Sleep, Poverty, and Biological Stress: Mitigating Sleep Health Disparities in Early Childhood

In the first years of life, poverty increases the risk of sleep problems such as late bedtimes and frequent night awakenings. In turn, children with sleep problems are more likely to go on to have poor physical and mental health outcomes as adults. The development of sleep and biological stress systems is connected, so that sleep problems can lead to abnormal function of the stress hormone cortisol and contribute to enduring socioeconomic health disparities. Sleep also is critical to brain and cognitive development. Sleep practices such as inconsistent bedtime and absence of a bedtime routine are more common in families experiencing poverty and stress. To address early childhood sleep problems, there is an urgent need for policies that help low-income families to access behavioral sleep interventions; provide families with affordable healthcare, housing, and nutrition; and adjust childcare and school practices to support healthy sleep.