# Socio-ecological factors linked to co-occurring early childhood sleep health disparities and developmental outcomes

> **NIH NIH R01** · CHILDREN'S HOSP OF PHILADELPHIA · 2022 · $780,851

## Abstract

PROJECT SUMMARY/ABSTRACT
There is an urgent need to address pediatric sleep health disparities in early childhood, as sleep deficiencies
disproportionately affect racially/ethnically minoritized children and negatively impact crucial neurobehavioral
and social-emotional development. Two common early childhood sleep deficiencies linked to adverse
outcomes are (1) sleep disordered breathing (SDB), which ranges from snoring to severe obstructive sleep
apnea (OSA), and (2) insufficient sleep, or sleeping less than age-based 24-hour sleep guidelines. Compared
to non-Latinx White (hereafter ‘White’) youth, non-Latinx Black/African American (‘Black’) youth are 4-6 times
more likely to experience SDB and are also more likely to experience short sleep duration. SDB and
insufficient sleep also often co-occur in young children. The mechanisms of racial disparities in co-occurring
SDB and insufficient sleep and their developmental impacts are poorly understood, which impedes effective
intervention. The long-term goal of this research is to develop multi-level interventions that leverage modifiable
socio-ecological factors to reduce the incidence and developmental consequences of common, co-occurring
racial sleep health disparities in preschoolers. To achieve this goal, there is a critical need to identify the
factors that contribute to or buffer against these disparities and their developmental impacts. Although
socioeconomic disparities in SDB and insufficient sleep are well documented, family factors including caregiver
stress, health literacy, and work schedules are rarely considered. Few studies have examined other modifiable
family factors, such as bedtime routines, bedtime electronics, and parenting practices, which may contribute to
or buffer against disparities in these sleep deficiencies and related outcomes. Furthermore, ongoing personally
mediated and structural racism faced by Black families, teachers’ racial bias, childcare quality, and
neighborhood characteristics are likely, but understudied, contributors to these disparities. To address these
gaps and inform effective interventions, the objectives of this work are to (1) examine racial disparities in the
neurobehavioral and social-emotional impacts of early childhood SDB and/or insufficient sleep and (2) identify
proximal and distal socio-ecological factors linked to these racial disparities in sleep-related outcomes. Black
and White 3-5-year-olds will be recruited with (A) SDB only, (B) insufficient sleep only, (C) SDB and insufficient
sleep, and (D) matched healthy controls to examine the following aims, using a multi-method, multi-informant
approach with caregiver and teacher reporters, observational tasks, and qualitative methods. Aim 1 will
compare neurobehavioral (executive functioning, attention, vigilance) and social-emotional functioning (social
skills, emotion regulation) in groups A, B, C, and D. Aim 2 will identify modifiable family factors that contribute
to sleep-related racial ...

## Key facts

- **NIH application ID:** 10450469
- **Project number:** 1R01HL163798-01
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Ariel A Williamson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $780,851
- **Award type:** 1
- **Project period:** 2022-08-20 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10450469

## Citation

> US National Institutes of Health, RePORTER application 10450469, Socio-ecological factors linked to co-occurring early childhood sleep health disparities and developmental outcomes (1R01HL163798-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10450469. Licensed CC0.

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