TY - JOUR
T1 - A community-based study of sleep and cognitive development in infants and toddlers
AU - Sun, Wanqi
AU - Li, Shirley Xin
AU - Jiang, Yanrui
AU - Xu, Xiaojuan
AU - Spruyt, Karen
AU - Zhu, Qi
AU - Tseng, Chia Huei
AU - Jiang, Fan
N1 - Funding Information:
The work was performed in Shanghai Children’s Medical Center in collaboration with Shijiazhuang City Maternal and Child Health Hospital (Hebei), Shijiazhuang Qiaodong Maternal and Child Health Station (Hebei), Yiwu City Maternal and Child Health Hospital (Zhejiang), Yiwu Choucheng Health Center (Zhejiang), Rizhao Juxian People’s Hospital (Shandong), Rizhao City People’s Hospital (Shandong), Hongze County Maternal and Child Health Hospital (Jiangsu), Huai’an City Maternal and Child Health Hospital (Jiangsu), Kunming Children’s Hospital (Yunnan), Inner Mongolia Maternal and Child Health Hospital (Inner Mongolia), Liuyang City Maternal and Child Health Hospital (Hunan), Liuyang Gugang Health Center (Hunan), Nandan County Maternal and Child Health Hospital (Guangxi), and Guangxi Autonomous Region Maternal and Child Health Hospital (Guangxi). All the authors have seen and approved the manuscript. The authors report no conflicts of interest. The study was supported by the Chinese National Natural Science Foundation (81422040, 81172685); MOE New Century Excellent Talents (NCET-13-0362); Ministry of Science and Technology (2010CB535000); Shanghai Science and Technology Commission (12411950405, 14441904004, 13QH1401800, 2016YFC1305203); Shanghai Municipal Committee of Education (D1502); The fourth round of Three-Year Public Health Action Plan (2015-2017) (GWIV-36). All funding was awarded to Dr. Fan Jiang. The funding body had no role in the conception, design, conduct, interpretation, or analysis of the study or in the approval of the publication.
PY - 2018/6/15
Y1 - 2018/6/15
N2 - Study Objectives: To examine the prevalence and correlates of nighttime awakenings and to explore the association between sleep and cognitive development in a community sample of infants and toddlers. Methods: A total of 590 healthy infants (aged 2-11 months) and 512 toddlers (aged 12-30 months) from 8 provinces of China were assessed for their sleep and cognitive development. Data on sleep duration and nighttime awakenings were collected through the Brief Infant Sleep Questionnaire. Cognitive development was assessed by trained pediatricians using the Bayley Scales of Infant Development. Results: Prevalence of no nighttime awakening, and nighttime awakening(s) for 1×/night, 2×/night, and = 3×/night was 6.8%, 20.2%, 33.2%, and 39.3% in infants, and was 25.8%, 34.6%, 23.8%, and 15.8% in toddlers, respectively. Nighttime awakenings were generally associated with younger age, lower maternal education level, and being currently breastfed. In addition, nighttime awakenings were associated with being boys in toddlers. After controlling for potential confounders, infants with nighttime awakenings for 2×/night were found to have significantly higher Mental Development Index (MDI) score, as compared to those without and those with more frequent nighttime awakenings. However, toddlers with nighttime awakenings for = 3×/night had significantly lower MDI, as compared to those with fewer nighttime awakenings. Total sleep duration was not associated with any developmental indices in both infants and toddlers. Conclusions: Frequent nighttime awakenings are associated with poor cognitive functions in toddlers. Meanwhile, a nonlinear association between nighttime awakenings and cognitive performance was found among infants. The findings provide a developmental context for the effect of sleep on cognitive abilities in young children. Further longitudinal studies and interventional studies on the effects of parent-based sleep-focused intervention on cognitive abilities among young children are warranted.
AB - Study Objectives: To examine the prevalence and correlates of nighttime awakenings and to explore the association between sleep and cognitive development in a community sample of infants and toddlers. Methods: A total of 590 healthy infants (aged 2-11 months) and 512 toddlers (aged 12-30 months) from 8 provinces of China were assessed for their sleep and cognitive development. Data on sleep duration and nighttime awakenings were collected through the Brief Infant Sleep Questionnaire. Cognitive development was assessed by trained pediatricians using the Bayley Scales of Infant Development. Results: Prevalence of no nighttime awakening, and nighttime awakening(s) for 1×/night, 2×/night, and = 3×/night was 6.8%, 20.2%, 33.2%, and 39.3% in infants, and was 25.8%, 34.6%, 23.8%, and 15.8% in toddlers, respectively. Nighttime awakenings were generally associated with younger age, lower maternal education level, and being currently breastfed. In addition, nighttime awakenings were associated with being boys in toddlers. After controlling for potential confounders, infants with nighttime awakenings for 2×/night were found to have significantly higher Mental Development Index (MDI) score, as compared to those without and those with more frequent nighttime awakenings. However, toddlers with nighttime awakenings for = 3×/night had significantly lower MDI, as compared to those with fewer nighttime awakenings. Total sleep duration was not associated with any developmental indices in both infants and toddlers. Conclusions: Frequent nighttime awakenings are associated with poor cognitive functions in toddlers. Meanwhile, a nonlinear association between nighttime awakenings and cognitive performance was found among infants. The findings provide a developmental context for the effect of sleep on cognitive abilities in young children. Further longitudinal studies and interventional studies on the effects of parent-based sleep-focused intervention on cognitive abilities among young children are warranted.
KW - Cognition
KW - Infant
KW - Psychomotor performance
KW - Sleep
KW - Toddler
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U2 - 10.5664/jcsm.7164
DO - 10.5664/jcsm.7164
M3 - Article
C2 - 29852903
AN - SCOPUS:85048598079
SN - 1550-9389
VL - 14
SP - 977
EP - 984
JO - Journal of Clinical Sleep Medicine
JF - Journal of Clinical Sleep Medicine
IS - 6
ER -