Executive function mediates prospective relationships between sleep duration and sedentary behavior in children

Abstract

Childhood sedentary behavior has been linked to increased obesity risk. Prior work has identified associations between sedentary behavior, executive function (EF), and sleep. This study tested the hypothesis that reduced sleep duration may adversely impact EF and lead to increased childhood sedentary behavior. Southern California schoolchildren participating in the school-based health promotion program Pathways to Health (N=709) were assessed annually from 4th through 6th grades (2010-2013) on self-report measures of sedentary behavior, sleep duration, and executive function. A series of path models were specified treating average nightly sleep duration and weekend wake/bed-time shift at 4th grade as predictors of 6th grade sedentary behavior. Four EF subdomains were tested as potential mediators of longitudinal associations at 5th grade. Significant associations between average nightly sleep duration, EF and sedentary behavior were identified (p<0.05), adjusting for participant gender, physical activity, SES, ethnicity, program group assignment, and the presence/absence of parental screen time rules. Fifth grade overall EF (p<0.05)-and in particular the subdomains of inhibitory control (p<0.05) and organization of materials (p<0.01)-significantly mediated the relationship between 4th grade sleep duration and 6th grade sedentary behavior (p<0.05). Furthermore, delay of weekend bed- or wake-times relative to weekdays was prospectively associated with decreased overall EF (p<0.05), but not increased sedentary behavior (p=0.35 for bed-time delay; p=0.64 for wake-time delay), irrespective of average nightly sleep duration. Findings suggest that sleep promotion efforts may reduce children's sedentary behavior both directly and indirectly through changes in EF.

Trial registration: ClinicalTrials.gov NCT00787709.

Keywords: Executive function; Inhibitory control; Neurocognition; Obesity prevention; Screen time; Sedentary behavior; Sleep.

Fig. 1

Longitudinal mediation model for the effect of nightly sleep duration at 4th grade on sedentary behavior at 6th grade through changes in executive function at 5th grade among Southern California schoolchildren. Two-sided ⁺P < 0.1 *P < 0.05 **P < 0.01 ***P < 0.001; non-significant covariance paths at 4th grade and error terms for endogenous variables were omitted for clarity.

Fig. 2

Longitudinal mediation models for the effect of nightly sleep duration at 4th grade (2010) on sedentary behavior at 6th grade through changes in individual EF subdomains at 5th grade among Southern California schoolchildren. [Each path model also adjusts for participant gender, physical activity, SES, ethnicity, parental screen-time rules, & control/intervention group in the same manner as Fig. 1] Two-sided ⁺P < 0.1 *P < 0.05 **P < 0.01 ***P < 0.001.

Fig. 3

Longitudinal mediation models for the effect of delaying weekend wake-time and bed-time at 4th grade (2010) on sedentary behavior at 6th grade through changes in executive function at 5th grade among Southern California schoolchildren. [Each model also adjusts for participant gender, physical activity, SES, ethnicity, parental screen-time rules, & control/intervention group in the same manner as Fig. 1, as well as average nightly sleep duration] Two-sided ⁺P < 0.1 *P < 0.05 **P < 0.01 ***P < 0.001.