Attention and Hyperactivity Symptoms at Kindergarten Entry Associated with Less Sleep in Preschool

Abstract

Objective: To assess the association between sleep and attention and hyperactivity symptoms in preschool children. Study Design: We conducted secondary analysis of data from the preschool and kindergarten waves of the Early Childhood Longitudinal Study – Birth Cohort (ECLS-B) study. The ECLS-B dataset includes a contemporary, representative sample of children and their families living in the United States and followed longitudinally. The sample consisted of approximately 6,860 children who had data on the variables of interest across the preschool and kindergarten waves. Parent-reported bedtime and wake time, obtained via interview at both time points, were used to calculate total nighttime sleep duration. Parents were also asked to rate their children’s behavior on brief measures of attention/task persistence and hyperactivity/impulsivity. Results: We performed two sets of regression analyses to identify whether (a) sleep duration in preschool-age children predicts attention and hyperactivity at kindergarten entry and (b) attention and hyperactivity symptoms at preschool predict sleep duration at kindergarten. Each analysis controlled for the outcome of interest at the preschool time point, as well as gender, ethnicity and family income. Less sleep at preschool significantly predicted worse parent-reported hyperactivity (β = -0.06, P < .02) and attention at kindergarten (β = 0.06, P < .01). Conversely, parent-reported attention and hyperactivity at preschool did not predict parent-reported sleep duration at kindergarten (attention: β = 0.04, P = .09; hyperactivity: β = -.01, ns). Conclusions : Short sleep duration may contribute to the development or worsening of inattention and hyperactivity/impulsivity during early childhood, or may serve as an early warning sign of emerging behavioral difficulties.