0123 Family Economic Strain Is Associated with Parent-Child Sleep Interactions

Abstract Introduction Family economic strain is perceived financial hardship that can be experienced regardless of income level but is more prevalent among families of low socioeconomic status (SES). Low SES is an important social determinant of health and is associated with poor sleep in children, but pathways between financial hardship and child sleep are unclear. In this study, we examine the role of family processes in this relationship, including caregiver stress and parent-child sleep interactions (sleep location, praise, tantrums). Methods We conducted a cross sectional study of caregivers in the United States with children aged 3-5 years. Caregivers completed the Family Economic Strain Scale (FESS), Parent-Child Sleep Interactions Scale (PSIS), Perceived Stress Scale (PSS), and a demographics form via Qualtrics. Participants were recruited through social media and community flyers. Adjusting for child age, household size, and caregiver relationship status, we conducted multivariate linear regression to examine associations between economic strain, perceived stress, and parent-child sleep interactions. We then tested mediation using 5,000 bootstrap samples. Results 111 caregivers completed all questionnaires. Higher family economic strain (β=.472, p.001) and perceived stress (β=.357, p.001) were associated with more problematic parent-child sleep interactions. Family economic strain was also associated with increased perceived stress (β=.559, p.001). However, perceived stress did not mediate the relationship between family economic strain and problematic parent-child sleep interactions (95% CI -0.46, 2.4). Conclusion Increased family economic strain is associated with increased stress in caregivers, and both economic strain and caregiver stress are associated with problematic parent-child sleep interactions. Therefore, supporting caregivers in promoting healthy bedtime interactions may be an important approach for intervention to promote sleep and reduce inequities related to financial strain and stress. Further, our findings suggest the relationship between family economic strain and parent-child sleep interactions is not attributable to increased caregiver stress. Additional research is needed to understand the relationship between family economic strain and child sleep, including the role of other social determinants such as caregiver shift work, employment, housing, and the neighborhood environment. Findings from this study and future research may inform multi-level and policy interventions to support children at risk for unhealthy sleep. Support (if any)