Journal article
Associations between a novel measure of sleep health and cognitive functioning in middle childhood: a crosssectional Environmental Influences on Child Health Outcomes cohort study
Sleep advances, v 6(3), zpaf049
Aug 2025
PMID: 40917573
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Study Objectives Research linking children’s sleep to cognitive outcomes is inconsistent and has largely focused on one aspect of sleep, such as duration, rather than measuring multiple dimensions of sleep health. We hypothesized that children’s sleep health would be positively associated with inhibitory control and cognitive functioning. Method We cross-sectionally assessed 1595 participants (ages 7–11) from the Environmental influences on Child Health Outcomes cohort using the NIH Toolbox Cognition Battery, Environmental influences on Child Health Outcomes Sleep Health of Children and Adolescents questionnaire, and Patient Reported Outcome Measurement Information System Sleep Disturbance/Sleep-related Impairment instruments. We created a novel scale measuring sleep health using dichotomous “good–bad” cutoffs for sleep duration, timing, latency, satisfaction, and alertness. We used generalized estimating equations and random forest models to examine associations between sleep health and inhibitory control, working memory, processing speed, cognitive flexibility, episodic memory, reading decoding, and receptive vocabulary. Results Sleep health did not have statistically significant associations with any aspect of cognitive functioning. Notably, over 75 per cent of our sample had good sleep health. Conclusions This study assessed sleep health as a multi-faceted construct, distinguishing between “good” and “poor” sleep health across several domains. The absence of statistically significant associations between sleep health and cognitive functioning suggests children’s cognitive functioning may not be cross-sectionally related to multidimensional sleep health measures. Experimentally manipulating key sleep domains such as duration or timing (as done in prior research) may be more robust. Future research might benefit from examining the cumulative impact of poor sleep health over time. Statement of significance It is essential to identify variables affecting children’s cognitive functioning because it is associated with many important health outcomes. This is the first study, to our knowledge, that captures a multidimensional measure of sleep health and cognitive functioning for children aged 7–11 years, providing results generalizable to a broad range of children, not just those with a cognitive impairment or sleep disorder. By measuring sleep health from a multidimensional standpoint, we avoid the pitfall of simply measuring sleep as the presence/non-presence of a sleep disorder. Our study findings indicate that subjectively measured sleep health is not associated with cognitive functioning in a large, nationally representative sample. Future studies would benefit from measuring sleep health longitudinally, building on our retrospective, cross-sectional study.
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- Title
- Associations between a novel measure of sleep health and cognitive functioning in middle childhood: a crosssectional Environmental Influences on Child Health Outcomes cohort study
- Creators
- Joshua Marchant (Corresponding Author) - University of UtahMatthew Ferrell - University of UtahYingjia Wei - University of UtahKelly Baron - University of UtahCourtney Blackwell - Northwestern UniversityAnat Sigal - Hackensack University Medical CenterSarah Geiger - University of Illinois Urbana-ChampaignSusan Schantz - University of Illinois Urbana-ChampaignTina Hartert - Vanderbilt UniversityRachel Kelly - Brigham and Women's HospitalHooman Mirzakhani - Brigham and Women's HospitalAmy Elliott - Avera HealthJody Ganiban - George Washington UniversityDana Dabelea - Colorado School of Public HealthJonika Hash - University of WashingtonJoseph Stanford - University of UtahP SmithL NewbyLinda AdairLisa JacobsonDiane CatellierMonica McGrathChristian DouglasPriya DuggalEmily KnappAmii KressMaxwell MansolfJin-Shei LaiEmily HoDavid CellaRichard GershonMichelle MacySuman DasJane FreedmanSimon MallalJohn McLeanRavi ShahMeghan ShiltsAkram AlshawabkehJose CorderoJohn MeekerLeonardo TrasandeCarlos CamargoKohei HasegawaZhaozhong ZhuAshley SullivanWei PerngTraci BekelmanGreta WilkeningSheryl MagzamenBrianna MooreAnne StarlingDeborah RinehartDaphne Koinis MitchellViren D'SaSean DeoniHans-Georg MuellerCristiane DuarteCatherine MonkGlorisa CaninoJonathan PosnerTenneill MurrayClaudia Lugo-CandelasAnne DunlopPatricia BrennanChristine HockettAssiamira FerraraLisa CroenMonique HeddersonJohn AinsworthLeonard BacharierCasper BendixsenJames GernDiane GoldTina Hartert - Vanderbilt UniversityDaniel JacksonChristine JohnsonChristine JosephMeyer KattanGurjit Khurana HersheyRobert LemanskeSusan LynchRachel MillerGeorge O'ConnorCarole OberDennis OwnbyKatherine Rivera-SpoljaricPatrick RyanChristine SeroogyAnne SinghRobert WoodEdward ZorattiRima HabreShohreh FarzanFrank GillilandIrva Hertz-PicciottoDeborah BennettJulie SchweitzerRebecca SchmidtJanine LaSalleAlison HipwellCatherine KarrNicole BushKaja LeWinnSheela SathyanarayanaQi ZhaoFrances TylavskyKecia CarrollChristine LoftusLeslie LeveJody Ganiban - George Washington UniversityJenae NeiderhiserScott WeissAugusto LitonjuaCindy McEvoyEliot SpindelRobert TepperCraig NewschafferKristen LyallHeather VolkRebecca LandaSally OzonoffJoseph PivenHeather HazlettJuhi PandeyRobert SchultzSteven DagerKelly BotteronDaniel MessingerWendy StoneJennifer AmesThomas O'ConnorRichard MillerEmily OkenMichele HackerTamarra James-ToddT O'SheaRebecca FryJean FrazierRachana SinghCaitlin RollinsAngela MontgomeryRuben VaidyaRobert JosephLisa WashburnSemsa GogcuKelly BearJulie RollinsStephen HooperGenevieve TaylorWesley JacksonAmanda ThompsonJulie DanielsMichelle HernandezKun LuMichael MsallMadeleine LenskiRawad ObeidSteven PastyrnakElizabeth JensenChristina SakaiSantos HudsonJean KerverNigel PanethCharles BaroneMichael ElliottDouglas RudenChris FussmanJulie HerbstmanAmy MargolisSarah Geiger - University of Illinois Urbana-ChampaignAndrea AguiarKaren TabbRita StrakovskyTracey WoodruffRachel Morello-FroschAmy PadulaChristina PorucznikAngelo GiardinoRosalind WrightRobert WrightBrent CollettNicole Baumann-BlackmoreRonald GangnonChris McKennanJo WilsonMatt AltmanJudy AschnerAnnemarie StroustrupStephanie MerharPaul MooreGloria PryhuberMark HudakAnn Reynolds LyndakerAndrea LamplandBurton RochelsonSophia JanMatthew BlitzMichelle KatzowZenobia BrownCodruta ChiuzanTimothy RafaelDawnette LewisNatalie MeirowitzBrenda PoindexterTebeb GebretsadikSarah OsmundsonJennifer StraughenAmy EapenAndrea Cassidy-BushrowGanesa WegienkaAlex SitarikKim WoodcroftAudrey UrquhartAlbert LevinTisa Johnson-HooperBrent DavidsonTengfei MaEmily BarrettMartin BlaserMaria Dominguez-BelloDaniel HortonManuel JimenezTodd RosenKristy PalomaresLyndsay AvalosYeyi ZhuKelly HuntRoger NewmanMichael BloomMallory AlkisJames RobertsSunni MumfordHeather BurrisSara DeMauroLynn YeeAaron HamvasAntonia OlidipoAndrew HaddadLisa EilandNicole SpillaneKirin SuriStephanie FisherJeffrey GoldsteinLeena MithalRaye-Ann DeRegnierNathalie MaitreRuby NguyenMeghan JaKaAbbey SidebottomMichael PaidasJoNell PotterRuby NataleLunthita DuthelyArumugam JayakumarKaren YoungIsabel MaldonadoMeghan MillerJonathan SlaughterSarah KeimCourtney LynchKartik VenkateshKristina WhitworthElaine SymanskiThomas NorthrupHector Mendez-FigueroaRicardo MosqueraMargaret KaragasJuliette MadanDebra MacKenzieJohnnye LewisBrandon RennieBennett LeventhalYoung Shin KimSomer BishopSara NozadiLi LuoBarry LesterCarmen MarsitTodd EversonCynthia LoncarElisabeth McGowanStephen SheinkopfBrian CarterJennifer CheckJennifer HeldermanCharles NealLynne Smith
- Publication Details
- Sleep advances, v 6(3), zpaf049
- Publisher
- Oxford University Press
- Number of pages
- 11
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001564839500001
- Other Identifier
- 991022087466604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Neurosciences