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Bedtime Inconsistency, Sugary Drink Consumption, and Anxiety Among a Nationally Representative Sample of U.S.
Adam P Knowlden1, Sarah M Flora1, Ashley L Merianos2
1Department Of Health Science, The University of Alabama, Tuscaloosa, Alabama, USA.
Insights
Consistent bedtime routines are linked to better child mental health, while sugary drink consumption is more strongly associated with physical health outcomes like obesity. Addressing both may improve overall child well-being.
Area of Science:
- Child Health
- Behavioral Science
- Public Health
Background:
- Bedtime consistency is a key family routine impacting children's sleep and emotional well-being.
- Irregular bedtimes may correlate with unhealthy dietary behaviors, such as sugar-sweetened beverage consumption, a risk factor for child anxiety and obesity.
- Limited population-level data exist on these combined behaviors and their impact on child mental and physical health.
Purpose of the Study:
- To examine the associations between bedtime inconsistency, sugary drink consumption, and child anxiety and overweight or obesity.
- To investigate the independent and combined effects of sleep routines and dietary habits on child health outcomes.
Main Methods:
- Utilized data from the 2024 National Survey of Children's Health (ages 3-17).
- Employed design-based logistic regression to analyze associations between bedtime inconsistency, sugary drink intake, anxiety, and overweight/obesity.
- Adjusted for complex survey design, demographics, and socioeconomic/behavioral factors in sensitivity analyses.
Main Results:
- Children with inconsistent bedtimes showed higher odds of frequent and moderate sugary drink consumption.
- Frequent sugary drink consumption was linked to increased odds of anxiety.
- Bedtime inconsistency remained significantly associated with anxiety across adjusted models.
- Sugary drink consumption was robustly associated with overweight or obesity, while bedtime inconsistency's link to it was attenuated after full adjustment.
Conclusions:
- Bedtime inconsistency is a significant correlate of child anxiety.
- Sugary drink consumption shows a stronger association with overweight or obesity in children.
- Sleep routines and dietary behaviors represent distinct, potentially modifiable factors influencing child mental and physical health.
Background:
Bedtime consistency is a family-regulated routine associated with children's sleep and emotional well-being. Irregular bedtimes may co-occur with unhealthy dietary behaviors, including sugar-sweetened beverage consumption, which has been linked to child anxiety and obesity risk. However, population-level studies examining these behaviors across both mental and physical health outcomes remain limited.
Methods:
Data were drawn from the 2024 National Survey of Children's Health and restricted to children aged 3-17 years. Design-based logistic regression models examined associations between bedtime inconsistency, sugary drink consumption, anxiety, and overweight or obesity (≥85th percentile). Analyses accounted for complex survey design and adjusted for age group, sex, and race or ethnicity. Sensitivity analyses incorporated socioeconomic, family, and behavioral characteristics.
Results:
Children with inconsistent bedtimes had higher odds of frequent sugary drink consumption (aOR = 2.51, 95% CI: 2.10-3.00) and moderate consumption (aOR = 1.46, 95% CI: 1.23-1.72). Frequent sugary drink consumption was associated with higher odds of anxiety (aOR = 1.28, 95% CI: 1.10-1.49). Bedtime inconsistency remained associated with anxiety in demographic-adjusted (aOR = 1.89, 95% CI: 1.63-2.18) and fully adjusted sensitivity analyses (aOR = 1.54, 95% CI: 1.33-1.79). Bedtime inconsistency was associated with overweight or obesity in demographic-adjusted models but was attenuated following expanded adjustment. In contrast, sugary drink consumption remained associated with overweight or obesity across model specifications.
Conclusions:
Bedtime inconsistency was consistently associated with anxiety, whereas sugary drink consumption demonstrated more robust associations with overweight or obesity. These findings suggest that sleep-related routines and dietary behaviors may represent distinct, modifiable correlates of child mental and physical health.
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