TRAJECTORIES OF PEDIATRIC SLEEPINESS AND ASSOCIATIONS WITH HEALTH-RELATED QUALITY OF LIFE: A LONGITUDINAL STUDY USING A PERSON-CENTERED APPROACH

Abstract

Adequate sleep is paramount for children’s healthy development of emotion regulation, academic achievement, and cognitive performance. The critical need for sleep in children has sparked extensive research in which four independent domains have emerged, some providing inconclusive support for detrimental outcomes in health-related quality of life (HRQOL) when impaired. Yet, daytime sleepiness, which uniquely captures a child’s subjective sleep experience, has seldom been explored. To determine the chronicity of sleepiness, the current study employed latent class growth analysis to identify longitudinal trajectories, or classes, of children’s daytime sleepiness. Trajectories were subsequently utilized to assess their association with HRQOL. The present sample included 158 elementary-age children. Children’s self-report of daytime sleepiness and HRQOL was collected at three time points across an academic year. Results provided support for three trajectories (i.e., classes) of sleepiness and a significant association between class membership and later HRQOL, F(2, 124) = 17.38, p < .001. Post hoc tests revealed significant differences in HRQOL between the Low and Moderate trajectories (p < .01), Low and High trajectories (p < .001), and between the Moderate and High trajectories (p < .01). Analyses indicated that children with high and stable sleepiness experienced impairments in HRQOL comparable to children with chronic health conditions. Results suggest that sleepiness is more pervasive and widespread than other facets of sleep behavior. Implications include the establishment of daytime sleepiness as a pervasive state with both statistical and clinical significance. Future research should focus on generating empirically derived normative data to provide researchers and clinicians reference values to assess sleepiness reports relative to clinical impairment.