Caregiver Perceived Stress and Child Sleep Health: An Item-Level Individual Participant Data Meta-Analysis.

Up to 50% of children and adolescents in the United States (U.S.) experience sleep problems. While existing research suggests that perceived stress in caregivers is associated with poorer sleep outcomes in children, research on this relationship is often limited to infant and early childhood populations; therefore, we investigated this association in school-age children and adolescents. We used cross-sectional caregiver-reported surveys and applied item response theory (IRT) followed by meta-analysis to assess the relationship between caregiver perceived stress and child sleep disturbance, and moderation of this relationship by child age and the presence of a child mental or physical health condition. We analyzed data from the National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) Program, a collaboration of existing pediatric longitudinal cohort studies that collectively contribute a diverse and large sample size ideal for addressing questions related to children's health and consolidating results across population studies. Participants included caregivers of children ages 8 to 16 years from four ECHO cohorts. Caregiver perceived stress was measured using the Perceived Stress Scale (PSS), and child sleep disturbance was assessed using five sleep-related items from the School-Age version of the Child Behavior Checklist (CBCL). Increases in caregiver perceived stress and child mental or physical health condition were independently associated with greater sleep disturbance among children. The findings reinforce the importance of accounting for, and potentially intervening on, the broader family context and children's mental and physical health in the interest of improving sleep health. Highlights: Existing research suggests caregiver perceived stress is associated with worse child sleep outcomes. Data from eight cohorts in the National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) program were used. We combined item-level analysis within each cohort with meta-analysis to aggregate results across cohorts. Higher caregiver perceived stress and child health conditions were independently associated with poorer child sleep. Study findings reinforce the importance of the broader family context in the interest of improving sleep health. [ABSTRACT FROM AUTHOR]