To evaluate the effect of maternal depression and anxiety symptoms on daily sleep duration in 4–5-year-old children.
Data were obtained from the PREDI Study, a larger cohort study conducted in Brazil. The current study is a cross-sectional study carried out in the homes of the participants between July 2016 and August 2017. The participants were submitted to anthropometric assessment and demographic, socioeconomic and psychological data were obtained. Total sleep time was self-reported by the women and classified as ≥ 10 or < 10 h of sleep/day. Maternal depression and anxiety symptoms were assessed using the Beck Depression Inventory and Beck Anxiety Inventory, respectively.
Of the 216 children included in the study, 77.3% and 22.7% had ≥ 10 and < 10 h of sleep/day, respectively. Regarding the women, 20.0% and 19.5% had moderate/severe depression and anxiety symptoms, respectively. Moderate/severe symptoms of maternal depression were associated with < 10 h of sleep/day (p = 0.034). Unadjusted analysis showed that children whose mothers had moderate/severe depression symptoms were significantly more likely to sleep < 10 h/day at 4–5 years of age than those whose mothers had minimal/mild depression symptoms (OR 2.38, p = 0.037). This association continued to be significant and increased to an OR of 3.99 (p = 0.006) after adjusting for potential confounders.
Conclusions for practice
Our study showed that sleeping less than 10 h/day at preschool age was associated with moderate/severe maternal depression symptoms. These results are important from a public health perspective since strategies designed to treat depression in women with school-age children may help improve their child’s sleep quality and, consequently, his cognitive performance and related behavioral and emotional problems in the future.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Alamian, A., Wang, L., Hall, A. M., Pitts, M., & Ikekwere, J. (2016). Infant sleep problems and childhood overweight: Effects of three definitions of sleep problems. Preventive Medicine Reports,4, 463–468. https://doi.org/10.1016/j.pmedr.2016.08.017.
Allen, S. L., Howlett, M. D., Coulombe, J. A., & Corkum, P. V. (2016). ABCs of SLEEPING: A review of the evidence behind pediatric sleep practice recommendations. Sleep Medicine Reviews,29, 1–14. https://doi.org/10.1016/j.smrv.2015.08.006.
Audelo, J., Kogut, K., Harley, K. G., Rosas, L. G., Stein, L., & Eskenazi, B. (2016). Maternal depression and childhood overweight in the CHAMACOS study of Mexican-American children. Maternal and Child Health Journal,20(7), 1405–1414. https://doi.org/10.1007/s10995-016-1937-9.
Bocknek, E. L., Richardson, P. A., van den Heuvel, M. I., Qipo, T., & Brophy-Herb, H. E. (2018). Sleep moderates the association between routines and emotion regulation for toddlers in poverty. Journal of Family Psychology. https://doi.org/10.1037/fam0000433.
Brambilla, P., Giussani, M., Pasinato, A., Venturelli, L., Privitera, F., Miraglia Del Giudice, E., et al. (2017). Sleep habits and pattern in 1-14 years old children and relationship with video devices use and evening and night child activities. Italian Journal of Pediatrics,43(1), 1–11. https://doi.org/10.1186/s13052-016-0324-x.
BRASIL. (1996). Lei nº 9.394, de 20 de dezembro de 1996. Estabelece as Diretrizes e Bases da Educação Nacional. Brasília. Retrieved April 17, 2017, from http://www.planalto.gov.br/ccivil_03/Leis/L9394.htm.
Cappuccio, F. P., Taggart, F. M., Kandala, N. B., Currie, A., Peile, E., Stranges, S., et al. (2008). Meta-analysis of short sleep duration and obesity in children and adults. Sleep,31(5), 619–626. https://doi.org/10.1093/sleep/31.5.619.
Chaput, J. P., Gray, C. E., Poitras, V. J., Carson, V., Gruber, R., Birken, C. S., et al. (2017). Systematic review of the relationships between sleep duration and health indicators in the early years (0-4 years). BMC Public Health,17(Suppl 5), 855. https://doi.org/10.1186/s12889-017-4850-2.
Chen, P., & Harris, K. M. (2019). Association of positive family relationships with mental health trajectories from adolescence to midlife. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2019.3336.
Constantino, B., Silva, J. C. D., Michels, M. D. S., & Mastroeni, M. F. (2019). Symptoms of maternal depression and anxiety and their effect on the child’s weight status four years after delivery. Early Child Development and Care. https://doi.org/10.1080/03004430.2019.1678608.
Fatima, Y., Doi, S. A., & Mamun, A. A. (2015). Longitudinal impact of sleep on overweight and obesity in children and adolescents: A systematic review and bias-adjusted meta-analysis. Obesity Reviews,16(2), 137–149. https://doi.org/10.1111/obr.12245.
Field, T., Diego, M., Hernandez-Reif, M., Figueiredo, B., Schanberg, S., & Kuhn, C. (2007). Sleep disturbances in depressed pregnant women and their newborns. Infant Behavior and Development,30(1), 127–133. https://doi.org/10.1016/j.infbeh.2006.08.002.
Gaffney, K. F., Kitsantas, P., Brito, A., & Swamidoss, C. S. (2014). Postpartum depression, infant feeding practices, and infant weight gain at six months of age. Journal of Pediatric Health Care,28(1), 43–50. https://doi.org/10.1016/j.pedhc.2012.10.005.
Gomes-Oliveira, M. H., Gorenstein, C., Lotufo Neto, F., Andrade, L. H., & Wang, Y. P. (2012). Validation of the Brazilian Portuguese version of the Beck Depression Inventory-II in a community sample. Revista Brasileira de Psiquiatria,34(4), 389–394. https://doi.org/10.1016/j.rbp.2012.03.005.
Gordon, C. C., Chumlea, W. C., & Roche, A. F. (1988). Stature, recumbent length, and weight. In T. G. Lohman, A. F. Roche, & R. Martorell (Eds.), Anthropometric standartization reference manual (pp. 3–8). Champaign: Human Kinetics Books.
Gorenstein, C., & Andrade, L. (1996). Validation of a Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Brazilian Journal of Medical and Biological Research,29(4), 453–457.
Gradisar, M., Wolfson, A. R., Harvey, A. G., Hale, L., Rosenberg, R., & Czeisler, C. A. (2013). The sleep and technology use of Americans: Findings from the National Sleep Foundation’s 2011 sleep in America poll. Journal of Clinical Sleep Medicine,9(12), 1291–1299. https://doi.org/10.5664/jcsm.3272.
Gregory, A. M., Van der Ende, J., Willis, T. A., & Verhulst, F. C. (2008). Parent-reported sleep problems during development and self-reported anxiety/depression, attention problems, and aggressive behavior later in life. Archives of Pediatrics and Adolescent Medicine,162(4), 330–335. https://doi.org/10.1001/archpedi.162.4.330.
Gruber, R., Carrey, N., Weiss, S. K., Frappier, J. Y., Rourke, L., Brouillette, R. T., et al. (2014). Position statement on pediatric sleep for psychiatrists. Journal of the Canadian Academy of Child and Adolescent Psychiatry,23(3), 174–195.
Hall, W. A., Zubrick, S. R., Silburn, S. R., Parsons, D. E., & Kurinczuk, J. J. (2007). A model for predicting behavioural sleep problems in a random sample of Australian pre-schoolers. Infant and Child Development,16(5), 509–523. https://doi.org/10.1002/icd.527.
Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni, O., DonCarlos, L., et al. (2015). National Sleep Foundation’s sleep time duration recommendations: Methodology and results summary. Sleep Health,1(1), 40–43. https://doi.org/10.1016/j.sleh.2014.12.010.
Hiscock, H., Bayer, J. K., Hampton, A., Ukoumunne, O. C., & Wake, M. (2008). Long-term mother and child mental health effects of a population-based infant sleep intervention: Cluster-randomized, controlled trial. Pediatrics,122(3), e621–627. https://doi.org/10.1542/peds.2007-3783.
Hiscock, H., & Wake, M. (2001). Infant sleep problems and postnatal depression: A community-based study. Pediatrics,107(6), 1317–1322.
Instituto Brasileiro de Geografia e Estatística. (2010). Pesquisa Nacional por Amostra de Domicílios. Retrieved April 17, 2017, from http://www.ibge.gov.br/home/estatistica/populacao/trabalhoerendimento/pnad98/saude/analise.shtm.
Karraker, K. H., & Young, M. (2007). Night waking in 6-month-old infants and maternal depressive symptoms. Journal of Applied Developmental Psychology,28(5–6), 493–498. https://doi.org/10.1016/j.appdev.2007.06.002.
Liu, Y., Croft, J. B., Wheaton, A. G., Perry, G. S., Chapman, D. P., Strine, T. W., et al. (2013). Association between perceived insufficient sleep, frequent mental distress, obesity and chronic diseases among US adults, 2009 behavioral risk factor surveillance system. BMC Public Health. https://doi.org/10.1186/1471-2458-13-84.
Magee, C. A., Caputi, P., & Iverson, D. C. (2013). Patterns of health behaviours predict obesity in Australian children. Journal of Paediatrics and Child Health,49(4), 291–296. https://doi.org/10.1111/jpc.12163.
Martini, J., Petzoldt, J., Knappe, S., Garthus-Niegel, S., Asselmann, E., & Wittchen, H. U. (2017). Infant, maternal, and familial predictors and correlates of regulatory problems in early infancy: The differential role of infant temperament and maternal anxiety and depression. Early Human Development,115, 23–31. https://doi.org/10.1016/j.earlhumdev.2017.08.005.
Mastroeni, M. F., Czarnobay, S. A., Kroll, C., Figueiredo, K. B., Mastroeni, S. S., Silva, J. C., et al. (2017). The independent importance of pre-pregnancy weight and gestational weight gain for the prevention of large-for gestational age Brazilian newborns. Maternal and Child Health Journal,21(4), 705–714. https://doi.org/10.1007/s10995-016-2156-0.
Meltzer, L. J., & Mindell, J. A. (2007). Relationship between child sleep disturbances and maternal sleep, mood, and parenting stress: A pilot study. Journal of Family Psychology,21(1), 67–73. https://doi.org/10.1037/0893-3184.108.40.206.
Mindell, J. A., Owens, J., Alves, R., Bruni, O., Goh, D. Y., Hiscock, H., et al. (2011). Give children and adolescents the gift of a good night’s sleep: A call to action. Sleep Medicine,12(3), 203–204. https://doi.org/10.1016/j.sleep.2011.01.003.
Mindell, J. A., Owens, J. A., & Carskadon, M. A. (1999). Developmental features of sleep. Child and Adolescent Psychiatric Clinics of North America,8(4), 695–725.
Norell-Clarke, A., & Hagquist, C. (2018). Child and adolescent sleep duration recommendations in relation to psychological and somatic complaints based on data between 1985 and 2013 from 11 to 15 year-olds. Journal of Adolescence,68, 12–21. https://doi.org/10.1016/j.adolescence.2018.07.006.
Petzoldt, J., Wittchen, H. U., Einsle, F., & Martini, J. (2016). Maternal anxiety versus depressive disorders: specific relations to infants’ crying, feeding and sleeping problems. Child: Care, Health and Development,42(2), 231–245. https://doi.org/10.1111/cch.12292.
Sadeh, A., Tikotzky, L., & Scher, A. (2010). Parenting and infant sleep. Sleep Medicine Reviews,14(2), 89–96. https://doi.org/10.1016/j.smrv.2009.05.003.
Sales, W. B., Silleno Junior, J. D., Kroll, C., Mastroeni, S. S., Silva, J. C., & Mastroeni, M. F. (2015). Influence of altered maternal lipid profile on the lipid profile of the newborn. Archives of Endocrinology Metabolism,59(2), 123–128. https://doi.org/10.1590/2359-3997000000024.
Scher, A., Zukerman, S., & Epstein, R. (2005). Persistent night waking and settling difficulties across the first year: Early precursors of later behavioural problems? Journal of Reproductive and Infant Psychology,23(1), 77–88. https://doi.org/10.1080/02646830512331330929.
Tikotzky, L., & Sadeh, A. (2009). Maternal sleep-related cognitions and infant sleep: A longitudinal study from pregnancy through the 1st year. Child Development,80(3), 860–874. https://doi.org/10.1111/j.1467-8624.2009.01302.x.
Weinraub, M., Bender, R. H., Friedman, S. L., Susman, E. J., Knoke, B., Bradley, R., et al. (2012). Patterns of developmental change in infants’ nighttime sleep awakenings from 6 through 36 months of age. Developmental Psychology,48(6), 1511–1528. https://doi.org/10.1037/a0027680.
World Health Organization. (2000). Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. Techical report series (Vol. 894i–xii, pp. 1–253). World Health Organization. Retrieved April 17, 2017, from https://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/.
World Health Organization. (2006). WHO child growth standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. WHO Multicentre Growth Reference Study Group. Geneva: World Health Organization. Retrieved April 17, 2017 from https://www.who.int/childgrowth/standards/height_for_age/en/.
World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO. Retrieved April 17, 2017 from https://www.who.int/mental_health/management/depression/prevalence_global_health_estimates/en/.
Wu, X., Tao, S., Rutayisire, E., Chen, Y., Huang, K., & Tao, F. (2017). The relationship between screen time, nighttime sleep duration, and behavioural problems in preschool children in China. European Child and Adolescent Psychiatry,26(5), 541–548. https://doi.org/10.1007/s00787-016-0912-8.
The authors thank the Darcy Vargas Maternity Hospital of Joinville, Santa Catarina, Brazil, for allowing the data collection at their facilities.
Conflict of interest
The authors declare no conflict of interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Schultz, L.F., Kroll, C., Constantino, B. et al. Association of Maternal Depression and Anxiety Symptoms with Sleep Duration in Children at Preschool Age. Matern Child Health J 24, 62–72 (2020). https://doi.org/10.1007/s10995-019-02843-z
- Sleep deprivation
- Preschool age