0904 Sleep Disturbances and Anxiety/Depressive Symptoms in Children Placed in Foster Care: The Moderating Effect of Caregiver Connection

Abstract Introduction Children who spend time in foster care experience high rates of sleep disturbances, often exacerbated by symptoms of anxiety or depression (Alfano, 2020). Other research has found positive interactions with caregivers prior to sleep to be protective of these problems (Cifre et al., 2024). The present study examined whether affectionate interactions with caregivers prior to sleep moderates the association between child anxiety/depressive symptoms and sleep disturbances among children adopted from foster care. Methods N=66 adoptive foster parents completed baseline surveys as part of a child sleep intervention study. Adopted children (Mage=7.9, SD=1.4) were roughly half female (56%) and relatively diverse (19% Black, 23% Hispanic). Parents completed the Children’s Sleep Habits Questionnaire (CSHQ), the Revised Child Anxiety and Depression Scale (RCADS-25), and the Bedtime Routines Questionnaire (BRQ). Two BRQ items capturing affectionate interactions (26. In the past month, in the hour before going to bed, how often did your child hug/kiss caregiver?; 31. In the past month, in the hour before going to bed, how often did your child cuddle with caregiver?) were examined as moderators. Results A linear regression model found higher RCADS scores were a strong predictor of greater sleep problems (b = 0.53, SE = 0.09, p < .001). The RCADS × Affectionate Interaction items approached significance (b = -0.08, SE = 0.04, p = .072) based on a small-to-moderate effect, whereby more frequent affectionate interactions reduced the strength of the association between anxiety and sleep problems. For specific types of sleep problems, affectionate interactions marginally moderate the relationship between RCADS and bedtime resistance (b = -0.03, SE = 0.01, p = .064) and significantly moderate the association with sleep onset delay (b = -0.01, SE = 0.004, p = .046). Conclusion Findings corroborate results from prior studies showing warm, intimate parent-child interactions before sleep have a positive impact on children’s sleep health, particularly bedtime resistance and sleep onset delay. Interventions that promote greater emotional connection as part of child bedtime routines may be particularly critical for children who have experienced maltreatment and/or interpersonal trauma. Support (if any) This study was supported by NIMH grant #R34MH128598 awarded to the last author.