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Sleep Difficulties in Infancy Are Associated with Symptoms of Inattention and Hyperactivity at the Age of 5 Years

A Longitudinal Study

Huhdanpää, Hanna MD*,†; Morales-Muñoz, Isabel PhD*,‡; Aronen, Eeva T. MD, PhD; Pölkki, Pirjo PhD§; Saarenpää-Heikkilä, Outi MD, PhD; Paunio, Tiina MD, PhD*,¶; Kylliäinen, Anneli PhD**; Paavonen, E. Juulia MD, PhD, BSocSc*,††

Journal of Developmental & Behavioral Pediatrics: June 03, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/DBP.0000000000000684
Original Article: PDF Only
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Objective: Sleep difficulties are associated with cognitive and behavioral problems in childhood. However, it is still unclear whether early sleep difficulties are related to later development. We studied whether parent-reported sleep duration, night awakenings, and parent-reported sleep problems in early childhood are associated with symptoms of inattention and hyperactivity at the age of 5 years.

Method: Our study is based on the Child-Sleep birth cohort initially comprising 1673 families, of which 713 were retained at the age of 5 years. We used the Brief Infant Sleep Questionnaire and the Infant Sleep Questionnaire, which were filled out by the parents when their child was 3, 8, and 24 months and 5 years old. Symptoms of inattention and hyperactivity at the age of 5 years were assessed using the Strengths and Difficulties Questionnaire and the Five-to-Fifteen questionnaire.

Results: Sleep duration at the age of 3, 8, and 24 months was associated with inattentiveness at 5 years of age. Moreover, parent-reported sleep problems at the age of 24 months were related to both inattentive and hyperactive symptoms at the age of 5 years. Finally, at the age of 5 years, parent-reported sleep problems and night awakenings were associated with concurrent symptoms of inattention and hyperactivity.

Conclusion: Our findings suggest that certain sleep characteristics related to sleep quality and quantity in early childhood are associated with inattentiveness and hyperactivity at the age of 5 years. Interestingly, sleep duration in early childhood is consistently related to inattention at the age of 5 years.

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

*Department of Health, National Institute for Health and Welfare, Helsinki, Finland;

Pediatric Research Center, Laboratory of Developmental Psychopathology and Children's Hospital, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;

Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom;

§Department of Social Sciences, University of Eastern Finland, Kuopio, Finland;

Department of Pediatrics, Tampere University Hospital, Tampere Center for Child Health Research, Tampere University and Tampere University Hospital, Tampere, Finland;

Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;

**Psychology, Faculty of Social Sciences and Humanities, Tampere University, Tampere, Finland.

††Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

Address for reprints: Hanna Huhdanpää, Department of Health, National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland; e-mail: hanna.huhdanpaa@hus.fi.

The project was funded by the Academy of Finland (#308588 to E. J. Paavonen; #134880 and #253346 to T. Paunio; #277557 to O. Saarenpää-Heikkilä; #317080 to A. Kylliäinen; and #315035 to I. Morales-Muñoz), the Gyllenberg Foundation, the Yrjö Jahnsson Foundation, the Foundation for Pediatric Research, the Finnish Cultural Foundation, the Pediatric Research Foundation, Competitive Research Financing of the Expert Responsibility Area of Tampere University Hospital, the Arvo ja Lea Ylppö Foundation, the Doctors' Association in Tampere, and a grant from Helsinki University Hospital Research Funds TYH2016202.

Disclosure: The authors declare no conflict of interest.

E. Juulia Paavonen, A. Kylliäinen, O. Saarenpää-Heikkilä, P. Pölkki, and T. Paunio designed the study, coordinated and supervised the data collection, and critically reviewed the manuscript. E. T. Aronen contributed to planning the data analyses and reviewed and revised the manuscript. H. Huhdanpää and I. Morales-Muñoz conducted the analyses, drafted the initial manuscript, and reviewed and revised the manuscript; all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Received December 04, 2018

Accepted April 02, 2019

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