Socio-ecological Factors Linked to Co-Occurring Early Childhood Sleep Health Disparities and Developmental Outcomes
Summary: Sleep deficiencies, such as sleep disordered breathing (SDB) and insufficient sleep, are linked to adverse health outcomes. These sleep deficiencies are more common in racial and ethnic minoritised children and have significant negative impacts on neurobehavioural and social-emotional development. The Sleep in Preschoolers Study (SIPS) focuses on identifying socioecological factors linked to racial disparities in neurobehavioural and social-emotional impacts of SDB. Data collection for SIPS is ongoing for the next 2-3 years. Opportunities for collaboration on SIPS include analysis of actigraphy and polysomnography data, caregiver-child interactions tasks, and biological samples.
Our study objectives are to (1) examine racial disparities in the neurobehavioural and social-emotional impacts of early childhood SDB and/or insufficient sleep and (2) identify proximal and distal socioecological factors linked to these sleep disparities and outcomes via a cross-sectional observational study. This investigation compares neurobehavioural (executive functioning, attention, vigilance) and social-emotional functioning (social skills, emotion regulation) in 400 dyads consisting of caregivers and their otherwise healthy Black and White 3–5 year-old children and divided into four groups: (A) preschoolers with SDB; (B) preschoolers with insufficient sleep; (C) preschoolers with both SDB and insufficient sleep and (D) matched controls. Child SDB, insufficient sleep, neurobehavioural skills and social-emotional functioning are measured using validated objective and subjective assessment tools, with a subset of caregivers completing qualitative interviews. Primary outcomes include individual differences in neurobehavioural and social-emotional functioning in these groups of Black and White preschoolers, and multilevel socioecological factors associated with variation in outcomes. Quantitative data will be analysed using descriptive analyses, linear regression and comparison of model coefficients. Qualitative data will be coded using thematic analysis and a joint display to stratify qualitative themes by child race and sleep deficiencies.
early childhood (adapted from Billings et al with permission). SDB = sleep disordered breathing (Uwah et al., 2025)
Funding: National Heart, Lung, and Blood Institute (NHLBI) (Grant #: R01HL163798, PI: Williamson)
Stage: Ongoing
Related Publications:
SIPS Protocol Paper:
- Uwah, E. A., Cicalese, O., Davis, B., Neelapu, M., Steinberg, G., Handa, A., Johnson, T. J., Mindell, J. A., Njoroge, W. F., Stefanovski, D., Tapia, I. E., Waller, R., & Williamson, A. A. (2025). Socioecological factors linked to co-occurring early childhood sleep health disparities and developmental outcomes: Protocol for the sleep in preschoolers cross-sectional study. BMJ Open, 15(3). https://doi.org/10.1136/bmjopen-2025-100956
Supporting Publications:
- Williamson, A.A., Fan, J., Distel, L., Xiao, R., Stefanovski, D., & Tapia, I. E. (2023). Nighttime sleep duration and variability in children with Obstructive Sleep Apnea Syndrome: Sociodemographic disparities and neurobehavioral outcomes. Sleep Medicine, 102: 165-172. doi: 10.1016/j.sleep.2023.01.003. PMID: 36682144.
- Williamson, A. A., Johnson, T. J., & Tapia, I. E. (2023). Health disparities in pediatric sleep disordered breathing. Paediatric Respiratory Reviews, 45: 2-7. doi: 10.1016/j.prrv.2022.01.005
Collaborators:
