Associations between community violence and pediatric sleep health: A systematic review

Inadequate sleep during childhood can have a lasting negative impact on lifelong health. Children living in disadvantaged neighborhoods are more likely to be exposed to community violence, which may disrupt sleep health. The purpose of this systematic review was to examine the associations between community violence and pediatric sleep health. We searched 4 electronic databases (CINAHL, Scopus, PubMed, and Embase) to identify articles that examined the associations between community violence and pediatric sleep health. We screened 2271 articles and included 29 eligible studies. Studies focused on sleep quality (n = 4), daytime sleepiness (n = 8), sleep timing (n = 4), sleep efficiency (n = 7), duration (n = 13), and sleep disturbance (n = 19). Most studies included adolescents (n = 18); others included infants (n = 1), those in early childhood (n = 2), and a wide range of ages (n = 7). Six studies were of fair quality, while 5 were of poor quality, often due to the use of measures that were not psychometrically sound and incomplete sample descriptions. Community violence exposure was consistently negatively associated with pediatric sleep health. Consistent definitions and measures of sleep and community violence are needed to promote rigor and comparisons across studies. Future studies should include infants and children under the age of 6 years and address potential risk and protective factors for sleep health. Research is needed to inform policy changes and multilevel community-based interventions to help buffer the harmful effects of community violence and promote pediatric sleep health.