Dr Diane Muller | SleepWake

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Muller, D
Paine, SJ
Signal, T. L.
ABSTRACT

This research investigated associations between multiple aspects of sleep health and child health, and the role of sleep in ethnic health inequities in early childhood. Questionnaire data on sleep and health of 3-year-old children (340 Māori, 570 non-Māori) in the Moe Kura: Mother and Child, Sleep and Wellbeing in Aotearoa/New Zealand study were analysed cross-sectionally. Logistic regression models investigated associations between poor sleep and health; and the contribution of socioeconomic deprivation, racism, and poor sleep to ethnic inequities in health (socioemotional difficulties; overweight/obesity; and asthma/eczema/allergy). Sleep measures included weekday and weekend sleep duration (per 24h), differences between weekday and weekend sleep duration and sleep timing, and sleep disturbance. Multiple aspects of sleep were associated with socioemotional or physical health outcomes. Ethnic health inequities existed, with Māori children having higher odds of poor health for all health measures. In sequential logistic regression models, socioeconomic deprivation attenuated ethnic health inequities, as did further adjustment for racism, and for sleep. Findings indicate that poor sleep health may be a pathway linking social disadvantage to ethnic inequities in health outcomes in early childhood. Results provide support for tackling systemic drivers of racism, and social and sleep inequities, to achieve health equity in early childhood.

Ladyman, C. I.
Muller, D.
Paine, S. J.
Signal, T. L.
Sweeny, B. M.
ABSTRACT

Moe Kura is a longitudinal study focused on the role of sleep in the health and well-being of mothers and children in Aotearoa New Zealand (NZ). The leadership, design and conduct of the study is informed by Kaupapa Māori research principles and is positioned within a broader rights-based approach to health, recognising that inequities in health must be identified and understood to improve the health of wāhine Māori and tamariki. In late pregnancy 418 Māori women and 768 non-Māori women were recruited and data collected at four waves (35–37 weeks gestation, 4–6 weeks postpartum, 11–13 weeks postpartum and when the Moe Kura child was 3–4 years of age) with linkage to birth records and national administrative datasets and associated qualitative research. Findings demonstrate substantial inequities in sleep health, infant and maternal health, and maternal employment between Māori and non-Māori, along with the important role of sleep in perinatal health and maternal mental health outcomes. The research philosophy that underpins the study, the primary focus on women, and the detailed measurement of sleep during the childbearing years has provided new and important findings that contribute to intervention development and health policy for women and children in NZ.

Muller, D.
Signal, T. L.
Santos-Fernández, E
Abstract

Study Objectives

To investigate the proportion of children in Aotearoa New Zealand (NZ) who do or do not meet sleep duration and sleep quality guidelines at 24 and 45 months of age and associated sociodemographic factors.

Methods

Participants were children (n = 6490) from the Growing Up in New Zealand longitudinal study of child development with sleep data available at 24 and/or 45 months of age (48.2% girls, 51.8% boys; 22.4% Māori [the Indigenous people of NZ], 12.9% Pacific, 13.4% Asian, 45.2% European/Other). Relationships between sociodemographic factors and maternally reported child sleep duration (across 24 hours) and night wakings were investigated cross-sectionally and longitudinally. Estimates of children in NZ meeting sleep guidelines were calculated using a range of analytical techniques including Bayesian linear regression, negative binomial multiple regression, and growth curve models.

Results

In NZ, 29.8% and 19.5% of children were estimated to have a high probability of not meeting sleep duration guidelines and 15.4% and 8.3% were estimated to have a high probability of not meeting night waking guidelines at 24 and 45 months respectively, after controlling for multiple sociodemographic variables. Factors associated cross-sectionally with children’s sleep included ethnicity, socioeconomic deprivation, material standard of living, rurality, and heavy traffic, and longitudinal sleep trajectories differed by gender, ethnicity, and socioeconomic deprivation.

Conclusions

A considerable proportion of young children in NZ have a high probability of not meeting sleep guidelines but this declines across the ages of 24 and 45 months. Sleep health inequities exist as early as 24 months of age in NZ.

Muller D
Paine SJ
Signal TL
Reference: Muller D, Paine S-J, Wu, LJ, Signal TL (2020). Sleep timing and sleep problems of preschoolers in Aotearoa/New Zealand: Relationships with ethnicity and socioeconomic position. Sleep Medicine, 76; 1-9.

Paine, SJ
Signal, TL
Sweeney, B
Priston, M
Muller, D
Smith, A
Huthwaite, M
Gander, PH
Lee, K
Paine SJ, Signal, TL, Sweeney B, Priston M, Muller D, Smith A, Huthwaite M, Gander PH, Lee, K. (2020). Maternal sleep disturbances in late pregnancy and the association with emergency caesarean section: A prospective cohort study. Sleep Health, 6(1), 65-70.

Muller, D
Paine, SJ
Signal, TL
Muller, D., Paine, S.-J., Wu, L. J., & Signal, T. L. (2019). How long do preschoolers in Aotearoa/New Zealand sleep? Associations with ethnicity and socioeconomic position. Sleep Health, 5(5), 452-458

Muller, D
Paine, SJ
Signal, TL
Muller, D., Paine, S.-J., Wu, L. J., & Signal, T. L. (2019). "Their sleep means more harmony": Maternal perspectives and experiences of preschoolers' sleep in ethnically and socioeconomically diverse families in Aotearoa/New Zealand. Qualitative Health Research, 29(14), 2023-2034.

Muller, D
Paine, SJ
Signal, TL
Muller, D., Paine, S.-J., Wu, L. J., & Signal, T. L. (2019). “We're doing the best job we can”: Maternal experiences of facilitators and barriers to preschoolers sleeping well in Aotearoa/New Zealand. Sleep Health, 5(3), 248-256.

Stoner, Lee
Castro, Nicholas
Signal, Leigh
Skidmore, Paula
Faulkner, James
Lark, Sally
Williams, Micheel A
Muller, Diane
Harrex, Harriet
Stoner Lee, Castro Nicholas, Signal Leigh, Skidmore Paula, Faulkner James, Lark Sally, Williams Michelle A., Muller Diane, and Harrex Harriet. Childhood Obesity. January 2018

Muller D
Signal L
Elder D
Gander P
Muller D, Signal L, Elder D, Gander P (2017). Environmental and behavioural factors associated with school children’s sleep in Aotearoa/New Zealand. Journal of Paediatrics and Child Health (2017); 53: 1 pp 68-74.

Signal TL
Sweeney B
Muller D
Priston M
Lee K
Gander P
Huthwaite M
Paine S-J
Signal TL, Paine S-J, Sweeney B, Muller D, Priston M, Lee K, Gander P, Huthwaite M (2016). The prevalence of symptoms of depression and anxiety, and the level of life stress and worry in New Zealand Maori and non-Maori women in late pregnancy. Australian and New Zealand Journal of Psychiatry (2016); 1-9: doi: 10.1177/0004867415622406

Howe LD
Signal TL
Paine SJ
Sweeney B
Priston M
Muller D
Lee K
Huthwaite M
Gander P
Howe LD, Signal TL, Paine SJ, Sweeney B, Priston M, Muller D, Lee K, Huthwaite M, Gander P (2015). Self-reported sleep in late pregnancy in relation to birth size and fetal distress: the E Moe, Mama prospective cohort study. BMJ Open (2015); 5(10): e008910.

Signal TL
Paine S-J
Sweeney B
Priston M
Muller D
Smith A
Lee KA
Huthwaite M
Reid P
Gander P
Signal TL, Paine S-J, Sweeney B, Priston M, Muller D, Smith A, Lee KA, Huthwaite M, Reid P, Gander P (2014). Prevalence of abnormal sleep duration and excessive daytime sleepiness in pregnancy and the role of socio-demographic factors: Comparing pregnant women with women in the general population. Sleep Medicine (2014); 15: pp 1477-1483

Castro N
Faulkner J
Skidmore P
Williams M
Lambrick DM
Signal L
Thunders M
Muller D
Lark S
Castro N, Faulkner J, Skidmore P, Williams M, Lambrick DM, Signal L, Thunders M, Muller D, Lark S, Hamlin M, Lane AM, Kingi TK, Stoner L (2014). Pre-adolescent cardio-metabolic associations and correlates: PACMAC methodology and study protocol. BMJ Open (2014); 4

Paine S-J
Priston M
Signal TL
Sweeney B
Muller D
Paine S-J, Priston M, Signal TL, Sweeney B, Muller D (2013). Developing new approaches for the recruitment and retention of indigenous participants in longitudinal research. Mai Journal (2013); 2(2): pp 122-132

Gander P
Signal T
Van Dongen H
Muller D
van den Berg M
Gander, P., Signal, T., Van Dongen, H., Muller, D., & Van den Berg, M. (2010). Stable inter-individual differences in slow-wave sleep during nocturnal sleep and naps. Sleep and Biological Rhythms, 8(4), 239-244.

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Diane (Dee) Muller

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