Associations between sleep trajectories up to 54 months and cognitive school readiness in 4 year old preschool children

Elaine Kwang Hsia Tham; Hai-Yan Xu; Xiuju Fu; Rick Siow Mong Goh; Peter D Gluckman; Yap-Seng Chong; Fabian Yap; Lynette Pei-Chi Shek; Oon Hoe Teoh; Joshua Gooley; Daniel Yam-Thiam Goh; Nora Schneider; Michael J Meaney; Shirong Cai; Birit F P Broekman

doi:10.3389/fpsyg.2023.1136448

Associations between sleep trajectories up to 54 months and cognitive school readiness in 4 year old preschool children

Front Psychol. 2023 Mar 28:14:1136448. doi: 10.3389/fpsyg.2023.1136448. eCollection 2023.

Authors

Elaine Kwang Hsia Tham¹, Hai-Yan Xu², Xiuju Fu², Rick Siow Mong Goh², Peter D Gluckman^{1

3}, Yap-Seng Chong^{1

4}, Fabian Yap⁵, Lynette Pei-Chi Shek^{1

6

7}, Oon Hoe Teoh⁸, Joshua Gooley⁹, Daniel Yam-Thiam Goh^{6

7}, Nora Schneider¹⁰, Michael J Meaney^{1

11}, Shirong Cai^{1

12}, Birit F P Broekman^{1

13}

Affiliations

¹ Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.
² Institute of High Performance Computing, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.
³ Liggins Institute, The University of Auckland, Auckland, New Zealand.
⁴ Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore, Singapore.
⁵ Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore, Singapore.
⁶ Department of Paediatrics, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore, Singapore.
⁷ Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, Singapore.
⁸ Respiratory Medicine Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore.
⁹ Program in Neuroscience and Behavioral Disorders, Duke-NUS Medical School, Singapore, Singapore.
¹⁰ Société des Produits Nestlé SA, Lausanne, Switzerland.
¹¹ Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada.
¹² Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹³ Department of Psychiatry, Amsterdam Public Health Institute, VU University, Amsterdam, Netherlands.

Abstract

Purpose: This study explores the association between the duration and variation of infant sleep trajectories and subsequent cognitive school readiness at 48-50 months.

Methods: Participants were 288 multi-ethnic children, within the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Caregiver-reported total, night and day sleep durations were obtained at 3, 6, 9, 12, 18, 24 using the Brief Infant Sleep Questionnaire and 54 months using the Child Sleep Habits Questionnaire. Total, night and day sleep trajectories with varying durations (short, moderate, or long) and variability (consistent or variable; defined by standard errors) were identified. The cognitive school readiness test battery was administered when the children were between 48 and 50 months old. Both unadjusted adjusted analysis of variance models and adjusted analysis of covariance models (for confounders) were performed to assess associations between sleep trajectories and individual school readiness tests in the domains of language, numeracy, general cognition and memory.

Results: In the unadjusted models, children with short variable total sleep trajectories had poorer performance on language tests compared to those with longer and more consistent trajectories. In both unadjusted and adjusted models, children with short variable night sleep trajectories had poorer numeracy knowledge compared to their counterparts with long consistent night sleep trajectories. There were no equivalent associations between sleep trajectories and school readiness performance for tests in the general cognition or memory domains. There were no significant findings for day sleep trajectories.

Conclusion: Findings suggest that individual differences in longitudinal sleep duration patterns from as early as 3 months of age may be associated with language and numeracy aspects of school readiness at 48-50 months of age. This is important, as early school readiness, particularly the domains of language and mathematics, is a key predictor of subsequent academic achievement.

Keywords: cognitive development; infant sleep; preschool children; school readiness; sleep trajectories.

Grants and funding

This research was supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore-NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding was provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore and Nestle SA (formerly Nestec Ltd), provided support in the form of salaries for authors (H-YX, XF, and RG), but did not have any role in the GUSTO cohort study design, data collection, and analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.