Table 3. Independent Contribution of Children’s Mental, Behavioral, or Developmental Disorders, Demographic, Neighborhood, and Family Factors to Short Sleep Duration, National Survey of Children’s Health, United States, 2016–2019.
| Variable | Short sleep duration,a adjusted prevalence ratio (95% CI)b |
|---|---|
| Mental, behavioral, or developmental disorders | |
| None | 1 [Reference] |
| Anyc | 1.06 (1.02–1.11) |
| Demographic characteristics | |
| Sex d | |
| Male | 1.01 (0.98–1.05) |
| Female | 1 [Reference] |
| Age, y | |
| 3–5 | 1.29 (1.22–1.36) |
| 6–12 | 1.33 (1.27–1.38) |
| 13–17 | 1 [Reference] |
| Race and ethnicity d | |
| Hispanic | 1.12 (1.06–1.19) |
| Non-Hispanic American Indian/Alaska Native | 1.00 (0.82–1.21) |
| Non-Hispanic Asian | 1.15 (1.06–1.24) |
| Non-Hispanic Black | 1.44 (1.36–1.51) |
| Non-Hispanic Native Hawaiian/Pacific Islander | 1.03 (0.76–1.39) |
| Non-Hispanic White | 1 [Reference] |
| Non-Hispanic other (2016–2018 only) | 1.05 (0.85–1.29) |
| Non-Hispanic ≥2 races | 1.05 (0.98–1.12) |
| Parental education d | |
| Less than high school | 1.34 (1.22–1.48) |
| High school | 1.25 (1.18–1.32) |
| Some college or associate degree | 1.18 (1.13–1.24) |
| College degree or higher | 1 [Reference] |
| Family income level, % of FPL e | |
| <100% | 1.12 (1.04–1.20) |
| 100% to ≤199% | 1.08 (1.01–1.15) |
| 200% to ≤399% | 1.07 (1.02–1.12) |
| ≥400% | 1 [Reference] |
| Negative neighborhood factors f | |
| ≥1 | 1.10 (1.05–1.15) |
| None | 1 [Reference] |
| Family factors | |
| Consistency of bedtime | |
| Inconsistentg | 1.70 (1.63–1.78) |
| Consistent | 1 [Reference] |
| Mental health of parent | |
| ≥1 Parent with fair/poor mental health | 1.09 (1.01–1.17) |
| No parent with fair/poor mental healthh | 1 [Reference] |
| Physical health of parent | |
| ≥1 Parent with fair/poor physical health | 1.09 (1.02–1.16) |
| No parent with fair/poor physical healthi | 1 [Reference] |
| No. of ACEsj | |
| 0 | 1 [Reference] |
| 1 | 1.19 (1.13–1.25) |
| 2 | 1.22 (1.15–1.30) |
| 3 | 1.25 (1.15–1.35) |
| ≥4 | 1.28 (1.19–1.39) |
Abbreviation: 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.
Adjusted prevalence ratio calculated by controlling for all other factors in the model: sex, age, race and ethnicity, parental education, poverty, neighborhood factor composite (ie, ≥1 negative neighborhood factors vs no negative neighborhood factors), inconsistent bedtime, ≥1 parent with fair/poor mental health, ≥1 parent with fair/poor physical health, ACEs, and mental, behavioral, or developmental disorders.
A response of yes to current mental, behavioral, or developmental disorder (includes attention-deficit/hyperactivity disorder), behavior problems, anxiety, depression, learning disability, developmental delay, intellectual disability, speech and language disorder, autism spectrum disorder, and Tourette syndrome.
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 the 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 child never/rarely/sometimes (vs usually/always) goes to bed 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; 4) 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.