Parental Perceptions of Environmental Factors on Preschoolers’ Sleep Duration Among 23 Low-, Middle-, and High-Income Countries

Abstract

Objective: To examine the associations between parent perceived environmental factors, nighttime sleep duration and 24-h sleep duration among an international sample of preschool-aged children. Methods: Secondary analyses of cross-sectional data from preschoolers across 23 countries (19 LMICs), collected during the third pilot phase (January 2021–August 2024) of the SUNRISE Study. Parents completed a questionnaire which asked about their child’s sleep patterns and environmental factors that impacted their child’s sleep in the previous 3 days. Results: Data from 2,219 children were analyzed. A significant difference was observed between nighttime sleep (F = 14.27, p = <0.0001) and nap duration (F = 9.10, p = 0.0004) across country income level. Environmental factors such as heat (−12.87, 95% CI: −11.54, −0.61) and cold (−17.70, 95% CI: −34.53, −0.85) were negatively associated with nighttime sleep duration. Conclusions: Public health researchers and professionals should prioritize context-specific strategies to minimize the impact of weather conditions on sleep to promote healthy levels of sleep among preschoolers from diverse settings.