Material Hardships and Infant and Toddler Sleep Duration in Low-Income Hispanic Families

Publication Date


Journal Title

Acad Pediatr


© 2020 Academic Pediatric Association Objective: To assess relationships between material hardships, shortened sleep duration, and suboptimal sleep practices across infancy and toddlerhood in low-income Hispanic families. Methods: We analyzed longitudinal data of 451 low-income Hispanic mother-child pairs from a child obesity prevention trial. During infancy and toddlerhood, we used adjusted linear regression to assess associations between material hardship (financial difficulty, food insecurity, housing disrepair, and multiple hardships), sleep duration (24-hour, night), and the number of suboptimal sleep practices (eg, later bedtime, co-sleeping). We used adjusted linear regression to assess the longitudinal association between the number of suboptimal sleep practices in infancy and toddlerhood, and tested whether specific or multiple hardships moderated this association. Results: In infants, financial difficulty and multiple hardships were associated with decreased night sleep (B = −0.59 hours, 95% confidence interval [CI]: −1.04, −0.14; and B = −0.54 hours, 95% CI: −1.00, −0.08). Housing disrepair was associated with decreased 24-hour sleep (B = −0.64 hours, 95% CI: −1.29, −0.01). In toddlers, each additional suboptimal sleep practice was associated with a decrease in night sleep (B = −0.19 hours, 95% CI: −0.29, −0.09). Each additional suboptimal sleep practice in infancy was associated with a 0.30 increase in the number of suboptimal sleep practices in toddlerhood (P < .001), with greater increases for those with food insecurity or multiple hardships. Conclusion: Specific and multiple hardships shortened sleep duration during infancy, and moderated the increase of suboptimal sleep behaviors between infancy and toddlerhood. Future studies should consider these early critically sensitive periods for interventions to mitigate material hardships and establish healthy sleep practices.

Volume Number


Issue Number



1184 - 1191

Document Type





School of Medicine

Primary Department

General Pediatrics






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