Early nap cessation in young children as a correlate of language and psychosocial outcomes: Evidence from a large Canadian sample.

OBJECTIVES: Most children stop napping between 2 and 5years old. We tested the association of early nap cessation (ie, children who stopped before their third birthday) and language, cognition functioning and psychosocial outcomes. METHODS: Data were from a national, longitudinal sample of Canadian children, with three timepoints. Children were 0-to-1 year old at T1, 2-to-3 years old at T2, and 4-to-5 years old at T3. Early nap cessation was tested as a correlate of children's psychosocial functioning (cross-sectionally and longitudinally), cognitive function (longitudinally), and language skills (longitudinally). There were 4923 children (50.9% male; 90.0% White) and their parents in this study who were included in the main analyses. Parents reported on demographics, perinatal and developmental variables, child functioning, and child sleep. Children completed direct assessments of receptive language and cognitive ability. Nap cessation, demographic, and developmental-control variables were tested as correlates of cross-sectional and longitudinal outcomes using linear regression (with a model-building approach). RESULTS: Early nap cessation correlated with higher receptive language ability (ß = 0.059 ± 0.028) and lower anxiety (ß = -0.039 ± 0.028) at T3, after controlling for known correlates of nap cessation, nighttime sleep, and other sociodemographic correlates of the outcomes. Cognitive ability, hyperactivity-inattention, and aggression were not correlated with nap cessation. CONCLUSIONS: Early nap cessation is related to specific benefits (ie, better receptive language and lower anxiety symptoms). These findings align with previous research. Future research should investigate differences associated with late nap cessation and in nap-encouraging cultures, and by ethnicity.

Regular, intermittent, and spontaneous: Patterns of preschool Children's nap behavior and their correlates.

BACKGROUND: Daytime sleep during the preschool years (i.e., 1-5-years-old) is characterized by high inter-child variability in several components of nap behavior, including nap duration, nap timing, and the proportion of sleep during daytime. We used an empirical approach to examine variations amongst children in these aspects of napping and investigated correlates of these components of nap behavior. METHODS: A large, nationally representative sample (N = 702) of Canadian parents completed an online survey, including a one-month retrospective report of their 1.5-5 year old's daytime and nighttime sleep behavior and other questionnaires. To understand patterns of children's nap behaviors we applied Latent Profile Analysis (LPA) to typical nap duration, typical timing of naps, frequency of naps, proportion of sleep during the daytime, and the proportion of naps which were spontaneous (i.e., child just fell asleep). Then, multinominal logistic regression was used to examine correlates of profile membership. RESULTS: Four profiles of children emerged: (1) regular nappers; (2) intermittent nappers; (3) spontaneous nappers; and (4) non-nappers. After controlling for demographic variables (e.g., child age, sex, ethnicity) and known correlates of napping behaviors (e.g., birthweight, nighttime sleep duration), profile membership was related to parents' beliefs about napping, parents' own nap behaviors, family functioning, and child nighttime sleep problems in a multinominal logistic regression. CONCLUSIONS: An empirical approach aided in understanding the inter-child variability in napping amongst preschool-age children. Parental beliefs about napping and the home environment were shown to be critical factors influencing this variability.

Thoughts and affect experienced by parents of preschool- and school-aged children during night-waking interactions.

Measures of parents' cognitions have advanced our understanding of infants' sleep. But, few comparable measures exist for use with parents of preschool- or school-age children. The Parents' night-waking thoughts and affect questionnaire (PNTQ), a self-report measure of parents' thoughts and feelings when their children wake during the night, addresses this need. This scale was evaluated in two community samples of parents (N = 473). Sample 1 included preschool-age children (2-5-years-old), and Sample 2 included preschool- and school-age children (2-10-years-old). A subsample completed 1-month test-retest reliability for the PNTQ (n = 201). Parents completed the PNTQ and measures of agreement with night-waking strategies, parenting stress, mental health, and night-waking. The psychometric properties of the PNTQ (i.e., internal consistency, test-retest reliability; content, construct, and convergent validity) were evaluated. A four-factor solution (positive thoughts about limit-setting, positive thoughts about active comforting, concerns about limit-setting, and distress about night-waking) demonstrated adequate fit in Sample 1 (robust CFI = .900; robust RMSEA = .060), which was replicated in Sample 2 (robust CFI = .870; robust RMSEA = .080). Internal consistency (αc = .68-.88) and test-retest reliability (r = .46-.80) were acceptable across subscales and samples. There was good evidence for convergent validity in both samples-including correlating with parent-reported night-waking behaviour. The PNTQ is a promising measure of thoughts and affect related to night-waking experienced by parents whose children wake during the night. The PNTQ may increase understanding of parents' use of specific night-waking strategies and may account for resistance to employing alternate techniques. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Parenting Practices, Bedtime Routines, and Consistency: Associations with Pediatric Sleep Problems.

OBJECTIVES: Investigate the direct and moderating effects of daytime parenting practices on the relationship between bedtime routines and pediatric sleep problems. METHODS: A community sample of 407 parents with children 2-10 years old completed measures of parenting practices (i.e., laxness and over-reactivity) and bedtime routines (i.e., consistency and reactivity to changes in routines). Sleep problems (i.e., severity and signaled night waking) were assessed by a parent-report questionnaire and sleep diaries. RESULTS: Higher parenting laxness (ß = .13) and less bedtime routine consistency (ß = -.34) significantly predicted sleep problem severity. Laxness moderated the relationship between bedtime reactivity and sleep problem severity: when bedtime reactivity was high, higher parental laxness was associated with more severe sleep problems. CONCLUSIONS: Daytime parenting practices are important to consider when children are reactive to changes in bedtime routines, as permissive or inconsistent daytime parenting practices were found to be associated with more severe sleep problems. Future research should examine the effects of parenting practices and bedtime routines on problematic signaled night waking in a clinical sample of children.

Influences on help-seeking decisions for behavioral child sleep problems: Why parents do and do not seek help.

OBJECTIVES: Behavioral sleep problems affect 25% of children and impact functioning, but little is known about help-seeking for these problems. We identified (1) predictors for sleep problem perception and help-seeking, using nested-logit regression and (2) reasons why parents did not seek professional help for sleep problems, using chi-square. METHODS: Parents (N = 407) of children (2-10-years-old) completed the study online. Parents indicated whether their child had no sleep problem, a mild problem, or a moderate-to-severe problem and completed additional questionnaires on parent/child functioning. RESULTS: Overall, 5.4% ± 2.2% of parents sought professional help for a child sleep problem. Greater child sleep problem severity and greater child socioemotional problems were significant predictors of parents perceiving a sleep problem. Among parents who perceived a sleep problem, greater parental socioemotional problems significantly predicted professional help-seeking. Parents who perceived no problem or a mild sleep problem reported not needing professional help as the main reason for not seeking help; parents who perceived a moderate-to-severe problem reported logistic barriers most often (e.g. treatment unavailability, cost). CONCLUSIONS: Problem perception and help-seeking predictors resemble the children's mental health literature. Differences in barriers, based on problem severity, suggest differential help-seeking interventions are needed (e.g. education vs access).

Risk and protective factors and processes for behavioral sleep problems among preschool and early school-aged children: A systematic review.

Behavioral sleep problems in early childhood are common, affecting about 25% of children, and include symptoms such as problems going to sleep and staying asleep. This review employed the developmental psychopathology framework and 4P model (Predisposing, Precipitating, Perpetuating, Protective) to organize the diverse risk/protective factors (distal variables experienced indirectly by the child) and processes (proximal variables experienced directly by the child) for child sleep problems among preschool (1-5 y) and school-age (6-10 y) children. Variables were categorized into biological, psychological, and environmental factors/processes at the individual, family/parent, and community levels. The quality of evidence was assessed using GRADE. A literature search identified 98 articles meeting inclusion criteria. Older child age, difficult temperament, previous sleep problems, externalizing psychopathology, internalizing psychopathology, and electronics use (e.g., bedtime TV viewing) were identified as child risk variables predicting sleep problems. Parental presence at bedtime (risk), negative parenting style (e.g., lax or permissive parenting; risk), consistent bedtime routines (protective), and lower composite socioeconomic status (risk) were identified as family/parent variables predicting child sleep problems. No well-established predictors were found at the community level. Future research should employ advanced research designs more frequently and investigate: 1) risk pathways across development; and 2) nightly fluctuations in sleep problems.