Published online October 19, 2009
PEDIATRICS Vol. 124 No. 5 November 2009, pp. e985-e993 (doi:10.1542/peds.2008-2005)

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ARTICLE

Short Nighttime Sleep-Duration and Hyperactivity Trajectories in Early Childhood

Evelyne Touchette, PhD^a,b, Sylvana M. Côté, PhD^a,c, Dominique Petit, PhD^b, Xuecheng Liu, PhD^d, Michel Boivin, PhD^e, Bruno Falissard, MD, PhD^a, Richard E. Tremblay, PhD^a,d,f,g,h and Jacques Y. Montplaisir, MD, CRCP(c), PhD^b,i

^a International Laboratory for Child and Adolescent Mental Health Development, INSERM U669, France and University of Montreal, Canada
^c Department of Social and Preventive Medicine, University of Montreal, Canada
^b Sleep Disorders Centre, Sacré-Coeur Hospital, Montreal, Canada
^d Research Unit on Children's Psychosocial Maladjustment, University of Montreal, Canada
^e Research Unit on Children's Psychosocial Maladjustment, Laval University, Canada
^f Research Centre, Ste-Justine Hospital, Montreal, Canada
^g Departments of Pediatrics and Psychology, University of Montreal, Canada
^h School of Public Health and Population Science, University College Dublin, Ireland
ⁱ Department of Psychiatry, University of Montreal, Canada

OBJECTIVES: Our objectives were to investigate the developmental trajectories of nighttime sleep duration and hyperactivity over the preschool years and to identify the risk factors associated with short nighttime sleep duration and high hyperactivity scores.

DESIGN, SETTING, AND PARTICIPANTS: Nighttime sleep duration and hyperactivity were measured yearly by questionnaires administered to mothers of 2057 children from age 1.5 to 5 years. Developmental trajectories of nighttime sleep duration and hyperactivity throughout early childhood were analyzed to determine interassociations. A multinomial logistic regression was performed to determine which factors among selected child, maternal, and family characteristics and parental practices surrounding sleep periods in early childhood were associated with short nighttime sleep duration and high hyperactivity scores.

RESULTS: The trajectories of nighttime sleep duration and hyperactivity were significantly associated. The odds ratio (OR) of reporting short nighttime sleep duration was 5.1 for highly hyperactive children (confidence interval [CI]: 3.2–7.9), whereas the OR of reporting high hyperactivity scores was 4.2 for persistently short sleepers (CI: 2.7–6.6). The risk factors for reporting short nighttime sleep duration and high hyperactivity scores were (1) being a boy, (2) having insufficient household income, (3) having a mother with a low education, and (4) being comforted outside the bed after a nocturnal awakening at 1.5 years of age.

CONCLUSIONS: The risk of short nighttime sleep duration in highly hyperactive children is greater than the risk of high hyperactivity scores in short sleepers. Preventive interventions that target boys living in adverse familial conditions could be used to address these concomitant behavioral problems.

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Key Words: hyperactivity • longitudinal study • risk factors • sleep patterns

Abbreviations: OR—odds ratio • CI—confidence interval

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Accepted Jun 5, 2009.

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