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Keywords:

  • childhood;
  • optimism;
  • self-esteem;
  • sleep quality;
  • sleep quantity

Summary

  1. Top of page
  2. Summary
  3. Introduction
  4. Materials and methods
  5. Results
  6. Discussion
  7. Acknowledgements
  8. Conflict of interest
  9. References

We tested the relationship of objectively measured sleep quantity and quality with positive characteristics of the child. Sleep duration, sleep latency and sleep efficiency were measured by an actigraph for an average of seven (range = 3–14) consecutive nights in 291 8-year-old children (standard deviation = 0.3 years). Children’s optimism, self-esteem and social competence were rated by parents and/or teachers. Sleep duration showed a non-linear, reverse J-shaped relationship with optimism (= 0.02), such that children with sleep duration in the middle of the distribution scored higher in optimism compared with children who slept relatively little. Shorter sleep latency was related to higher optimism (= 0.01). The associations remained when adjusting for child’s age, sex, body mass index, and parental level of education and optimism. In conclusion, sufficient sleep quantity and good sleep quality are related to children’s positive characteristics. Our findings may inform why sleep quantity and quality and positive characteristics are associated with wellbeing in children.


Introduction

  1. Top of page
  2. Summary
  3. Introduction
  4. Materials and methods
  5. Results
  6. Discussion
  7. Acknowledgements
  8. Conflict of interest
  9. References

Insufficient sleep quantity and poor sleep quality, defined as short sleep duration, long sleep latency and low sleep efficiency, are common among adults as well as children. In industrialized countries, the average sleep duration among adults (Bonnet and Arand, 1995; Rajaratnam and Arendt, 2000; Iglowstein et al., 2003) has decreased substantially during the past few decades, and complaints about poor sleep quality are frequent (Heath et al., 1998; Sateia et al., 2000). Estimates are that between 20 and 40% of children suffer from poor sleep (Fricke-Oerkermann et al., 2007; Liu et al., 2005; Smaldone et al., 2007), with half of them having persistent problems over time (Fricke-Oerkermann et al., 2007).

Epidemiological evidence in adults shows that both short and/or long sleep duration and poor sleep quality relate to a wide spectrum of detrimental physical health consequences, such as obesity (Gangwisch et al., 2005; Hasler et al., 2004; Patel and Hu, 2008; Vioque et al., 2000), type 2 diabetes (Ayas et al., 2003b; Gangwisch et al., 2007; Knutson et al., 2006; Yaggi et al., 2006), hypertension (Gangwisch et al., 2006), coronary heart disease (Ayas et al., 2003a) and even premature death (Ferrie et al., 2007; Heslop et al., 2002; Hublin et al., 2007; Kojima et al., 2000; Kripke et al., 2002; Tamakoshi and Ohno, 2004). Insufficient sleep quantity is also associated with poor health in children and adolescents. Children with shorter sleep duration are more likely to be obese (Patel and Hu, 2008; for meta analyses, see Cappuccio et al., 2008; Chen et al., 2008), and prospective studies show that short sleep duration predicts a higher body mass index (BMI) later in childhood (Reilly et al., 2005) and in adolescence (Snell et al., 2007). Furthermore, poor sleep in children is associated with poorer cognitive performance (Meijer et al., 2000; Randazzo et al., 1998; Sadeh et al., 2002; Touchette et al., 2007), and with depression, anxiety, conduct problems and hyperactivity (Aronen et al., 2000; Cohen-Zion and Ancoli-Israel, 2004; El-Sheikh et al., 2007; Gregory and O’Connor, 2002; Gregory et al., 2004; Ivanenko et al., 2006).

Relative to the wealth of studies focusing on the negative consequences of poor sleep, much less is known about the beneficial consequences of sufficient sleep quantity and good sleep quality. There is evidence that adults who get adequate sleep report more optimism and satisfaction with life compared with adults who sleep less than 6 h a night (National Sleep Foundation, 2002). Experimentally induced sleep deprivation in adults results in a gradual reduction in optimism and sociability, suggesting that the association between sufficient sleep and these positive characteristics may be causal (Haack and Mullington, 2005). In adolescents, longer sleep duration predicts prospectively higher self-esteem (Fredriksen et al., 2004). We are not aware of any studies focusing on associations between sufficient sleep quantity, good sleep quality and positive characteristics in young children.

Accordingly, we examined if children’s objectively measured sleep quantity and quality are associated with their level of optimism rated by parents, and with their level of self-esteem and social competence rated by parents and teachers. We focused on optimism, self-esteem and social competence, as a wealth of evidence suggests that these are important characteristics promoting good physical and mental health in children and/or in adults (Aspinwall and Taylor, 1992; Ben-Zur, 2003; Bromberger and Matthews, 1996; Burt et al., 2008; Carvajal et al., 1998; Chang and Mackenzie, 1998; Matthews et al., 2004; McGee and Williams, 2000; O’Donnell et al., 2008; Orth et al., 2008; Räikkönen et al., 1999; Reitzes and Mutran, 2006; Roberts et al., 1998; Scheier and Carver, 2003; Stamatakis et al., 2004; Trzesniewski et al., 2006). Indeed, more optimistic/less pessimistic children and/or adolescents show lower ambulatory blood pressure (Räikkönen and Matthews, 2008), and they report more positive and less negative effects, depression, hopelessness, suicidal ideation and substance abuse (Ben-Zur, 2003; Carvajal et al., 1998; Roberts et al., 1998). Parents report that their more optimistic children have less internalizing and externalizing behaviour problems (Lemola et al., 2010). Children and/or adolescents with higher self-esteem show better self-, parent- and teacher-rated psychological adjustment, better self-reported school adjustment, higher grade levels, less self-reported delinquency and health-compromising behaviour, and better objective and subjective health later in life (Aspinwall and Taylor, 1992; Donnellan et al., 2005; McGee and Williams, 2000; Orth et al., 2008; Trzesniewski et al., 2006). Higher social competence in children relates to better peer-reported social acceptance, less parent- and teacher-reported problem behaviour, higher grade levels, and predicts a lower risk to develop psychopathology later in life (Burt et al., 2008; Chen et al., 2000; Rubin et al., 1998). We hypothesized that children whose sleep duration is sufficient (not short or long in duration), and who have shorter sleep latency and higher sleep efficiency would be more optimistic and less pessimistic, and would have higher self-esteem and social competence, relative to their same-aged peers with compromised sleep quantity and quality.

Materials and methods

  1. Top of page
  2. Summary
  3. Introduction
  4. Materials and methods
  5. Results
  6. Discussion
  7. Acknowledgements
  8. Conflict of interest
  9. References

Participants

The children came from an initial cohort comprising 1049 infants born between 1 March and 30 November 1998 in Helsinki, Finland, and their mothers. In 2006, children and their parents were invited to participate in a follow-up with a focus on individual differences in physical and psychological development (Räikkönen et al., 2009). Nine-hundred and fifty-eight (91.3%) mothers of the initial cohort gave permission to be included in the follow-up; 922 (87.9%) could be contacted. Of these, a subsample of 413 children was invited for a follow-up examination, and 321 (77.7%) agreed to participate. Non-participation did not relate to child’s gender, birth date, weight, length, head circumference or BMI at birth, birth order, mode of delivery, mother’s gestational diabetes, gestational hypertension, preeclampsia, age, height, weight, BMI, occupational status or blood pressure at delivery, alcohol consumption, licorice confectionery consumption or stress during pregnancy (all P-values > 0.10); non-participation was related to more frequent maternal smoking during pregnancy (= 0.02). The Ethical Committee of the City of Helsinki Health Department and the Ethical Committee of the Helsinki University Hospital of Children and Adolescents and the Uusimaa Hospital District approved the project. Each child and its parent gave an informed consent.

Of the 321 children participating in the follow-up, 305 participated in the actigraphy protocol, of whom 291 (91%; 150 girls and 141 boys) provided valid readings. Three-hundred and five children had maternal and 227 children had paternal ratings of child optimism, self-esteem and social competence available; 255 children had teacher ratings of child self-esteem and social competence available. The analyses excluded children who, according to parental report, had been diagnosed with a developmental delay (= 3) or Asperger syndrome (= 1).

Measures

Sleep quantity and quality

Sleep parameters were estimated from actigraphy data by automatic scoring (Actiwatch AW4, Cambridge Neurotechnology, UK) and subsequent manual verification. The wrist actigraph is approximately the size of a standard wristwatch and provides a non-intrusive instrument to measure sleep parameters by assessing body movement (Sadeh et al., 1995). As described elsewhere (Paavonen et al., 2009; Pesonen et al., 2009a), the participants were instructed to wear the actigraphs for at least seven consecutive days on their non-dominant wrist; on average, the devices were worn for 7.1 days (SD = 1.2; 3–4 days, = 2; 5 days, = 6; 6 days, = 43; 7 days, = 171; 8 days, = 41; 9 days, = 25; 10 days, = 6; 11–14 days, = 3), including nights on weekdays (mean = 5.1, SD = 1.0; range 1–10) and weekends (mean = 2.0, SD = 0.4; range 1–4). We instructed the parents to keep a sleep log on bedtimes and waking times, temporary pauses in actigraph registration (e.g. while taking a shower), and significant events that might affect sleep quantity or quality (illness, pain, injury, travel or other events likely to disturb sleep). The child was instructed to press a button (event marker) on the actigraph at bedtime and waking times. A completed sleep log was obtained from all participants, including both parent-reported sleep log and event markers on bedtimes and waking times reported by the child. The activity data were visually inspected to detect significant discrepancies among the sleep log, event markers and the activity pattern. If there were several event markers for one night, the most recent was used and compared with the sleep log. If the sleep log was not synchronous with the event marker, the event marker was used to define the bedtime. We found high concordance between the sleep log records and the event markers; for 71% of the participants, no discrepancies were found; for 21%, a discrepancy was found for one or two nights; and, for 8%, a discrepancy was found for three or more nights. Nights were excluded from further sleep analysis if: (a) the actigraph was not in use; (b) information on bedtime was missing; (c) the child was asleep according to the data of reported bedtime; (d) information on waking time was missing and the activity pattern was not unequivocally interpretable; or (e) the parent reported a change in normal life due to, for example, illness or travel. There were 257 participants (89%) without excluded nights. Data were scored with Actiwatch Activity & Sleep Analysis version 5.4 software with medium sensitivity and a 1-min epoch duration. Sleep duration refers to the actual sleeping time. Sleep latency was defined as the time it takes the child to fall asleep after he or she went to bed. We used the validated Actiwatch algorithm (Tonetti et al., 2008), which defines ‘sleep start’ as 10 min of consecutively recorded immobile data. Sleep efficiency was defined as the actual sleep time divided by the time in bed, thus including sleep latency.

Dispositional optimism

Dispositional optimism of the children was rated by their parents. The parents completed the Parent-rated Life Orientation Test of children (PLOT; Lemola et al., 2010). The PLOT is composed of eight items rated on a scale ranging from ‘not at all true of my child’ (1) to ‘very true of my child’ (4). Four items measure generalized optimistic expectations; a sample item is ‘When entering a new situation, my child expects to have fun’. The other four items measure generalized pessimistic expectations; a sample item is ‘My child often expects that the day will not turn out to be nice’. In addition to a total score derived from summing the optimism and reverse-scored pessimism items (a higher score indicates higher optimism), two subscale scores measuring higher optimism and higher pessimism can be derived by summing the four optimism items and the four pessimism items, respectively. As shown previously, the scale has good construct and convergent validity (Lemola et al., 2010). For the current analyses, mother and father ratings were averaged to increase reliability of measurement. The general coefficients of reliability (Tarkkonen and Vehkalahti, 2005) were 0.82, 0.85 and 0.78 for the combined mother- and father-rated total optimism scale, and optimism and pessimism subscales, respectively.

Self-esteem

Parents and teachers completed the Behavioral Rating Scale of Presented Self-Esteem in Young Children (Fuchs-Beauchamp, 1996; Haltiwanger and Harter, 1988). The scale has 15 items assessing young children’s behavioural manifestations of self-esteem (e.g. self-confidence, independence, initiative), which are rated on a four-point Likert scale. A sample item is ‘My child approaches challenging tasks with confidence’. The scale has good validity, internal consistency (Fuchs-Beauchamp, 1996; Verschueren et al., 2001) and stability over a 3-year period (= 0.59; Verschueren et al., 1998). For the current analyses, mother, father and teacher ratings were averaged to increase reliability of measurement. In the current study, the general coefficient of reliability (Tarkkonen and Vehkalahti, 2005) was 0.92 for the combined mother-, father- and teacher-rated scale.

Social competence

Parents and teachers completed the Social Competence subscale of the Social Competence and Behavior Evaluation Scale (the Short Form; SCBE-30; LaFreniere and Dumas, 1996). Social competence is defined as well-adjusted, flexible, emotionally mature and generally pro-social behaviour, and is assessed by 10 items rated on a six-point Likert scale. A sample item includes ‘My child comforts or assists another child in difficulty’. The scale has good construct validity and internal consistency (LaFreniere and Dumas, 1996). For the current analyses, mother, father and teacher ratings were averaged to increase reliability of measurement. In the current study, the general coefficient of reliability (Tarkkonen and Vehkalahti, 2005) was 0.87 for the combined mother-, father- and teacher-rated scale.

Covariates

Mothers and fathers reported their level of education, and the highest achieved level of education of either parent was dummy coded (with the lower level of education as the referent) and used in the analyses. Further, the child’s weight (kg) and height (cm) were measured by a research nurse in a clinic, and BMI was calculated (kg m−2). Mothers and fathers also reported their own optimism using the Life Orientation Test – Revised (LOT-R; Scheier et al., 1994).

Statistical analyses

The linear associations of sleep duration, latency and efficiency with optimism, self-esteem and social competence were tested by multiple linear regression analyses. Multiple linear regression analysis was also used in testing if sleep duration displayed a non-linear association with the psychological outcomes, such that children in the middle of the distribution would show higher optimism, and higher self-esteem and social competence. Non-linearity was modelled by entering a squared term of sleep duration together with sleep duration as a linear term (squared and linear terms centred on grand mean) in the regression equation.

In addition to treating the sleep variables as continuous, we treated them as categorical predictors in multiple regression analyses with the psychological variables as outcomes, as previous studies in this and other cohorts (e.g. Ferrie et al., 2007; Heslop et al., 2002; Paavonen et al., 2009; Pesonen et al., 2009b; Räikkönen et al., 2010) found stronger effects for categorized compared with linear sleep parameters. Furthermore, categorizing sleep duration was considered important because health effects have been found for both long and short sleep (Ayas et al., 2003a; Ferrie et al., 2007; Kaneita et al., 2006). As in our previous analyses (Paavonen et al., 2009; Pesonen et al., 2009a, 2009b; Räikkönen et al., 2010), we used the 10th and 90th percentiles as cut-offs. For sleep duration, we used three groups (≤7.6 h: ≤10th percentile; 7.7–9.3 h: 10th–90th percentile; ≥9.4 h: >90th percentile), with the middle category as the referent. Sleep latency (short to average versus ≥32 min, >90th percentile) and sleep efficiency (≤77.2%, ≤10th percentile versus average to high) were dichotomized.

All analyses were adjusted for child’s sex, age, BMI and parental level of education. Additionally, the associations between sleep and optimism were tested adjusting for parental optimism.

We calculated effect sizes by using a hierarchical multiple linear regression approach where sleep variables (each tested in a separate model) were entered into the regression equation in the last step (after controlling the covariates sex, age, BMI and parental education), with effect size being the R-square change in the explained variance.

Moreover, we tested whether any associations varied for boys and girls by including interaction terms in the models. In no instance was there a significant sex interaction term (P-values > 0.10; data not shown). For this reason we report the results with both sexes combined.

Results

  1. Top of page
  2. Summary
  3. Introduction
  4. Materials and methods
  5. Results
  6. Discussion
  7. Acknowledgements
  8. Conflict of interest
  9. References

On average the children slept for 8.4 h (SD = 40 min), their average sleep latency was 19 min (SD = 11 min), and they were asleep on average for 84.0% (SD = 5.9%) of the time they spent in bed. Sleep duration correlated significantly with sleep efficiency (= 0.80) and sleep latency (= −0.19), and sleep latency correlated with sleep efficiency (= −0.48; all P-values < 0.001). In Table 1, means and standard deviations for sleep duration, sleep latency and sleep efficiency are displayed separately for girls and boys. In comparison to boys, girls slept on average longer (= 0.001), their sleep latency was marginally shorter (= 0.06) and their sleep efficiency higher (= 0.01).

Table 1.   Characteristics of the sample
 Girls N = 150Boys N = 141P
Mean N(SD) (%)Mean N(SD) (%)
  1. BMI, body mass index; PLOT, Parent-rated Life Orientation Test.

Child
 Age (years)8.1(0.3)8.2(0.3)0.096
 Weight (kg)28.3(5.2)29.4(7.5)0.160
 Height (cm)130.4(5.3)131.8(5.9)0.033
 BMI (kg m−2)16.6(2.2)16.9(4.2)0.945
Parent
 Maternal age (years)39.1(4.4)38.4(4.5)0.195
 Paternal age (years)41.1(5.1)40.9(6.4)0.819
 Highest education in the family
  High-school diploma16(10.7)23(16.3)0.158
  Vocational education48(32.0)31(22.0) 
  Some college24(16.0)20(14.2) 
  Degree beyond college62(41.3)67(47.5) 
PLOT-Scales (mother- and father ratings averaged):
 Total optimism27.2(2.2)26.6(2.6)0.016
 Optimism subscale12.3(1.7)11.9(1.9)0.032
 Pessimism subscale5.1(1.1)5.2(1.1)0.332
Self-esteem (mother, father and teacher ratings averaged)50.0(4.3)47.6(5.2)<0.001
Social competence (mother, father and teacher ratings averaged)46.7(4.9)43.1(5.9)<0.001
Sleep quantity and quality:
 Sleep duration (h)8.5(0.6)8.3(0.7)0.001
 Sleep latency (min)18.1(9.8)20.2(11.4)0.064
 Sleep efficiency (%)84.9(6.0)83.2(5.7)0.013

Table 1 also presents, for girls and boys separately, the means and standard deviations for parent-rated total optimism score, and optimism and pessimism subscale scores, as well as parent- and teacher-rated self-esteem and social competence scores. On average, the girls were rated as more optimistic (P-values < 0.03) and higher in self-esteem and social competence than were the boys (both P-values < 0.001); girls and boys did not differ in pessimism (= 0.20).

Sleep quantity, quality and positive characteristics

Table 2 shows that sleep duration had a non-linear relationship with parent-rated optimism (total optimism score: R2 change = 2.0%, = 0.02; optimism subscale score: R2 change = 2.7%, = 0.005). Children in the middle of the distribution of sleep duration were rated as more optimistic (Fig. 1) than children in the shorter or longer ends of the distribution of sleep duration. Categorical analyses of sleep duration revealed that children whose sleep duration was between the 10th and 90th percentiles of the distribution were more optimistic (total optimism score: R2 change = 2.3%, = 0.01; optimism subscale score: R2 change = 2.6%, = 0.009) than children whose sleep duration was short (below 10th percentile); average (10th–90th percentiles) and long sleepers (above 90th percentile) did not differ significantly from each other (P-values > 0.16).

Table 2.   Associations of sleep quantity and quality with parent-rated optimism, and parent- and teacher-rated self-esteem, and social competence of the child
Sleep quantity and qualityTotal optimismOptimism subscalePessimism subscaleSelf-esteemSocial competence
βPβPβPβPβP
  1. Note: coefficients represent standardized regression coefficients derived from multiple linear regression analyses adjusted for child’s sex, age, BMI and parental level of education.

  2. BMI, body mass index.

Sleep duration
 Linear effect0.080.1610.080.206−0.060.3090.040.5150.060.309
 Non-linear effect−0.150.015−0.170.0050.040.469−0.050.373−0.100.096
 Average (7.7–9.3 h) versus
  Short (≤7.6 h)−0.150.014−0.160.0090.070.291−0.050.444−0.070.239
  Long (≥9.4 h)0.040.5370.000.977−0.090.166−0.020.720−0.040.478
Sleep latency
 Linear effect−0.150.010−0.130.0240.120.044−0.110.0600.040.515
 Short-average (<32 min) versus
  Long (>32 min)−0.080.179−0.050.3560.080.162−0.120.026−0.030.620
Sleep efficiency
 Linear effect0.070.2650.070.226−0.030.603−0.010.892−0.010.809
 Average-high (>77.4%) versus
  Low (<77.4%)−0.050.443−0.090.131−0.040.5230.010.9050.010.823
image

Figure 1.  Non-linear relationship between sleep duration and parent-rated dispositional optimism (total score) of the child. Linear regression equation: = 0.4b + 23.8; non-linear regression equation: = −0.6b2 + 9.8b– 16.0.

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Table 2 also shows that sleep latency and parent-rated optimism (total optimism score: R2 change = 2.3%, = 0.01; optimism subscale score: R2 change = 1.7%, = 0.02) and pessimism (R2 change = 1.4%, = 0.04), and combined parent- and teacher-rated self-esteem (R2 change = 1.1%, approaching statistical significance, = 0.06) were linearly related. The shorter the sleep latency, the higher was the child’s optimism and self-esteem, and the lower the child’s pessimism. Analyses of sleep latency as a dichotomous variable revealed no significant differences between children with short to average and long sleep latency in optimism and social competence, while there was a difference in self-esteem: the children with a short to average sleep latency were higher in parent- and teacher-rated self-esteem (R2 change = 1.5%, = 0.03). All the significant associations listed above were adjusted for child’s age, sex, BMI and highest education in the family. The significant associations between sleep and child optimism remained also when further controlling for maternal and paternal optimism (all P-values < 0.05).

Discussion

  1. Top of page
  2. Summary
  3. Introduction
  4. Materials and methods
  5. Results
  6. Discussion
  7. Acknowledgements
  8. Conflict of interest
  9. References

We examined if sufficient sleep quantity and good sleep quality are associated with optimism, self-esteem and social competence in children. In accordance with our hypothesis, we found a non-linear relationship between sleep duration and optimism. The relation resembled a reverse J-shaped curve, such that children whose sleep duration was in the middle of the distribution scored higher on optimism compared with children who slept relatively little. Further, children with shorter sleep latency scored higher on optimism and tended to have higher scores on self-esteem. The associations remained when adjusting for child’s age, sex, BMI and parental level of education, factors that may increase risk for less optimal sleep patterns and/or for lower scores on positive characteristics. Additionally, the association of sleep with optimism did not change when the parent ratings of their own optimism were controlled.

Our findings in the 8-year-old children are consistent with the previous epidemiological and experimental studies in adults (Haack and Mullington, 2005; National Sleep Foundation, 2002). The findings are, however, not in line with those by Fredriksen et al. (2004) who showed that adolescents who report sleeping longer scored higher on self-esteem. There are methodological differences in the measurement of sleep duration, however, between the current and the Fredriksen et al. (2004) study that may explain the differences. While the present study relied on actigraphy measurement of sleep, participants of the Fredriksen et al. (2004) study reported their sleep duration on a survey questionnaire. It is also worth noting that adolescence is a period when the biological need for sleep is altered (e.g. Iglowstein et al., 2003). Therefore, our findings in prepubertal children do not necessarily apply to adolescents.

Our findings also parallel data in adults showing that physical and mental health may be better among those with average sleep duration compared with those with either short and/or long sleep duration (e.g. Ayas et al., 2003a; Ferrie et al., 2007; Kaneita et al., 2006), and among those with short sleep latency compared with those suffering from long sleep latency (Paudel et al., 2008; Taylor et al., 2007; Vgontzas et al., 2009).

Data in adults and adolescents show that optimism and self-esteem are predictors of good physical and mental health. For instance, optimistic adults have lower ambulatory blood pressure levels (Räikkönen et al., 1999), and are less likely to develop signs of subclinical cardiovascular disease (Matthews et al., 2004) and to suffer from symptoms of depression (Bromberger and Matthews, 1996). The associations between optimism and physical and mental health in children and/or adolescents are in line with the findings in adults, with respect to ambulatory blood pressure levels, positive and negative affect, depression, hopelessness, suicidal ideation, substance abuse, and internalizing and externalizing behaviour problems (Ben-Zur, 2003; Carvajal et al., 1998; Lemola et al., 2010; Räikkönen and Matthews, 2008; Roberts et al., 1998). Higher self-esteem, in turn, is associated in adults, for instance, with better physical fitness (Reitzes and Mutran, 2006), lower stress-induced cardiovascular and inflammatory responses (O’Donnell et al., 2008), and lower risk of all-cause mortality (Stamatakis et al., 2004). Also, the findings relating self-esteem with mental and physical health in children and/or adolescents are in line with the findings in adults, with respect to psychological adjustment, health compromising and delinquent behaviour, and health symptoms (Aspinwall and Taylor, 1992; Donnellan et al., 2005; McGee and Williams, 2000; Orth et al., 2008; Trzesniewski et al., 2006). Thus, our findings showing a relation between an optimal sleep pattern and positive characteristics in children may inform why positive characteristics are associated with better physical and mental health.

The associations between the children’s sleep duration and latency with optimism and/or self-esteem were modest in effect size. In interpreting the effect sizes, one should, however, keep in mind that we examined a generally healthy population of young children. The effect sizes are comparable to, for instance, the size of the relation of sleep duration with BMI reported in some epidemiological studies in children. While it is well acknowledged that short sleep duration poses a risk for obesity in children/adolescents (Cappuccio et al., 2008; Chen et al., 2008), in some large-scale epidemiological studies the size of the cross-sectional association between sleep duration and BMI has been modest (Eisenmann et al., 2006; Snell et al., 2007) – comparable or even smaller than the effect sizes we report for the relation of sleep with optimism and self-esteem in this study. It should also be kept in mind that we cannot draw causal inferences from the cross-sectional findings of this study. Hence, it is possible that good sleep and positive characteristics are reciprocally related. In other words, good sleep, by promoting better physical and mental wellbeing, may result in a more positive psychological profile. Equally, it may be true that positive psychological characteristics, by promoting better physical and mental wellbeing, result in quantitatively and qualitatively better sleep. Further, the associations may also be determined by a common, but yet unknown, underlying factor, such as genetic variants for sleep–wake cycles. Thus, the underlying physical, genetic or psychological mechanisms linking sleep and positive characteristics have yet to be identified.

Apart from the cross-sectional study design and lack of data on the underlying mechanisms, a further limitation of our study relates to the generalizability of the findings; sleep pattern changes with age and pubertal maturation (Iglowstein et al., 2003). Thus, our findings cannot be generalized to much younger or older age groups. Further, our sample was predominantly Caucasian, and none of the children suffered from severe physical or mental health problems. Thus, our findings may not either generalize to samples with different ethnic backgrounds or with greater variance in health. Also, nearly half of the sample had rather well-educated parents with degrees beyond college. While we did not observe associations between parental level of education and sleep patterns, our findings may not generalize to less affluent populations.

Further, whereas sleep duration and sleep efficiency in children, measured with the chosen actigraph brand, have shown high agreement with polysomnography (with agreement rate of 87.3, sensitivity of 93.9 and specificity of 59.0 with a medium activity threshold; Hyde et al., 2007), concerns have been raised about the reliability of sleep latency in children (Sitnick et al., 2008), which is highly dependent on the reliability of the bedtime reported in a sleep log. However, very rarely have sleep logs and event marker data been compared to assess the reliability of the reported bedtime. We were able to do this in our study, and found very high correspondence between the sleep log completed by the parents and the event markers in the actigraph data. Still, it has to be kept in mind that results involving sleep latency should be interpreted cautiously.

Although the actigraphy measurement may lack the accuracy provided by polysomnography in measuring sleep quantity and quality in young children (Ohayon et al., 2004), actigraphy has the benefit of being ecologically valid as children sleep in their own beds over many consecutive nights (Acebo and LeBourgeois, 2006). A further strength to our study is that we did not rely on a single informant in measuring the children’s positive characteristics, as both mothers and fathers rated their children’s optimism, and mothers, fathers and teachers rated the children’s self-esteem and social competence.

In summary, we found associations between objectively measured sleep patterns and positive psychological characteristics in young children. Our results show that sufficient sleep quantity and good sleep quality are related to higher levels of optimism, and good sleep quality is related to higher levels of self-esteem. Thus, our results may inform why sleep quantity and quality and positive characteristics are associated with wellbeing in children.

Acknowledgements

  1. Top of page
  2. Summary
  3. Introduction
  4. Materials and methods
  5. Results
  6. Discussion
  7. Acknowledgements
  8. Conflict of interest
  9. References

This study was sponsored by grants from the Juho Vainio Foundation, the John D. and Catherine T. MacArthur Foundation, the European Science Foundation (EuroSTRESS), the Yrjö Jahnsson Foundation, the Emil Aaltonen Foundation, the Finnish Medical Society Duodecim, the Finnish Foundation for Pediatric Research, the Signe and Ane Gyllenberg Foundation, the Ahokas Foundation, the Finnish Ministry of Education, the University of Helsinki, and the Academy of Finland. Preparation of the manuscript was supported by a grant for individual short visits of the Swiss National Science Foundation awarded to Sakari Lemola (grant IZKOZ1-127779/1), and by grants from the National Heart, Lung and Blood Institute (NIH HL076852 and HL076858).

References

  1. Top of page
  2. Summary
  3. Introduction
  4. Materials and methods
  5. Results
  6. Discussion
  7. Acknowledgements
  8. Conflict of interest
  9. References
  • Acebo, C. and LeBourgeois, M. K. Actigraphy. Respir. Care Clin. N. Am., 2006, 12: 2330. Viii.
  • Aronen, E. T., Paavonen, E. J., Fjallberg, M., Soininen, M. and Torronen, J. Sleep and psychiatric symptoms in school-age children. J. Am. Acad. Child Psych., 2000, 39: 502508.
  • Aspinwall, L. G. and Taylor, S. E. Modeling cognitive adaptation: a longitudinal investigation of the impact of individual differences and coping on college adjustment and performance. J. Pers. Soc. Psychol., 1992, 63: 9891003.
  • Ayas, N. T., White, D. P., Al-Delaimy, W. K. et al. A prospective study of self-reported sleep duration and incident diabetes in women. Diabetes Care, 2003a, 26: 380384.
  • Ayas, N. T., White, D. P., Manson, J. E. et al. A prospective study of sleep duration and coronary heart disease in women. Arch. Intern. Med., 2003b, 163: 205209.
  • Ben-Zur, H. Happy adolescents: the link between subjective well-being, internal resources, and parental factors. J. Youth Adol., 2003, 32: 6779.
  • Bonnet, M. H. and Arand, D. L. We are chronically sleep deprived. Sleep, 1995, 18: 908911.
  • Bromberger, J. T. and Matthews, K. A. A longitudinal study of the effects of pessimism, trait anxiety, and life stress on depressive symptoms in middle-aged women. Psychol. Aging, 1996, 11: 207213.
  • Burt, K. B., Obradović, J., Long, J. D. and Masten, A. S. The interplay of social competence and psychopathology over 20 years: testing transactional and cascade models. Child Dev., 2008, 79: 359373.
  • Cappuccio, F. P., Taggart, F. M., Kandala, N. B. et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep, 2008, 31: 619626.
  • Carvajal, S. C., Clair, S. D., Nash, S. G. and Evans, R. I. Relating optimism, hope, and self-esteem to social influences in deterring substance use in adolescents. J. Soc. Clin. Psychol., 1998, 17: 443465.
  • Chang, A. M. and Mackenzie, A. E. State self-esteem following stroke. Stroke, 1998, 29: 23252328.
  • Chen, X., Beydoun, M. A. and Wang, Y. Is sleep duration associated with childhood obesity? A systematic review and meta-analysis Obesity, 2008, 16: 265274.
  • Cohen-Zion, M. and Ancoli-Israel, S. Sleep in children with attention-deficit hyperactivity disorder (ADHD): a review of naturalistic and stimulant intervention studies. Sleep Med. Rev., 2004, 8: 379402.
  • Donnellan, M. B., Trzesniewski, K. H., Robins, R. W. et al. Low self-esteem is related to aggression, antisocial behavior, and delinquency. Psychol. Sci., 2005, 16: 328335.
    Direct Link:
  • Eisenmann, J. C., Ekkekakis, P. and Holmes, M. Sleep duration and overweight among Australian children and adolescents. Acta Paediatr., 2006, 95: 956963.
  • El-Sheikh, M., Buckhalt, J. A., Cummings, E. M. and Keller, P. Sleep disruptions and emotional insecurity are pathways of risk for children. J. Child Psychol. Psych., 2007, 48: 8896.
  • Ferrie, J. E., Shipley, M. J., Cappuccio, F. P. et al. A prospective study of change in sleep duration: associations with mortality in the Whitehall II cohort. Sleep, 2007, 30: 16591666.
  • Fredriksen, K., Rhodes, J., Reddy, R. and Way, N. Sleepless in Chicago: tracking the effects of adolescent sleep loss during the middle school years. Child Dev., 2004, 75: 8495.
  • Fricke-Oerkermann, L., Pluck, J., Schredl, M. et al. Prevalence and course of sleep problems in childhood. Sleep, 2007, 30: 13711377.
  • Fuchs-Beauchamp, K. D. Preschoolers’ inferred self-esteem: the behavioral rating scale of presented self-esteem in young children. J. Genet. Psychol., 1996, 157: 204210.
  • Gangwisch, J. E., Malaspina, D., Boden-Albala, B. and Heymsfield, S. B. Inadequate sleep as a risk factor for obesity: analyses of the NHANES I. Sleep, 2005, 28: 12891296.
  • Gangwisch, J. E., Heymsfield, S. B., Boden-Albala, B. et al. Short sleep duration as a risk factor for hypertension: analyses of the first National Health and Nutrition Examination Survey. Hypertension, 2006, 47: 833839.
  • Gangwisch, J. E., Heymsfield, S. B., Boden-Albala, B. et al. Sleep duration as a risk factor for diabetes incidence in a large U.S. sample. Sleep, 2007, 30: 16671673.
  • Gregory, A. M. and O’Connor, T. G. Sleep problems in childhood: a longitudinal study of developmental change and association with behavioral problems. J. Am. Acad. Child Adolesc. Psych., 2002, 41: 964971.
  • Gregory, A. M., Eley, T. C., O’Connor, T. G. and Plomin, R. Etiologies of associations between childhood sleep and behavioral problems in a large twin sample. J. Am. Acad. Child Psych., 2004, 43: 744751.
  • Haack, M. and Mullington, J. M. Sustained sleep restriction reduces emotional and physical well-being. Pain, 2005, 119: 5664.
  • Haltiwanger, J. and Harter, S. Behavioral Measure of Young Children’s Presented Self-Esteem. Unpublished manuscript. University of Denver, Denver, 1988.
  • Hasler, G., Buysse, D. J., Klaghofer, R. et al. The association between short sleep duration and obesity in young adults: a 13-year prospective study. Sleep, 2004, 27: 661666.
  • Heath, A. C., Eaves, L. J., Kirk, K. M. and Martin, N. G. Effects of lifestyle, personality, symptoms of anxiety and depression, and genetic predisposition on subjective sleep disturbance and sleep pattern. Twin Res., 1998, 1: 176188.
  • Heslop, P., Smith, G. D., Metcalfe, C., Macleod, J. and Hart, C. Sleep duration and mortality: the effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women. Sleep Med., 2002, 3: 305314.
  • Hublin, C., Partinen, M., Koskenvuo, M. and Kaprio, J. Sleep and mortality: a population-based 22-year follow-up study. Sleep, 2007, 30: 12451253.
  • Hyde, M., O’Driscoll, D. M., Binette, S. et al. Validation of actigraphy for determining sleep and wake in children with sleep disordered breathing. J. Sleep Res., 2007, 16: 213216.
  • Iglowstein, I., Jenni, O. G., Molinari, L. and Largo, R. H. Sleep duration from infancy to adolescence: reference values and generational trends. Pediatrics, 2003, 111: 302307.
  • Ivanenko, A., Crabtree, V. M., Obrien, L. M. and Gozal, D. Sleep complaints and psychiatric symptoms in children evaluated at a pediatric mental health clinic. J. Clin. Sleep Med., 2006, 2: 4248.
  • Kaneita, Y., Ohida, T., Uchiyama, M. et al. The relationship between depression and sleep disturbances: a Japanese nationwide general population survey. J. Clin. Psych., 2006, 67: 196203.
  • Knutson, K. L., Ryden, A. M., Mander, B. A. and Van Cauter, E. Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch. Intern. Med., 2006, 166: 17681774.
  • Kojima, M., Wakai, K., Kawamura, T. et al. Sleep patterns and total mortality: a 12-year follow-up study in Japan. J. Epidemiol., 2000, 10: 8793.
  • Kripke, D. F., Garfinkel, L., Wingard, D. L., Klauber, M. R. and Marler, M. R. Mortality associated with sleep duration and insomnia. Arch. Gen. Psych., 2002, 59: 131136.
  • LaFreniere, P. J. and Dumas, J. E. Social competence and behavior evaluation in children ages 3 to 6 years: the short form (SCBE-30). Psychol. Assess, 1996, 8: 369377.
  • Lemola, S., Räikkönen, K., Matthews, K. A. et al. A new measure for dispositional optimism and pessimism in young children. Eur. J. Personality, 2010, 24: 7184.
  • Liu, X., Liu, L., Owens, J. A. and Kaplan, D. L. Sleep patterns and sleep problems among schoolchildren in the United States and China. Pediatrics, 2005, 115: 241249.
  • Matthews, K. A., Räikkönen, K., Sutton-Tyrrell, K. and Kuller, L. H. Optimistic attitudes protect against progression of carotid atherosclerosis in healthy middle-aged women. Psychosom. Med., 2004, 66: 640644.
  • McGee, R. and Williams, S. Does low self-esteem predict health compromising behaviors among adolescents? J. Adolescence, 2000, 23: 569582.
  • Meijer, A. M., Habekothe, H. T. and Van Den Wittenboer, G. L. H. Time in bed, quality of sleep and school functioning of children. J. Sleep Res., 2000, 9: 145153.
  • National Sleep Foundation. 2002. Sleep in America Poll. 2002. Available at: http://www.sleepfoundation.org/sites/default/files/2002SleepInAmericaPoll.pdf. Accessed on: 14 November 2008.
  • O’Donnell, K., Brydon, L., Wright, C. E. and Steptoe, A. Self-esteem levels and cardiovascular and inflammatory responses to acute stress. Brain Behav. Immun., 2008, 22: 12411247.
  • Ohayon, M. M., Carskadon, M. A., Guilleminault, C. and Vitiello, M. V. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep, 2004, 27: 12551273.
  • Orth, U., Robins, R. W. and Roberts, B. W. Low self-esteem prospectively predicts depression in adolescence and young adulthood. J. Pers. Soc. Psychol., 2008, 95: 695708.
  • Paavonen, E. J., Räikkönen, K., Lahti, J. et al. Short sleep duration and behavioral symptoms of attention-deficit/hyperactivity disorder in healthy 7- to 8-year-old children. Pediatrics, 2009, 123: e857e864.
  • Patel, S. R. and Hu, F. B. Short sleep duration and weight gain: a systematic review. Obesity, 2008, 16: 643653.
  • Paudel, M. L., Taylor, B. C., Diem, S. J. et al. Association between depressive symptoms and sleep disturbances among community-dwelling older men. J. Am. Geriatr. Soc., 2008, 56: 12281235.
  • Pesonen, A.-K., Räikkönen, K., Matthews, K. et al. Prenatal origins of poor sleep in children. Sleep, 2009a, 32: 10861092.
  • Pesonen, A.-K., Räikkönen, K., Paavonen, E. J. et al. Sleep duration and regularity are associated with behavioral problems in 8-year-old children. Int. J. Behav. Med., 2009b. DOI: 10.1007/s12529-009-9065-1.
  • Räikkönen, K. and Matthews, K. A. Do dispositional pessimism and optimism predict ambulatory blood pressure during schooldays and nights in adolescents. J. Pers., 2008, 76: 605629.
  • Räikkönen, K., Matthews, K. A., Flory, J. D., Owens, J. F. and Gump, B. B. Effects of optimism, pessimism and trait anxiety on ambulatory blood pressure and mood during everyday life. J. Pers. Soc. Psychol., 1999, 76: 104113.
  • Räikkönen, K., Pesonen, A.-K., Heinonen, K. et al. Maternal licorice consumption and detrimental cognitive and psychiatric outcomes in 8-year-old children. Am. J. Epidemiol., 2009, 170: 11371146.
  • Räikkönen, K., Matthews, K. A., Pesonen, A.-K. et al. Poor sleep and altered hypothalamic-pituitary-adrenocortical and sympatho-adrenal-medullary system activity in children. J. Clin. Endocrinol. Metab., 2010, 95: 22542261.
  • Rajaratnam, S. M. W. and Arendt, J. Health in a 24-h society. Lancet, 2000, 358: 9991005.
  • Randazzo, A. C., Muehlbach, M. J., Schweitzer, P. K. and Walsh, J. K. Cognitive function following acute sleep restriction in children ages 10–14. Sleep, 1998, 21: 861868.
  • Reilly, J., Armstrong, J., Dorosty, A. et al. Early life risk factors for obesity in childhood: cohort study. Br. Med. J., 2005, 330: 13571363.
  • Reitzes, D. C. and Mutran, E. J. Self and health: factors that encourage self-esteem and functional health. J. Gerontol., 2006, 61B: S44S51.
  • Roberts, R. E., Roberts, C. R. and Chen, Y. R. Suicidal thinking among adolescents with a history of attempted suicide. J. Am. Acad. Child. Psych., 1998, 37: 12941300.
  • Rubin, K. H., Bukowski, W. and Parker, J. G. Peer interactions, relationships, and groups. In: W.Damon and N.Eisenberg (Eds) Handbook of Child Psychology: Social, Emotional, and Personality Development. John Wiley, New York, NY, USA, 1998, 3: 619700.
  • Sadeh, A., Hauri, P. J., Kripke, D. F. and Lavie, P. The role of actigraphy in the evaluation of sleep disorders. Sleep, 1995, 18: 288302.
  • Sadeh, A., Gruber, R. and Raviv, A. Sleep, neurobehavioral functioning, and behavior problems in school-age children. Child Dev., 2002, 73: 405417.
  • Sateia, M. J., Doghramji, K., Hauri, P. J. and Morin, C. M. Evaluation of chronic insomnia. Sleep, 2000, 23: 121.
  • Scheier, M. F. and Carver, C. S. Self-regulatory processes and responses to health threats: effects of optimism on well-being. In: J.Suls and K.Wallston (Eds) Social Psychological Foundations of Health. Blackwell, Oxford, UK, 2003: 395428.
  • Scheier, M. F., Carver, C. S. and Bridges, M. W. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a re-evaluation of the Life Orientation Test. J. Pers. Soc. Psychol., 1994, 67: 10631078.
  • Sitnick, S. L., Goodlin-Jones, B. L. and Anders, T. F. The use of actigraphy to study sleep disorders in preschoolers: some concerns about detection of nighttime awakenings. Sleep, 2008, 31: 395401.
  • Smaldone, A., Honig, J. C. and Byrne, M. W. Sleepless in America: inadequate sleep and relationships to health and well-being of our nation’s children. Pediatrics, 2007, 119: S29S37.
  • Snell, E. K., Adam, E. K. and Duncan, G. J. Sleep and the body mass index and overweight status of children and adolescents. Child Dev., 2007, 78: 309323.
  • Stamatakis, K. A., Lynch, J. W., Everson, S. A., Raghunathan, T. E., Salonen, J. T. and Kaplan, G. A. Self-esteem and mortality: prospective evidence from a population- based study. Ann. Epidemiol., 2004, 14: 5865.
  • Tamakoshi, A. and Ohno, Y. Self-reported sleep duration as a predictor of all-cause mortality: results from the JACC study, Japan. Sleep, 2004, 27: 5154.
  • Tarkkonen, L. and Vehkalahti, K. Measurement errors in multivariate measurement scales. J. Mult. Anal., 2005, 96: 172189.
  • Taylor, D. J., Mallory, L. J., Lichstein, K. L. et al. Comorbidity of chronic insomnia with medical problems. Sleep, 2007, 30: 213218.
  • Tonetti, L., Pasquini, F., Fabbri, M., Belluzzi, M. and Natale, V. Comparison of two different actigraphs with polysomnography in healthy young subjects. Chronobiol. Int., 2008, 25: 145153.
  • Touchette, E., Petit, D., Seguin, J. R., Boivin, M., Tremblay, R. E. and Montplaisir, J. Y. Associations between sleep duration patterns and behavioral/cognitive functioning at school entry. Sleep, 2007, 30: 12131219.
  • Trzesniewski, K. H., Donnellan, M. B., Moffitt, T. E. et al. Low self-esteem during adolescence predicts poor health, criminal behavior, and limited economic prospects during adulthood. Dev. Psychol., 2006, 42: 381390.
  • Verschueren, K., Marcoen, A. and Buyck, P. Five-year-olds’ behaviorally presented self- esteem: relations to self-perceptions and stability across a three-year period. J. Genet. Psychol., 1998, 159: 27379.
  • Verschueren, K., Buyck, P. and Marcoen, A. Self-representations and socioemotional competence in young children: a 3-year longitudinal study. Dev. Psychol., 2001, 37: 126134.
  • Vgontzas, A. N., Liao, D., Bixler, E. O., Chrousos, G. P. and Vela-Bueno, A. Insomnia with objective short sleep duration is associated with a high risk for hypertension. Sleep, 2009, 32: 491497.
  • Vioque, J., Torres, A. and Quiles, J. Time spent watching television, sleep duration and obesity in adults living in Valencia, Spain. Int. J. Obesity, 2000, 24: 16831688.
  • Yaggi, H. K., Araujo, A. B. and McKinlay, J. B. Sleep duration as a risk factor for the development of type 2 diabetes. Diabetes Care, 2006, 29: 657661.