Longitudinal changes in sleep patterns and circadian rhythm metrics in preschool-age children from Northern Mexico

Rachel Bleiweiss-Sande; Adam P Spira; Jiawei Bai; Arturo Jiménez-Cruz; Montserrat Bacardí-Gascón; Amy R Wolfson; Sara E Benjamin-Neelon

doi:10.1016/j.sleh.2021.07.001

Longitudinal changes in sleep patterns and circadian rhythm metrics in preschool-age children from Northern Mexico

Sleep Health. 2021 Oct;7(5):596-602. doi: 10.1016/j.sleh.2021.07.001. Epub 2021 Aug 17.

Authors

Rachel Bleiweiss-Sande¹, Adam P Spira², Jiawei Bai³, Arturo Jiménez-Cruz⁴, Montserrat Bacardí-Gascón⁴, Amy R Wolfson⁵, Sara E Benjamin-Neelon⁶

Affiliations

¹ Department of Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Electronic address: rachel.sande@jhu.edu.
² Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bloomberg School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA.
³ Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁴ Department of Medicine and Psychology, Universidad Autónoma de Baja California, Tijuana, BC, Mexico.
⁵ Department of Psychology, Loyola University Maryland, Baltimore, Maryland, USA.
⁶ Department of Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

PMID: 34417150
DOI: 10.1016/j.sleh.2021.07.001

Abstract

Objectives: To assess changes in sleep parameters and circadian rhythm metrics measured by actigraphy in preschool-aged children.

Design: Longitudinal analysis over 1 year.

Participants: Ninety-four children living in Tijuana and Ensenada, Mexico.

Measurements: Children wore accelerometers on the right hip for one continuous week at baseline and 1-year follow-up. Parents recorded child bedtime, waketime, and naps in sleep diaries. We used cosinor and nonparametric approaches to calculate circadian rhythm metrics.

Results: At baseline, children had a mean age of 4.2 years, and 51.1% were girls. In multivariable models adjusted for age, gender, BMI category, parental education, household income and city, at follow-up children had significantly earlier waketimes (β = -7.99 minutes, p < .001) compared to baseline. Children also had lower sleep onset latency (β = -2.32 minutes, p = .057), and longer nighttime sleep (β = 9.38 minutes, p = .079), but these changes were not significant at the α < 0.05 level. We found significant increases in log relative amplitude (β = 0.017, p = .009), and decreases in log midline estimated statistic of rhythm (β = -0.084, p = .017) and log of the least active 5-hour period (β = -0.057, p = .010). When we adjusted for co-sleeping, we found significant decreases in the number of nighttime awakenings (β = -1.29, p = .011) but otherwise similar results. There were no other changes in sleep parameters or circadian rhythm metrics.

Conclusions: Mean increases in nighttime sleep and earlier wake times over one year were concomitant with decreases in overall activity levels and increases in circadian rhythm robustness. Co-sleeping was a predictor of sleep disturbances. This study provides longitudinal evidence regarding changes in sleep and circadian metrics in a sample of children from an under-researched sociodemographic group during an important, early life period.

Keywords: Actigraphy; Circadian timing; Early childhood; Longitudinal; Rest-activity patterns; Sleep patterns.

MeSH terms

Actigraphy
Benchmarking*
Child
Child, Preschool
Circadian Rhythm*
Female
Humans
Mexico / epidemiology
Sleep