Neighborhood predictors of short sleep duration and bedtime irregularity among children in the United States: results from the 2019–2020 National Survey of Children’s Health

Abstract

Background: Environmental factors may contribute to short sleep duration and irregular bedtime in children. Neighborhood factors and children’s sleep duration and bedtime regularity remain a less investigated area. The aim of this study was to investigate the national and state-level proportions of children with short sleep duration and irregular bedtime and their neighborhood predictors. Methods: A total of 67,598 children whose parents completed the National Survey of Children’s Health in 2019–2020 were included in the analysis. Survey-weighted Poisson regression was used to explore the neighborhood predictors of children’s short sleep duration and irregular bedtime. Results: The prevalence of short sleep duration and irregular bedtime among children in the United States (US) was 34.6% [95% confidence interval (CI) = 33.8%–35.4%] and 16.4% (95% CI = 15.6%–17.2%) in 2019–2020, respectively. Safe neighborhoods, supportive neighborhoods, and neighborhoods with amenities were found to be protective factors against children’s short sleep duration, with risk ratios ranging between 0.92 and 0.94, P < 0.05. Neighborhoods with detracting elements were associated with an increased risk of short sleep duration [risk ratio (RR) = 1.06, 95% CI = 1.00–1.12] and irregular bedtime (RR = 1.15, 95% CI = 1.03–1.28). Child race/ethnicity moderated the relationship between neighborhood with amenities and short sleep duration. Conclusions: Insufficient sleep duration and irregular bedtime were highly prevalent among US children. A favorable neighborhood environment can decrease children’s risk of short sleep duration and irregular bedtime. Improving the neighborhood environment has implications for children’s sleep health, especially for children from minority racial/ethnic groups.