Within-child associations between sleep quality and emotional self-regulation over 6 months among preschool-aged (3- to 5-year-old) children.

Objective:We leveraged an observational, repeated-measures study to examine the within-child associations between sleep quality and emotional self-regulation, controlling for between-child effects. Methods: Children aged 3-5 years and one parent each were recruited from the community in northern New England between 2019 and 2022. Parents completed online surveys at baseline and 2, 4, and 6 months post-baseline. Child sleep quality was measured with the validated Children's Sleep Habits Questionnaire modified for preschoolers; higher scores indicate worse sleep quality (range 32-96). Child emotional self-regulation was measured with the validated Child Social Behavior Questionnaire; higher scores indicate better emotional self-regulation (range 1-7). Adjusted mixed-effects linear regression was used to model the associations between nighttime sleep quality (exposure) and emotional self-regulation (outcome)measured at each of the four study time points while disaggregating the between- and within-child effects. Results: Children (n = 91) were largely white, non-Hispanic (88.7%), and from a higher social-economic status. Sleep quality scores averaged 38.9 (SD: 6.6) at baseline; 23.1% of children had scores >41, which is considered evidence of significant sleep problems. Emotional self-regulation scores averaged 4.2 (SD: 1.0). There was a significant within-child association between sleep quality and emotional self-regulation. Specifically, a decrease in sleep quality at any one time point, relative to each child'smean sleep quality, related to worse emotional self-regulation [standardized beta, βs = -0.31; 95% CI (0.53, -0.09)]; the between-child effect was not significant. Results were consistent when limited to children with complete data at all study visits (n = 78). Conclusions: The findings support a causal, within-child association between sleep quality and emotional self-regulation in preschool-aged children, with effects evident over 6 months. [ABSTRACT FROM AUTHOR]