Individual, Social and Environmental Influences on Sleep in Latino Pre-Adolescents: A Qualitative Analysis

A community-based qualitative study identified multilevel influences on sleep duration, quality, and timing in 10 to 12-year-old Latino pre-adolescents via 11 focus groups with 46 children and 15 interviews with parents. An iterative content analysis revealed three themes negatively and positively impacted sleep: (1) Individual-level; (2) Social-level; and (3) Environmental-level influences. At the individual level, use of technology (e.g., phones), activity levels (e.g., sitting all day), dietary intake (e.g., junk food) and emotions (e.g., stress/anxiety) were reported to impact children's sleep. Social-level influences included interactions with peers and family members as well as time hanging out and arguing/fighting. Environmental-level influences were living in home and neighborhood settings with certain sounds (e.g., soothing music), uncomfortable temperatures, and items/things (e.g., stuffed animal) in the sleeping area. Parent reports indicated that some factors at each level were exacerbated by the COVID-19 pandemic. Findings that influences at various levels interacted to impact sleep illustrate the need to simultaneously account for multiple levels of influence to best inform intervention development. Thus, application of social ecological models of behavior change to interventions may enhance sleep duration, quality, and timing among Latino pre-adolescents, as these models account for single as well as interacting influences to explain behavior.