Concordance in Caregiver and Child Sleep Health Metrics among Families Experiencing Socioeconomic Disadvantage: A Pilot Study

Purpose: Child and caregiver sleep occurs in a family system, with socioeconomically disadvantaged families experiencing disproportionately worse sleep health than more advantaged families. The extent to which objectively measured sleep health metrics (i.e., sleep duration, midpoint, regularity, efficiency) are concordant within disadvantaged family systems, including caregiver-child dyads, is not clear. To address this gap, this study aimed to: (1) characterize sleep health metrics and (2) identify levels of sleep health concordance among caregiver-child dyads living in families experiencing socioeconomic disadvantage. Design and methods: We enrolled 20 caregivers and 26 children in this micro-longitudinal study. Eligible primary caregivers slept in the same house as the child [greater than or equal to]4 nights/week and had no sleep disorders. Eligible children were aged 6-14 years and reported no medical problems. Dyads wore an actigraphy device continuously for 14 consecutive days. Sleep duration, bedtime, midpoint, and efficiency were estimated, and concordance evaluated using linear mixed modeling (R v.3.5.2). Results: Most caregivers were female (85%), Non-Hispanic Black (80%), and aged 40.45 years (SD=11.82). On average, caregivers were not meeting national recommendations for sleep duration and efficiency. Similarly, sleep duration recommendations were not met by child participants. Bivariate results showed that bedtime ??=0.19, p<0.001), sleep efficiency (??=0.24, p<0.001), and sleep midpoint (??=0.39, p<0.001), were concordant between child and caregiver. Multivariable models showed that caregiver bedtime was predictive of child sleep midpoint (b=0.16, p<0.05), and caregiver sleep midpoint was predictive of child bedtime (b=0.29, p<0.01) and child sleep midpoint (b=0.31, p<0.001). Conclusion: Objectively estimated caregiver sleep may be connected to the sleep timing of their children. Improving child sleep may require addressing caregiver sleep habits too. Practice Implications: Results highlight the importance of providers considering caregiver sleep health when assessing child sleep health during well child visits.