Associations Between Gestational Polybrominated Diphenyl Ether (PBDE) Serum Concentrations and Child Sleep Outcomes from Ages 2 to 8 Years

Gestational polybrominated diphenyl ethers (PBDEs) exposures have been associated with thyroid disruption in pregnant women and adverse neurobehavioral outcomes in their children, but it is unknown if they interfere with children's sleep patterns. We assessed gestational PBDE exposure (16 weeks) and child sleep patterns from ages 2 to 8 years using 410 mother-child dyads in the Health Outcomes and Measures of the Environment (HOME) Study. Gestational biomarkers of serum PBDEs include PBDE-153 (GM±GSD: 5.2±2.8 ng/g lipid), PBDE-100 (4±2.6), PBDE-99 (4.6±2.7), PBDE-47 (20.2±2.6), PBDE-28 (1.3±2.2), and ΣPBDEs (37.03±2.52). We measured child sleep patterns using the adapted Child Sleep Health Questionnaire, which includes sleep irregularity (mean±SD: 2.5±0.8), hypersomnolence (4.7±1.5), sleep disruption (6.7±1.6), and sleep duration. We assessed longitudinal associations between gestational PBDEs and sleep patterns using generalized estimating equations, adjusting for covariates. For PBDE-visit interactions (p < 0.1), visit-specific estimates with 95% CIs were calculated; otherwise, the overall estimate was reported. Every 10-fold increase in PBDE-99 (β=0.18, 95% CI: -0.04, 0.23), PBDE-47 (0.15, 95% CI: 0.001, 0.3) and ΣPBDEs (0.13, 95% CI: -0.21, 0.27) was associated with increased sleep irregularity for all years, and PBDE-28 was associated with this outcome at age 5 and 8 years (0.43, 95% CI: 0.09, 0.77). PBDE-153 (-0.5, 95% CI: -1.06, 0.05) was associated with decreased hypersomnolence at age 4 years. PBDE-47 (0.3, 95% CI: 0.004, 0.61), PBDE-99 (0.38, 95% CI: 0.1, 0.67 and 0.62), and ΣPBDEs (0.27, 95% CI: -0.02, 0.56) were associated with increased sleep disruption for all ages. We observed no significant associations between PBDEs and sleep duration. We found that gestational PBDEs were associated with sleep irregularity and sleep disruption in children, highlighting the need to explore sleep as a mediator of PBDE-associated neurobehavioral problems.