Sleep duration in preschool age and later behavioral and cognitive outcomes: an individual participant data meta-analysis in five European cohorts

Guerlich, Kathrin; Avraam, Demetris; Cadman, Tim; Calas, Lucinda; Charles, Marie-Aline; Elhakeem, Ahmed; Fernández-Barrés, Sílvia; Guxens Junyent, Mònica; Heude, Barbara; Ibarluzea, Jesús; Inskip, Hazel; Julvez, Jordi; Lawlor, Deborah; Murcia, Mario; Salika, Theodosia; Sunyer Deu, Jordi; Tafflet, Muriel; Koletzko, Berthold; Grote, Veit; Plancoulaine, Sabine

Sleep duration in preschool age and later behavioral and cognitive outcomes: an individual participant data meta-analysis in five European cohorts

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dc.contributor.author Guerlich, Kathrin
dc.contributor.author Avraam, Demetris
dc.contributor.author Cadman, Tim
dc.contributor.author Calas, Lucinda
dc.contributor.author Charles, Marie-Aline
dc.contributor.author Elhakeem, Ahmed
dc.contributor.author Fernández-Barrés, Sílvia
dc.contributor.author Guxens Junyent, Mònica
dc.contributor.author Heude, Barbara
dc.contributor.author Ibarluzea, Jesús
dc.contributor.author Inskip, Hazel
dc.contributor.author Julvez, Jordi
dc.contributor.author Lawlor, Deborah
dc.contributor.author Murcia, Mario
dc.contributor.author Salika, Theodosia
dc.contributor.author Sunyer Deu, Jordi
dc.contributor.author Tafflet, Muriel
dc.contributor.author Koletzko, Berthold
dc.contributor.author Grote, Veit
dc.contributor.author Plancoulaine, Sabine
dc.date.accessioned 2023-03-27T08:20:24Z
dc.date.available 2023-03-27T08:20:24Z
dc.date.issued 2024
dc.description.abstract Short sleep duration has been linked to adverse behavioral and cognitive outcomes in schoolchildren, but few studies examined this relation in preschoolers. We aimed to investigate the association between parent-reported sleep duration at 3.5 years and behavioral and cognitive outcomes at 5 years in European children. We used harmonized data from five cohorts of the European Union Child Cohort Network: ALSPAC, SWS (UK); EDEN, ELFE (France); INMA (Spain). Associations were estimated through DataSHIELD using adjusted generalized linear regression models fitted separately for each cohort and pooled with random-effects meta-analysis. Behavior was measured with the Strengths and Difficulties Questionnaire. Language and non-verbal intelligence were assessed by the Wechsler Preschool and Primary Scale of Intelligence or the McCarthy Scales of Children's Abilities. Behavioral and cognitive analyses included 11,920 and 2981 children, respectively (34.0%/13.4% of the original sample). In meta-analysis, longer mean sleep duration per day at 3.5 years was associated with lower mean internalizing and externalizing behavior percentile scores at 5 years (adjusted mean difference: - 1.27, 95% CI [- 2.22, - 0.32] / - 2.39, 95% CI [- 3.04, - 1.75]). Sleep duration and language or non-verbal intelligence showed trends of inverse associations, however, with imprecise estimates (adjusted mean difference: - 0.28, 95% CI [- 0.83, 0.27] / - 0.42, 95% CI [- 0.99, 0.15]). This individual participant data meta-analysis suggests that longer sleep duration in preschool age may be important for children's later behavior and highlight the need for larger samples for robust analyses of cognitive outcomes. Findings could be influenced by confounding or reverse causality and require replication.
dc.description.sponsorship Open Access funding enabled and organized by Projekt DEAL. This research (LifeCycle Project ID: ECCNLC201914) was funded by the European Union’s Horizon 2020 research and innovation programme under Grant Agreement N: 733206, LifeCycle project. Kathrin Guerlich was granted a LifeCycle Fellowship (Grant Agreement N: 733206, LifeCycle project). Berthold Koletzko is the Else Kröner Seniorprofessor of Paediatrics at LMU – University of Munich, financially supported by Else Kröner-Fresenius-Foundation, LMU Medical Faculty and LMU University Hospital. Deborah A Lawlor and Ahmed Elhakeem work in a Unit that receives support from the University of Bristol and UK Medical Research Council (MC_UU_00011/6). Deborah A Lawlor is a British Heart Foundation Chair (CH/F/20/90003) and a National Institute of Health Research Senior Investigator (NF-0616–10102). Mònica Guxens is funded by a Miguel Servet II fellowship (CPII18/00018) awarded by the Spanish Institute of Health Carlos III. Jordi Julvez holds Miguel Servet-II contract (CPII19/00015) awarded by the Instituto de Salud Carlos III (Co-funded by European Social Fund "Investing in your future"). Tim Cadman was funded a Marie Sklodowska-Curie Individual Fellowship. Funding details for each cohort are provided in Online Resource 1. No funder had any influence on the study design, data collection, statistical analyses or interpretation of findings. The views expressed in this paper are those of the authors and not necessarily of any funders.
dc.format.mimetype application/pdf
dc.identifier.citation Guerlich K, Avraam D, Cadman T, Calas L, Charles MA, Elhakeem A, et al. Sleep duration in preschool age and later behavioral and cognitive outcomes: an individual participant data meta-analysis in five European cohorts. Eur Child Adolesc Psychiatry. 2024 Jan;33(1):167-77. DOI: 10.1007/s00787-023-02149-0
dc.identifier.doi http://dx.doi.org/10.1007/s00787-023-02149-0
dc.identifier.issn 1018-8827
dc.identifier.uri http://hdl.handle.net/10230/56358
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartof Eur Child Adolesc Psychiatry. 2024 Jan;33(1):167-77
dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/733206
dc.rights © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject.keyword Externalizing behavior
dc.subject.keyword Internalizing behavior
dc.subject.keyword Language
dc.subject.keyword Multi-cohort analysis
dc.subject.keyword Non-verbal intelligence
dc.subject.keyword Preschool sleep duration
dc.title Sleep duration in preschool age and later behavioral and cognitive outcomes: an individual participant data meta-analysis in five European cohorts
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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