Early Childhood Sleep Disturbances Associated With Later Mental Health Symptoms Among Children in Foster Care

Abstract

Sleep plays a foundational role in early childhood development. Yet, children exposed to early adversity, such as those in foster care, are at elevated risk for sleep disturbances that may contribute to later emotional and behavioral difficulties. This longitudinal study investigated the association between early sleep disturbances and subsequent internalizing and externalizing symptoms in young children in foster care. A sample of 133 caregiver-child dyads participated in assessments at two time points: when children were approximately 25 months and 48 months old. Sleep was assessed through caregiver-reported measures across three days and two nights, and child mental health symptoms were measured using the Child Behavior Checklist (CBCL). Cross-lagged panel modeling revealed a significant association between early sleep disturbances and later mental health symptoms, both internalizing and externalizing. These findings underscore the potential lasting impact of early sleep disturbances on emotional development in children in foster care and highlight the need for early identification and intervention to promote healthy developmental outcomes among children facing early adversity.