Sleep Patterns and School Readiness of Pre-Kindergarteners from Racially and Ethnically Diverse, Low-Income Backgrounds

Abstract

Objective: To explore patterns in parent-reported child sleep health and to investigate connections between such patterns and school readiness for newly enrolled prekindergarten (PreK) attendees from racially and ethnically diverse, low-income backgrounds.

Study design: In a secondary analysis from a larger multiple-cohort longitudinal observational study of prekindergartners in low-income families, parental reports of sleep health for 351 children (mean age, 52.8 ± 3.5 months) during the first month of PreK were analyzed. Children also had completed direct assessments measuring language, literacy, mathematics, and executive functioning, and teachers rated children's social-emotional-behavioral competencies and approaches to learning at PreK entry. We performed latent class analyses to identify patterns in sleep health and used regression models to examine concurrent associations between child sleep health patterns and school readiness competencies across 6 domains: language, literacy, mathematics, executive functioning, social-emotional-behavioral, and approaches to learning.

Results: Two classes emerged reflecting more and less desirable patterns of sleep health. Children classified in the earlier, longer, consistent sleep health class (87% of children) experienced earlier bedtimes, longer night-time sleep durations, more consistent sleep routines, less caffeine consumption ≤3 hours before bedtime, and scored higher on a direct assessment of expressive vocabulary and on teacher-reported measures of social-emotional-behavioral competencies and learning approaches than their peers in the later, shorter, inconsistent sleep health class (13% of children).

Conclusions: Consistent sleep routines and more optimal sleep health may serve as a protective mechanism for the language development, social-emotional-behavioral regulation, and approaches to learning of PreK from racially and ethnically diverse, low-income backgrounds. Clinician-parent discussions regarding optimal sleep health may provide key opportunities for targeted education that promotes school readiness skill development.

Keywords: bedtime routines; pediatric sleep; preschool; school readiness; sleep routines.

Figure 1.. Sleep Routine and Sleep Health Item Means for Each Class

Note. Item 1=Child weeknight bedtime later than 9:00 pm; Item 2=Child sleep duration (in hours) on weeknights (Sun-Thu); Item 3=Child sleep duration (in hours) on weekend nights (Fri-Sat); Item 4=Family Involvement Questionnaire: Regular morning and bedtime schedule; Item 5= Confusion, Hubbub, and Order Scale: Child has a regular bedtime routine; Item 6=Weekend-weeknight bedtime discrepancy (in hours) Item 7 Child sleeps for varying lengths of time each night; Item 8=Child drinks a caffeinated beverage three hours or less before going to bed Item 9 =Child plays video games, surfs the internet, or send texts within one hour of bedtime