Sleep and Sensory Processing in Infants and Toddlers: A Cross-Sectional and Longitudinal Study

Importance: Typically developing children who are sensitive to sensory stimulation appear to have more sleep difficulties than children with average sensory sensitivities; however, at what age sleep difficulties emerge and whether they extend to children outside of sleep clinics are unclear. Objective: To investigate cross-sectional and longitudinal relationships between sleep and sensory processing in typically developing infants and toddlers. Design: Observational; cross-sectional and longitudinal. Setting: Community. Participants: Children (N = 160) enrolled in a larger four-armed randomized controlled trial of overweight prevention in infancy (40 randomly selected from each arm). Outcomes and Measures: Parent-reported sleep patterns at ages 6 mo, 1 yr, 2 yr, and 2.5 yr. Sensory Processing Measure-Preschool questionnaire covering five sensory systems and higher level functions: praxis and social participation at age 2.5 yr. Relationships between sleep and sensory variables were analyzed using multiple linear regression models. Results: More problematic sleep at age 2.5 yr was associated with more difficulties in social-relational skills (p <.001), a finding supported by the longitudinal data. Longer settling times were associated with higher vision (p = .036) and touch (p = .028) sensitivities at age 2.5 yr; in the longitudinal data (ages 6 mo-2.5 yr), longer settling times were associated with more sensitive hearing (p = .042). Conclusions and Relevance: Results support a link between sleep patterns and sensory processing difficulties in toddlers that, in some, can emerge in infancy. Practitioners should be alert to this association in young children presenting with sensory sensitivity or sleep challenges. What This Article Adds: Study findings illustrate that bedtime challenges in typically developing toddlers could be related to sensory processing. A possible way to assist more sensitive children in settling to sleep is to pay attention to visual, tactile, and auditory stimuli that potentially interfere with sleep onset.