Bidirectional relationship between child happiness and sleep quality and the predictive role of prenatal psychosocial support: results from U.S. and China cohort studies.

Abstract

Background: The relationship between daily affective states and subjective sleep measures is known to be reciprocal in both adults and children. However, its consistency across infancy to early adolescence and varying sociocultural contexts remain unclear. We investigated the bidirectional relationship between happiness and sleep quality in children from the U.S. and China and examined the predictive role of maternal prenatal psychosocial support.

Methods: A total of 1300 children aged 11-12 years in the U.S. Healthy Brain and Behavior Study (HBBS) and China Jintan Child Cohort (CJCC) studies were included in the analyses. Happiness and sleep quality from infancy to early adolescence were retrospectively reported by mothers. Prenatal psychosocial factors were recalled by mothers through a structured interview. Random-intercept cross-lagged panel modeling was conducted to analyze the data.

Results: Happiness and sleep quality trajectories differed significantly between U.S. adolescents in the HBBS and Chinese adolescents in the CJCC (P < 0.001). In both cohorts, cross-lagged effects showed consistent associations between happiness and subsequent sleep quality across the five time points (coefficients: 0.086-0.154, P < 0.01). The relationship between sleep quality and subsequent happiness was significant from 1-3 to 11 years. The bidirectional relationship was stronger in the Chinese cohort. Maternal prenatal psychosocial support positively predicted children's happiness (β = 0.072, P < 0.001) and sleep quality (β = 0.056, P < 0.001) trajectories.

Conclusions: A bidirectional relationship exists between children's happiness and sleep quality, with potential cultural variations. Maternal prenatal psychosocial support plays a key role in fostering children's long-term emotional well-being and sleep quality.