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Research on the longitudinal courses of child social–emotional symptoms and sleep during the COVID-19 pandemic within societies would be of key value for promoting child well-being in global crises. We characterized the course of children’s social–emotional and sleep symptoms before and throughout the pandemic in a Finnish longitudinal cohort of 1825 5- to 9-year-old children (46% girls) with four follow-up points during the pandemic from up to 695 participants (spring 2020–summer 2021). Second, we examined the role of parental distress and COVID-related stressful events in child symptoms. Child total and behavioral symptoms increased in spring 2020 but decreased thereafter and remained stable throughout the rest of the follow-up. Sleep symptoms decreased in spring 2020 and remained stable thereafter. Parental distress was linked with higher child social–emotional and sleep symptoms. The cross-sectional associations between COVID-related stressors and child symptoms were partially mediated by parental distress. The findings propose that children can be protected from the long-term adverse influences of the pandemic, and parental well-being likely plays a mediating role between pandemic-related stressors and child well-being. Further research focusing on the societal and resilience factors underlying family and child responses to the pandemic is warranted.

Background: Paternal mental health in pregnancy and postpartum has been increasingly highlighted as important both in its own right, but also as crucial for the development of children. Rates of help-seeking among fathers is low, possibly due to conceptualising their own difficulties as stress rather than problems with mood. The relationship between paternal stress and child outcomes has not been investigated. Methods: This study used data from the Finnish CHILD-SLEEP birth cohort. Data were available for 901 fathers and 939 mothers who completed questionnaires on demographics, stress, anxiety and depression at 32 weeks gestation, 3 months, 8 months and 24 months postpartum. Parental report of child emotional and behavioural problems was collected at 24 months. Results: Around 7% of fathers experienced high stress (over 90% percentile) at each timepoint measured in the perinatal period, rising to 10% at 2 years postpartum. Paternal stress measured antenatally, at 3 and 24 months was associated with child total problems at 24 months, while paternal depression and anxiety were not related to child outcomes when in the same model. After adjusting for concurrent maternal depression, anxiety and stress, an association remained between paternal stress at each timepoint and child total problem scores at 24 months. The strongest association was with paternal stress at 3 months (OR 3.17; 95% CI 1.63–6.16). There were stronger relationships between paternal stress and boys' rather than girls' total problem scores, although the interactions were not statistically significant. Conclusions: Paternal stress is an important manifestation of perinatal distress and is related to child mental health, particularly when present in the early postpartum months. Paternal stress should therefore be assessed in the perinatal period, which presents opportunities for early intervention and prevention of difficulties for both father and child. publishedVersion

Recent advances in genome-wide association studies have enabled the estimation of genetic risk of complex traits, including neuroticism, with polygenic risk scores (PRS). Neuroticism PRS has been associated with psychiatric disorders and symptoms in adults, but studies in children are scarce. We studied whether neuroticism PRS, and its subscales, worry PRS and depressive affect PRS, were associated with externalizing and internalizing symptoms in 2-year-olds. We also examined parental neuroticism PRSs' association with children's externalizing and internalizing symptoms and whether parental depressive symptoms mediated the effect. Participants from two Finnish birth cohorts, CHILD-SLEEP and FinnBrain Birth Cohort Study, who had DNA and data on Brief Infant-Toddler Social and Emotional Assessment (BITSEA) available were included in the study (N = 806 and N = 987, respectively). PRSs were calculated based on GWAS data from UK Biobank. Child's neuroticism PRS, and its subscale worry PRS, were positively associated with externalizing symptoms in 2-year-old boys, but not in girls. Mother's depressive symptoms mediated the association between maternal neuroticism PRS and externalizing and internalizing symptoms in boys, but not in girls. Our results suggest that neuroticism PRS, and its subscale worry PRS, are associated with externalizing symptoms in already as young as 2-year-old boys, and, that subclinical symptoms of maternal depression that are based on genetic disposition, have an effect on boy's internalizing and externalizing symptoms. As we did not find any associations in girls, our study supports the suggestion that girls and boys may differ in how genetic and environmental factors contribute to their development. publishedVersion

Study Objectives We studied the associations between polygenic risk score (PRS) for attention deficit and hyperactivity disorder (ADHD) and (1) ADHD symptoms in 5-year-old children, (2) sleep duration throughout childhood, and (3) the interaction between PRS for ADHD and short sleep duration relative to ADHD symptoms at 5 years. Methods This study is based on the population-based CHILD-SLEEP birth cohort (N = 1420 children). PRS was used to quantitate the genetic risk for ADHD. Parent-reported ADHD symptoms at 5 years were obtained from 714 children, using the Strengths and Difficulties Questionnaire (SDQ) and the Five-to-Fifteen (FTF). Our primary outcomes were SDQ-hyperactivity and FTF-ADHD total scores. Parent-reported sleep duration was measured at 3, 8, 18, 24 months, and 5 years in the whole sample and actigraphy-based sleep duration at 2 and 24 months in a subsample. Results PRS for ADHD associated with SDQ-hyperactivity (β = 0.214, p = .012) and FTF-ADHD total (β = 0.639, p = .011), and FTF-inattention and hyperactivity subscale scores (β = 0.315, p = .017 and β = 0.324, p = .030), but not with sleep duration at any time point. Significant interactions were found between high PRS for ADHD and parent-reported short sleep throughout childhood in FTF-ADHD total score (F = 4.28, p = .039) and FTF-inattention subscale (F = 4.66, p = .031). We did not find any significant interaction between high PRS for ADHD and actigraphy-based short sleep. Conclusions Parent-reported short sleep moderates the association between genetic risk of ADHD and ADHD symptoms in early childhood in the general population, so that children with short sleep, in combination with high genetic risk for ADHD, could be at highest risk for ADHD symptoms.

Objectives The causal nature of the sleep-obesity association is unclear. To control for potential confounding by genes and shared environment, we studied monozygotic twin pairs discordant for body mass index (BMI). First, we investigated sleep in relation to BMI. Second, we examined associations of objective and subjective sleep duration and sleep debt (objective or subjective sleep duration minus subjective sleep need) with eating behaviors and physical activity (PA). Design Cross-sectional study. Setting Finnish twins in everyday life circumstances. Participants Seventy-four healthy young adult monozygotic twin pairs, of whom 36 were BMI-discordant (∆BMI ≥ 3 kg/m2). Measurements Clinical measurements estimated BMI and body composition. Sleep, eating, and PA behaviors were measured by self-report and actigraphy. Results Compared to co-twins with lower BMI, co-twins with higher BMI reported shorter sleep (P = .043), more snoring (P = .0093), and greater tiredness (P = .0013) and trended toward eveningness (P = .036). Actigraphy-measured sleep duration correlated highly within BMI-discordant twin pairs (r = 0.63, P = .004). Subjective sleep debt was consistently positively associated with disinhibited eating and binge eating, but not with BMI. Subjective and objective sleep debt had negative correlations with moderate-to-vigorous PA. Conclusions Twins with higher BMI showed less favorable sleep characteristics than their co-twins with lower BMI. Subjective sleep debt is a potential target for intervention to reduce eating and PA behaviors that promote weight gain. Experimental studies could elucidate mechanisms underlying tiredness in individuals with higher BMI and investigate causal relationships between sleep debt, BMI, and lifestyle.

Objective/Background: Slow wave activity (SWA) and sigma frequency activity (SFA) are hallmarks of NREM sleep EEG and important indicators of neural plasticity, development of the central nervous system, and cognition. However, little is known about the factors that modulate these sleep EEG activities, especially in small children. Patients/methods: We analyzed the power spectral densities of SWA (1–4 Hz) and SFA range (10–15 Hz) from six EEG derivations of 56 infants (8 months) and 60 toddlers (24 months) during their all-night sleep and during the first and the last half of night sleep. The spectral values were compared between the four seasons. Results: In the spring group of infants, compared with the darker seasons, SFA was lower in the centro-occipital EEG derivations during both halves of the night. The SWA findings of the infants were restricted to the last half of the night (SWA2) and frontally, where SWA2 was higher during winter than spring. The toddlers presented less frontal SWA2 during winter compared with autumn. Both age groups showed a reduction in both SWA and SFA towards the last half of the night. Conclusions: The sleep EEG spectral power densities are more often associated with seasons in infants’ SFA range. The results might stem from seasonally changing light exposure, but the exact mechanism warrants further study. Moreover, contrary to the adult-like increment of SFA, the SFA at both ages was lower at the last part of the night sleep. This suggests different regulation of spindle activity in infants and toddlers. publishedVersion

Background Knowledge of the continuity of sleep problems and the associations between sleep and psychiatric symptoms in child psychiatric patients is scarce. Objectives To investigate the persistency of sleep problems and how sleep at preschool age predicts sleep problems and psychiatric symptoms at school age in child psychiatric patients. Methods Participants ( n = 68) were child psychiatry outpatients at Helsinki University Hospital in 2015–2017. Caregivers evaluated sleep with the Sleep Disturbance Scale for Children (SDSC) and psychiatric symptoms with the Child Behavior Checklist (CBCL) at baseline (age 4–7 years) and again at follow-up (age 8–13 years). Family background information was collected at both time points. Results Sleep problems at preschool age predicted sleep problems at school age (R2Adjusted = .48, p < .001). Persistent sleep problems associated strongly with the intensity of psychiatric symptoms ( p = .001). Internalizing symptoms were predicted by sleep problems ( p = .038) even after controlling for age, sex, and psychiatric symptoms at preschool age. Conclusion Sleep problems are prevalent and persistent and relate to psychiatric symptoms in children treated at child psychiatry clinics. These results emphasize the need for identification and treatment of sleep problems in these children.