Association of sleep quality, media use and book reading with behavioral problems in early childhood. The Ulm SPATZ Health Study

C Ricci; T Poulain; J Keil; D Rothenbacher; J Genuneit

doi:10.1093/sleepadvances/zpac020

Association of sleep quality, media use and book reading with behavioral problems in early childhood. The Ulm SPATZ Health Study

Sleep Adv. 2022 Jun 24;3(1):zpac020. doi: 10.1093/sleepadvances/zpac020. eCollection 2022.

Authors

C Ricci¹, T Poulain^{2

3}, J Keil⁴, D Rothenbacher⁵, J Genuneit^{1

5}

Affiliations

¹ Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany.
² LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany.
³ Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany.
⁴ Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Leipzig , Leipzig, Germany.
⁵ Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.

Abstract

Study objectives: The objective of the study was to investigate the association of sleep quality, media use and book reading on internalizing, externalizing and prosocial behavior in early childhood.

Methods: In this cross-sectional study, we investigated a data set consisting of three consecutive yearly waves of the prospective Ulm SPATZ Health Study, conducted in southern Germany with 565, 496, and 421 children of 4-6 years of age, respectively.Standardized effects of the overall score and subscales of the Children's Sleep Habits Questionnaire, parent-reported child media use and book reading as well as their interaction term on the total score of the Strengths and Difficulties Questionnaire along with its externalizing, internalizing and prosocial subscales were estimated by multivariate adjusted random intercept mixed models.

Results: Overall sleep quality was associated more with internalizing than externalizing behavior; parasomnias associated with both behaviors. Night waking and sleep anxiety associated only with internalizing behavior. High levels of media use were associated with less internalizing behavior. More book reading resulted in less externalizing and internalizing behavior but more prosocial behavior. Finally, book reading and media use do not interact to determine child's behavior.

Conclusions: The current work supports a strategy of monitoring sleep quality, reducing media use and promoting book reading in order to avoid behavioral problems in early childhood.

Keywords: SPATZ study; behavior; book reading; early childhood; media use; sleep quality.