144 Temporal and Bidirectional Associations between Objectively Measured Physical Activity and Sleep in Preschoolers

Physical activity (PA) and sleep contribute to overall health in early childhood. To explore the interactive relationships of these behaviors in older children and adults, previous studies have examined temporal between- and within-person associations through micro-longitudinal designs. However, such analyses have not been conducted in early childhood, when behaviors are guided by adult caregivers. The purpose of this analysis was to examine temporal and bidirectional associations between SED, PA, and sleep in preschool children. Methods Wake (activity counts/min and percent time in SED, light PA [LPA], and moderate-to-vigorous PA [MVPA]) and overnight sleep (sleep duration, sleep efficiency [SE], mid-sleep point [MSP]) were assessed via wrist-based actigraphy (mean = 10.4 days and 9.8 nights) and recorded as repeated (daily) measures. Multilevel models with lagged effects and AR(1) error covariance structure were used to examine the temporal associations between wake and sleep measures and adjusted for age, sex, socioeconomic status, and nap frequency. Results With PA measures as predictors, between-person associations were positive between activity counts and SE (p=0.004), SED and SE (p=0.004), LPA and sleep duration (p=0.005), and negative between LPA and MSP (p=0.039) and MVPA and SE (p=0.003). Within-person associations were positive between activity counts and sleep duration (p=0.010), activity counts and SE (p=0.018), MVPA and sleep duration (p=0.003), MVPA and SE (p=0.004), and negative between SED and SE (p=0.034) and LPA and sleep duration (p=0.045). With sleep measures as predictors, associations were positive between sleep duration and LPA (p<0.001) and SE and SED (p=0.008), and negative between MSP and LPA (p=0.009), SE and activity counts (p=0.001), and SE and MVPA (p=0.003). Within-person associations were positive between SE and activity counts (p=0.001) and SE and MVPA (p=0.001), and negative between sleep duration and LPA (p=0.001) and SE and SED (p=0.012). Conclusion Generally, days with higher levels of activity or sleep were not associated with greater subsequent sleep or PA. Conversely, when participants obtained greater PA or sleep compared to their individual average, some beneficial associations were evident. These findings demonstrate some evidence of temporal associations between PA and sleep, although the bidirectional nature was not conclusive. Support (if any) NIH R01 HL111695