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A Community-Based Study of Sleep and Cognitive Development in Infants and Toddlers
Wanqi Sun1,2, Shirley Xin Li2,3, Yanrui Jiang1
1Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China.
Insights
Nighttime awakenings impact infant and toddler cognitive development differently. Frequent awakenings may harm toddler cognition, while a moderate amount may benefit infant cognitive scores.
Area of Science:
- Developmental Psychology
- Pediatrics
- Sleep Science
Background:
- Nighttime awakenings are common in infants and toddlers.
- Understanding the relationship between sleep patterns and cognitive development is crucial for early childhood.
Purpose of the Study:
- To determine the prevalence and factors associated with nighttime awakenings in young children.
- To investigate the link between sleep disturbances and cognitive development in infants and toddlers.
Main Methods:
- A community-based study involving 590 infants (2-11 months) and 512 toddlers (12-30 months) in China.
- Sleep data collected via the Brief Infant Sleep Questionnaire; cognitive development assessed using the Bayley Scales of Infant Development.
Main Results:
- Prevalence of frequent nighttime awakenings (≥3 times/night) was higher in infants (39.3%) than toddlers (15.8%).
- Nighttime awakenings were linked to younger age, lower maternal education, and breastfeeding. Infants with 2 awakenings/night showed higher Mental Development Index (MDI) scores, while toddlers with ≥3 awakenings/night had lower MDI scores.
- Total sleep duration was not significantly associated with cognitive development in either group.
Conclusions:
- Nighttime awakenings exhibit a nonlinear association with cognitive performance in infants, but frequent awakenings are linked to poorer cognitive function in toddlers.
- These findings highlight the complex interplay between sleep and cognitive development in early childhood.
- Further research, including longitudinal and intervention studies, is recommended to explore parent-based sleep interventions.
Study Objectives:
To examine the prevalence and correlates of nighttime awakenings and to explore the association between sleep and cognitive development in a community sample of infants and toddlers.
Methods:
A total of 590 healthy infants (aged 2-11 months) and 512 toddlers (aged 12-30 months) from 8 provinces of China were assessed for their sleep and cognitive development. Data on sleep duration and nighttime awakenings were collected through the Brief Infant Sleep Questionnaire. Cognitive development was assessed by trained pediatricians using the Bayley Scales of Infant Development.
Results:
Prevalence of no nighttime awakening, and nighttime awakening(s) for 1×/night, 2×/night, and ≥ 3×/night was 6.8%, 20.2%, 33.2%, and 39.3% in infants, and was 25.8%, 34.6%, 23.8%, and 15.8% in toddlers, respectively. Nighttime awakenings were generally associated with younger age, lower maternal education level, and being currently breastfed. In addition, nighttime awakenings were associated with being boys in toddlers. After controlling for potential confounders, infants with nighttime awakenings for 2×/night were found to have significantly higher Mental Development Index (MDI) score, as compared to those without and those with more frequent nighttime awakenings. However, toddlers with nighttime awakenings for ≥ 3×/night had significantly lower MDI, as compared to those with fewer nighttime awakenings. Total sleep duration was not associated with any developmental indices in both infants and toddlers.
Conclusions:
Frequent nighttime awakenings are associated with poor cognitive functions in toddlers. Meanwhile, a nonlinear association between nighttime awakenings and cognitive performance was found among infants. The findings provide a developmental context for the effect of sleep on cognitive abilities in young children. Further longitudinal studies and interventional studies on the effects of parent-based sleep-focused intervention on cognitive abilities among young children are warranted.
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