The role of sleep in health and health inequities in early childhood in Aotearoa New Zealand

This research investigated associations between multiple aspects of sleep health and child health, and the role of sleep in ethnic health inequities in early childhood. Questionnaire data on sleep and health of 3-year-old children (340 Māori, 570 non-Māori) in the Moe Kura: Mother and Child, Sleep and Wellbeing in Aotearoa/New Zealand study were analysed cross-sectionally. Logistic regression models investigated associations between poor sleep and health; and the contribution of socioeconomic deprivation, racism, and poor sleep to ethnic inequities in health (socioemotional difficulties; overweight/obesity; and asthma/eczema/allergy). Sleep measures included weekday and weekend sleep duration (per 24h), differences between weekday and weekend sleep duration and sleep timing, and sleep disturbance. Multiple aspects of sleep were associated with socioemotional or physical health outcomes. Ethnic health inequities existed, with Māori children having higher odds of poor health for all health measures. In sequential logistic regression models, socioeconomic deprivation attenuated ethnic health inequities, as did further adjustment for racism, and for sleep. Findings indicate that poor sleep health may be a pathway linking social disadvantage to ethnic inequities in health outcomes in early childhood. Results provide support for tackling systemic drivers of racism, and social and sleep inequities, to achieve health equity in early childhood.