Parental socioeconomic status and childhood sleep: A systematic review and meta-analysis

Abstract

Parental socioeconomic status (SES) is increasingly understood to be a key contributor to sleep health, but the research in childhood has not been synthesized. To examine the associations between indicators of child SES and child sleep (≤18 years old), we conducted a systematic review and meta-analyses. CINAHL with Full Text, PsycINFO, MEDLINE/PubMed, and Embase were searched using terms to define SES and childhood to ascertain all relevant, peer-reviewed articles from database inception to 27 December 2019. Studies were included if an association between an indicator of parental SES and a measure of child sleep (duration, quality, and problems) was reported. Data was extracted from 46 studies (N = 72,915). Across these studies, total sample size across participants included in the meta-estimate was N = 69,373. Data was extracted from 46 studies (N = 72,915). Across these studies, total sample size across participants included in the meta-estimate was N = 69,373. Higher parental education was associated with longer childhood sleep duration (stronger in samples with a higher proportion of White children) (OR = 1.302, 95% CI [1.111, 1.526], p = .001) and better sleep quality (OR = 1.332, 95% CI [1.014, 1.751], p = .040). Parental education was not directly associated with child sleep problems (OR = 1.191, 95% CI [0.733, 1.935], p = .479); moderation occurred by continent and the relationship was more pronounced in the Asian meta-estimate. Higher household income was not directly associated with longer childhood sleep duration (OR = 0.570, 95% CI [0.167, 1.943], p = 0.369), but moderation occurred by higher quality studies and the proportion of White children in the sample. Higher household income was associated with fewer sleep problems (moderated by continent) (OR = 0.764 (95% CI [0.689, 0.848], p < .001) and higher sleep quality (OR = 1.558, 95% CI [1.036, 2.342], p = .033). This review was limited by the number and methods of available published studies meeting inclusion criteria. Preventative programs that emphasize improvements in sleep of children and adolescents growing up in lower SES families are needed.

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