Night Awakening and Its Association With Executive Functioning Across the First Two Years of Life

Abstract

Longitudinal associations between signaled night awakening and executive functioning (EF) at 8 and 24 months in children with (≥ 3 awakenings, n = 77) and without parent-rated fragmented sleep (≤ 1 awakening, n = 69) were studied. EF was assessed with the Switch task at 8 and 24 months. At 24 months, behavioral tasks and parental ratings of EF (Behavior Rating Inventory of Executive Function-Preschool version) were also used. In the Switch task, children with fragmented sleep were less able to learn stimulus sequences and inhibit previously learned responses than children without fragmented sleep. The groups differed only marginally in parental ratings of EF, and no differences were found in behavioral EF tasks. These results suggest that eye movement-based measures may reveal associations between sleep and EF already in infancy and toddlerhood. Sleep can be considered one of the most important functions during early development. By the age of 2 years, an infant has spent over half of his or her life in a sleeping state (Dahl, 1996a). In infancy, a typical feature of sleep is its fragmentation (i.e., night awakenings that are followed by periods of wakefulness after sleep onset). Night awakenings are normative between sleep stages (Anders, 1978), but persistent signaled night awakenings are a burden for the entire family (Sadeh, Flint-Ofir, Tirosh, & Tikotzky, 2007). Signaled night awakening refers to night awakenings that are signaled to their parent, for example, with crying. Approximately 20%-30% of 1-year-old infants (Adair, Zuckerman,

Signaled night awakening and its association with social information processing and socio-emotional development across the first two years

“…The infants with three or more signaled night awakenings formed the waking group. Infants with no more than one signaled night awakening formed the nonwaking group [ 12 , 54 ]. The exclusion criteria were prematurity or native language other than Finnish.…”

“…The demographic statistics of the sample are shown in Table 1 . At 8 months of age, the two groups differed in the amount of breastfeeding ( X 2 (1, n = 133) = 13.413, p = .001), co-sleeping ( X 2 (1, n = 119) = 20.376, p < .001), and the infant’s ability to fall asleep alone ( X 2 (1, n = 133) = 16.454, p < .001) [ 12 ]. The infants in the waking group were more likely to be breastfed, to co-sleep with their parents, and less able to fall asleep alone than the infants in the nonwaking group.…”

“…Additional parent-reported and actigraphy-based sleep duration and quality parameters are shown in Table 2 according to the group. Our previous work showed that based on parent reports, the infants in the waking group slept less in total and they spent more time awake during the night than the nonwaking group [ 54 ], but they did not differ in actigraphy-based sleep duration measures [ 12 ]. In addition, the waking group had more parent-reported signaled night awakenings than the nonwaking group at 18 and 24 months of age [ 54 ].…”

“…In addition, the waking group had more parent-reported signaled night awakenings than the nonwaking group at 18 and 24 months of age [ 54 ]. The group formation at 8 months was also validated with actigraphy-based night awakening data which showed that the waking group had more night awakenings than the nonwaking group when measured with actigraphy [ 12 ].…”

“…Prolonged and recurrent signaled night awakenings can be persistent in infants [ 6 , 9 , 10 ] and even in children aged 4–6 years [ 5 , 11 ]. In addition, it has been proposed that signaled night awakening could be a precursor for later appearing sleep difficulties [ 2 ] and a risk factor for the development of higher-order cognitive processes, such as executive functioning [ 12 , 13 ]. However, the associations between signaled night awakening and socio-emotional development in infancy have received little attention even though the bases of social behavior, that is, perception and understanding of social information start to develop during the first year [ 14 ].…”