Table 1. Weighted Prevalence of Short Sleep Duration Among Children Aged 3–17 Years, by Demographic, Neighborhood, and Family Characteristics, National Survey of Children’s Health, United States, 2016–2019.
| Characteristic | No. of children | Short sleep duration,a weighted % (95% CI) | Prevalence ratio (95% CI) |
|---|---|---|---|
| Individual demographic factors | |||
| Sex b | |||
| Male | 58,341 | 35.1 (34.1–36.0) | 1.02 (0.98–1.06) |
| Female | 54,584 | 34.4 (33.4–35.3) | 1 [Reference] |
| Age, y | |||
| 3–5 | 19,966 | 35.0 (33.5–36.6) | 1.14 (1.08–1.21) |
| 6–12 | 46,897 | 37.5 (36.5–38.5) | 1.22 (1.17–1.28) |
| 13–17 | 46,062 | 30.7 (29.6–31.7) | 1 [Reference] |
| Race and ethnicity b | |||
| Hispanic | 12,885 | 38.6 (36.7–40.5) | 1.33 (1.26–1.40) |
| Non-Hispanic American Indian/Alaska Native | 665 | 37.5 (31.2–44.2) | 1.29 (1.09–1.53) |
| Non-Hispanic Asian | 5,767 | 32.7 (30.2–35.1) | 1.12 (1.04–1.21) |
| Non-Hispanic Black | 7,048 | 50.0 (47.9–52.0) | 1.72 (1.64–1.80) |
| Non-Hispanic Native Hawaiian/Pacific Islander | 277 | 36.3 (25.5–48.2) | 1.25 (0.93–1.69) |
| Non-Hispanic White | 78,733 | 29.0 (28.4–29.6) | 1 [Reference] |
| Non-Hispanic other (2016–2018 only) | 647 | 36.1 (29.3–43.3) | 1.24 (1.03–1.50) |
| Non-Hispanic ≥2 races | 6,903 | 33.5 (31.2–35.8) | 1.15 (1.07–1.24) |
| Parental educationb | |||
| Less than high school | 2,680 | 45.6 (42.1–49.1) | 1.66 (1.53–1.80) |
| High school | 14,570 | 42.5 (40.8–44.3) | 1.55 (1.48–1.63) |
| Some college or associate degree | 26,325 | 38.6 (37.3–39.9) | 1.41 (1.35–1.47) |
| College degree or higher | 68,484 | 27.4 (26.7–28.2) | 1 [Reference] |
| Family income, % of FPL c | |||
| <100% | 12,371 | 44.9 (43.0–46.8) | 1.73 (1.63–1.82) |
| 100% to ≤199% | 18,205 | 39.3 (37.5–41.0) | 1.51 (1.43–1.59) |
| 200% to ≤399% | 34,700 | 33.4 (32.2–34.7) | 1.29 (1.22–1.35) |
| ≥400% | 47,649 | 26.0 (25.2–26.9) | 1 [Reference] |
| Negative neighborhood factors | |||
| Overall | |||
| ≥1 Negative neighborhood factorsd | 83,770 | 36.5 (35.7–37.3) | 1.28 (1.22–1.34) |
| No negative neighborhood factors | 27,901 | 28.5 (27.3–29.7) | 1 [Reference] |
| Safety | |||
| Unsafe neighborhoode | 3,589 | 46.2 (42.7–49.7) | 1.36 (1.26–1.47) |
| Safe neighborhood | 107,376 | 34.0 (33.3–34.7) | 1 [Reference] |
| Support | |||
| Neighborhood lacks supportf | 23,813 | 40.6 (39.1–42.0) | 1.25 (1.20–1.30) |
| Neighborhood provides support | 86,446 | 32.4 (31.7–33.2) | 1 [Reference] |
| Condition | |||
| Neighborhood in bad conditiong | 23,196 | 40.3 (38.8–41.9) | 1.24 (1.19–1.29) |
| Neighborhood in good condition | 87,560 | 32.6 (31.9–33.3) | 1 [Reference] |
| Amenities | |||
| Neighborhood lacks amenitiesh | 70,140 | 35.8 (35.0–36.7) | 1.10 (1.06–1.15) |
| Neighborhood has amenities | 40,522 | 32.6 (31.5–33.7) | 1 [Reference] |
| Family factors | |||
| Consistency of bedtime | |||
| Inconsistenti | 12,448 | 57.3 (55.4–59.2) | 1.82 (1.75–1.90) |
| Consistent | 100,103 | 31.4 (30.7–32.1) | 1 [Reference] |
| Mental health of parent | |||
| ≥1 Parent with fair/poor mental health | 7,988 | 47.5 (45.0–50.1) | 1.43 (1.35–1.51) |
| No parent with fair/poor mental healthj | 101,120 | 33.3 (32.6–34.0) | 1 [Reference] |
| Physical health of parent | |||
| ≥1 Parent with fair/poor physical health | 10,269 | 46.0 (43.7–48.3) | 1.40 (1.32–1.47) |
| No parent with fair/poor physical healthk | 98,946 | 33.0 (32.3–33.7) | 1 [Reference] |
| No. of ACEs l | |||
| 0 | 64,843 | 28.9 (28.1–29.8) | 1 [Reference] |
| 1 | 24,776 | 39.2 (37.7–40.6) | 1.35 (1.29–1.42) |
| 2 | 10,517 | 42.1 (40.0–44.2) | 1.45 (1.37–1.54) |
| 3 | 5,305 | 44.4 (41.3–47.4) | 1.53 (1.42–1.65) |
| ≥4 | 6,364 | 47.2 (44.4–49.9) | 1.63 (1.53–1.74) |
Abbreviations: ACEs, adverse childhood experiences; FPL, federal poverty level.
For children aged 3–5 years: “During the past week, how many hours of sleep did this child get during an average day (count both nighttime sleep and naps)?” For children aged 6–17 years for 2018–2019: “During the past week, how many hours of sleep did this child get on most weeknights.” The question in 2016–2017 asked about “an average weeknight.” Short sleep duration was defined as <10 h for children aged 3–5 years, <9 h for children aged 6–12 years, and <8 h for children aged 13–17 years.
If missing, this variable was imputed by using hot-deck imputation methods.
If missing, family income was imputed by using sequential regression as an input to FPL; FPL was multiply imputed and contained 6 implicates.
Category comprised 4 subcategories: “unsafe neighborhood,” “neighborhood lacks support,” “neighborhood in bad condition,” and “neighborhood lacks amenities.” Endorsement of any of these subcategories was counted as a respondent having ≥1 negative neighborhood factor.
A response of definitely disagree/somewhat disagree (vs somewhat agree/definitely agree) when asked whether the child is safe in their neighborhood.
A response of definitely disagree/somewhat disagree (vs somewhat agree/definitely agree) when asked whether people in the neighborhood help each other out, watch out for each other’s children, and know where to go for help in their community when they encounter difficulties.
A response of yes to any of these 3 items: 1) litter or garbage on the street or sidewalk, 2) poorly kept or rundown housing, or 3) vandalism such as broken windows or graffiti in their neighborhood.
A response of no to any of these 4 items: 1) sidewalks or walking paths, 2) a park or playground, 3) a recreation center, community center, or boys’ and girls’ club, and 4) a library or bookmobile in the neighborhood.
A response of child never/rarely/sometimes (vs usually/always) goes to bed at the same time on weeknights.
Parent (both parents if 2 primary caregivers) reported fair/poor (vs good/very good/ excellent) mental health.
Parent (both parents if 2 primary caregivers) reported fair/poor (vs good/very good/excellent) physical health.
Child’s ACEs included 9 items: 1) lived in a household where it was very hard to cover the basics, like food or housing, on the family’s income; 2) parent or guardian divorced; 3) parent or guardian died; 4) parent or guardian served time in jail; 5) child saw or heard parents or adults slap, hit, kick, punch one another in the home; 6) was victim of violence or witnessed violence in neighborhood; 7) lived with anyone who was mentally ill, suicidal, or severely depressed, or 8) anyone who had a problem with alcohol or drugs; and 9) treated or judged unfairly because of his or her race or ethnic group. Data on ACEs related to child maltreatment were not available because the survey was based on parent report.