OD8 Impact of environmental factors on sleep and behaviors in preschool children


Compared to the literature in school-aged children relating sleep to child behavior, little is known in preschoolers. In a systematic review on sleep and its relation to behavior and cognition in preschoolers, Sabine Plancoulaine showed that a longer sleep duration and a higher quality of sleep were associated with better behavioral and cognitive outcomes. However, small sample sizes limited the validity of the results. Sabine Plancoulaine will present the results of the longitudinal association between sleep at age 3 and  behavior from ages 4 to 6 years in 6 cohorts from the Lifecycle EU child network (ALSPAC, BiB, EDEN, ELFE, INMA and SWS). These cohorts included a total of about 55,000 infants at birth and followed them up for different durations.

Several studies have examined the relationship between screen use and child behavior. The highest level of evidence is for attention deficit disorder with/without hyperactivity in school-aged children and adolescents. In preschool children, two systematic reviews reached discordant conclusions. Jonathan Bernard or Maria Melchior will present the relations between screen exposition at age 3.5 years and behavior measured through SDQ completed at the age of 4.5 by teachers and at the age of 5 years by parents in the ELFE study. The ELFE study is a nationwide French study that included about 18,000 infants at birth in 2011.

Currently available data on the COVID-19 lockdown suggest that sleep among preschoolers was not affected. As soon as the lockdown in France ended (duration: 2 months), the SDSC was distributed to 110 French mothers for completion: these assessed the frequency of sleep disturbances in their children during the lockdown. In 2018, this same questionnaire was completed by 316 mothers. Age and gender matching of the children was undertaken, creating 92 pairs of children comparable in age, gender and room-sharing/co-sleeping habits.

Using a robust methodology, these results are the first to demonstrate a significant increase in sleep disorders among young children during the lockdown. Florian Leceulle will give further details and will discuss the results.

This last study aimed to explore the repercussion of a two-months quarantine on the symptoms of ADHD, ODD and anxiety in children, as well as the implication of behavioral regulation in the expression of these symptoms. The study involved 235 children aged 6 to 13Y, members of the association HyperSupers – TDAH France, with ADHD and under treatment by methylphenidate during the study. The evolution of ADHD, ODD and anxiety symptoms was investigated with standardized scales with repeated measures: one month after the beginning of quarantine, two months after it’s beginning and one month after its end. The Behavioral Regulation Index, assessed for each participant, was associated with patterns of evolution for the symptoms of ADHD, ODD and anxiety during the French quarantine from March to May 2020. An increase of every scores was observed between the first and the second month of quarantine in all subjects. The results of this study will be further detailed and discussed by Anna Pech de Laclause.           

Learning Objectives

Upon completion of this CME activity, participants should be able to:

      • Identify the long-term influence of sleep on behaviors in pre-school children
      • Recognize the effects of environmental factors such as screen exposure or COVID lockdown conditions on sleep and behaviors in pre-school children
      • Describe the long-term effect of screen on behaviors in pre-school children

Target Audience

Researchers, clinicians, sleep technologists


Patricia Franco (France)

Sleep and behavior: Longitudinal study on lifecycle EU child network

Sabine Plancoulaine (France)

Impact of screen on child behavior: Longitudinal study on Elfe study

Jonathan Bernard (France)

Impact of COVID lockdown on child behavior

Anna Pech de Laclause (France)

Impact of COVID lockdown on sleep in children

Florian Lecuelle (France)

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