1064 Longitudinal Association Between Co-Sleeping and Sleep Anxiety in a 6-year Child Cohort Study

Abstract Introduction The impact of co-sleeping on children and parents has been insufficiently explored in longitudinal research. Although previous studies have reported associations between co-sleeping and sleep problems, this study examines these relationships over a 6-year period using longitudinal data, especially in a country with high co-sleeping rates. Methods This study is based on a larger prospective child cohort study in South Korea. We used data from 2016 (Time 1) to 2021 (Time 6), and data was connected annually. The mean age of the children (n = 298) at baseline was 3.37 ± 0.87 years (50.00% girls). Sleep problems and sleeping arrangements were assessed using the Children’s Sleep Habits Questionnaire (CSHQ). Children who were reported sleeping in the same bed with other family members more than twice a week were categorized as co-sleeping. An autoregressive cross-lagged model (ACLM) was used to examine the relationship between children’s sleeping arrangements and sleep problems. Before conducting the ACLM, multiple imputations were performed to address missing data. Participants with missing data on co-sleeping variables or with more than 25% missing data were excluded. Results At Time 1, 94.97% of the children reported co-sleeping, with more than 70% of the sample co-sleeping at each time point. Sleep anxiety and co-sleeping showed a significant longitudinal relationship. Goodness-of-fit indices for the final model were adequate (CFI=0.940, TLI=0.934, RMSEA=0.080, and SRMR=0.086). All autoregressive paths between co-sleeping (ORs=1.29-4.71) and sleep anxiety (βs=0.61-0.79) were significant. From Time 2 to 4, high levels of sleep anxiety at the previous time point significantly increased the likelihood of co-sleeping at the subsequent time point (ORs=1.20-1.22). From Time 3 to 6, co-sleeping at the previous time point significantly predicted greater sleep anxiety at the next time point (βs=0.14-0.20). Conclusion Our findings indicate that co-sleeping was longitudinally associated with sleep anxiety. Specifically, while sleep anxiety may lead to co-sleeping during early childhood, the influence of co-sleeping on sleep anxiety appears to become more pronounced as children grow older. Support (if any) This research was supported by a grant of the R&D project, funded by the National Center for Mental Health (grant number: MHER22B03).