Objective and subjective socioeconomic gradients exist for sleep in children and adolescents

Socioeconomic position (SEP) is inversely associated with many health outcomes, yielding a socioeconomic gradient in health. In adults, low SEP is associated with short sleep duration, poorer sleep quality, and difficulty initiating and maintaining sleep. Relatively little is known about this relation in youth. The aim of the present study was to examine whether socioeconomic gradients exist for various sleep indices among a healthy sample of children and adolescents.

Participants took part in the larger Healthy Heart Project and included 239 youth (69.6% Caucasian; 45.6% female), aged 8-17 years (M = 12.6, SD = 1.9). Parental income and education were used to measure objective SEP. The Subjective Social Status Scale-Youth Version was used to measure subjective SEP. Sleep duration, sleep quality, daytime sleepiness, and sleep disturbances were assessed through self- and parent-report.

In children, objective SEP was related with sleep duration (β = .35, p < .01), although subjective SEP was related with daytime sleepiness (βavg = .33, p < .01) and parent-reported sleep duration (β = .23, p < .05). In adolescents, subjective SEP was related with sleep quality (β = .28, p < .01) and parent-reported sleep duration (β = -.18, p < .05), even after controlling for objective SEP.

Socioeconomic gradients were observed for multiple sleep measures in youth. Objective parental SEP was related with sleep complaints (e.g., sleep disturbances), and subjective SEP was related with sleep quality and daytime sleepiness. Findings suggest sleep may be one pathway underlying the socioeconomic gradient in health. Future research should aim to elucidate how distinct sleep constructs may explain how socioeconomic status "gets under the skin" to affect health.