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Early sleep duration trajectories and children’s cognitive development: a prospective cohort study

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Abstract

We aimed to investigate the association between sleep duration trajectories and cognitive performance in preschool-aged Chinese children. We included 2131 children from the Ma’anshan birth cohort (MABC) study. Sleep duration trajectories from 6 to 48 months of age were determined using the group-based trajectory modeling (GBTM). Children’s intellectual development was assessed using the Wechsler Preschool and Primary Scale of Intelligence. Compared to those with a medium total sleep duration trajectory, children with a short total sleep duration trajectory had poorer cognitive performance on the Visual Spatial Index (VSI) (β = −3.65; 95% CI = −6.77 to −0.53), which was associated with an increased risk of a low full-scale intelligence quotient (FSIQ) (OR = 1.60; 95% CI = 1.02 to 2.51). The short total sleep duration trajectory was associated with a low VSI compared with both the medium total sleep duration trajectory and the long total sleep duration trajectory. Compared to children with normal nighttime sleep duration and normal daytime sleep duration trajectories, children with short nighttime sleep and long daytime sleep duration trajectories, normal nighttime sleep and long daytime sleep duration trajectories, and short nighttime sleep and normal daytime sleep duration trajectories all had lower cognitive performance. The restricted cubic spline (RCS) also showed that children with and appropriate total sleep duration, an adequate nighttime sleep duration, and a moderate daytime sleep duration had higher FSIQ.

Conclusions: The results of this study emphasize that a medium total sleep duration, adequate sleep at nighttime, and appropriate sleep in the daytime appear to be more beneficial for children’s cognitive development.

What is Known:

• Sleep duration in infancy is strongly associated with neurocognitive development.

What is New:

• Medium and long total sleep duration trajectories are beneficial for children’s cognitive performance compared to the short total sleep duration trajectory.

• A medium total sleep duration, adequate sleep at nighttime and appropriate sleep in the daytime appear to be more beneficial for children’s cognitive development.

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Availability of data and materials

The datasets used and/or analyzed in the current study are available upon reasonable request to the corresponding author.

Abbreviations

CSHQ:

Child Sleep Habits Questionnaire

WAIS-RC:

Wechsler Adult Intelligence Scale-Revised by China

DAG:

Directed acyclic graph

VCI:

Verbal comprehension index

VSI:

Visual spatial index

FRI:

Fluid reasoning index;

WMI:

Working memory index

PSI:

Processing speed index

FSIQ:

Full-scale intelligence quotient

GBTM:

Group-based trajectory modeling

MABC:

Ma’anshan birth cohort

BISQ:

Brief Infant Sleep Questionnaire

BIC:

Bayesian information criteria

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Acknowledgements

We are grateful for all mother-child pairs in MABC, and all staff who have contributed their valuable time and efforts to the cohort follow-up.

Funding

The research was supported by the National Natural Science Foundation of China (82273639); the National Key Research and Development Program (2022YFC27022901), Regional Innovation and Development Joint Fund of the National Natural Science Foundation of China (U22A20361), and Research Fund of Anhui Institute of translational medicine (ZHYX2020A001).

Author information

Authors and Affiliations

  1. Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China

    Jixing Zhou, Linlin Zhu, Yuzhu Teng, Shuangqin Yan, Fangbiao Tao & Kun Huang

  2. Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China

    Jixing Zhou, Linlin Zhu, Yuzhu Teng, Fangbiao Tao & Kun Huang

  3. NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China

    Jixing Zhou, Linlin Zhu, Yuzhu Teng, Fangbiao Tao & Kun Huang

  4. Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China

    Jixing Zhou, Linlin Zhu, Yuzhu Teng, Juan Tong, Fangbiao Tao & Kun Huang

  5. Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China

    Kun Huang

  6. Maternal and Child Health Care Center of Ma’anshan, No 24 Jiashan Road, Ma’anshan, 243011, Anhui, China

    Guopeng Gao & Shuangqin Yan

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  1. Jixing Zhou
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  8. Kun Huang
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Contributions

FBT, HK, and SQY were responsible for the conception and design of the cohort. JXZ, YZT, LLZ, JT, GPG, SQY, FBT, and HK were responsible for the follow-up of the cohort. JXZ and YZT were responsible for the acquisition and analysis of data. All authors took part in drafting the manuscript and approved the final version.

Corresponding author

Correspondence to Kun Huang.

Ethics declarations

Ethical approval

The study was approved by the ethics committees of Anhui medical university (No. 20131195). We confirm that all methods in this study were performed in accordance with the relevant guidelines and regulations.

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This is not applicable.

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The authors declare no competing interests.

Additional information

Communicated by Gregorio Milani

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Zhou, J., Zhu, L., Teng, Y. et al. Early sleep duration trajectories and children’s cognitive development: a prospective cohort study. Eur J Pediatr 182, 5353–5365 (2023). https://doi.org/10.1007/s00431-023-05195-7

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