 5–6 years and behavior at age 5–6 years.MethodsWithin the French birth cohort study EDEN, repeated measures of children's night-waking were collected at age 2, 3 and 5–6 through parental questionnaires and were used to model night-waking trajectories. Behavior was assessed with the "Strengths and Difficulties Questionnaire," which provides five subscales measuring a child's conduct problems, emotional symptoms, peer relation problems, antisocial behavior, and hyperactivity/attention problems. The behavioral subscales were dichotomized at the 10th percentile. Multivariable logistic regressions, adjusted for parents' socio-economic factors, parental characteristics, and children's characteristics and sleep habits allowed us to study, in 1143 children, the association between night-waking trajectories from 2 to 5–6 years and behavior at age 5–6 years.ResultsThe "2 to 5–6 rare night-waking" trajectory represented 78% of the included population (n = 896), and the "2 to 5–6 common night-waking" 22% (n = 247%). Children belonging to the "2 to 5–6 common night-waking trajectory" had, at age 5–6, increased risk of presenting emotional symptoms (odds ratio [OR] = 2.17, 95% CI = 1.27–3.70, p = 0.004), conduct problems (OR = 1.63, 95% CI = 1.00–2.65, p = 0.050), and hyperactivity/attention problems (OR = 1.61, 95% CI = 1.00–2.57, p = 0.049). After adjusting for baseline behavior at age 2 years, only the association with emotional symptoms remained significant (OR = 2.02, 95% CI = 1.15–3.55, p = 0.015). Results did not differ according to sex.ConclusionResults suggest that the persistence of night-waking difficulties in early years is positively associated with emotional symptoms, hyperactivity/inattention, and conduct problems.



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