Sleep Health Among Children Recently Adopted from Foster Care

Sleep disruption is prevalent among children placed in foster care, elevating the risk for a range of deleterious outcomes. Theoretically, achieving permanency via adoption may have a positive influence on children’s sleep via the presence of various factors, but little is known about the sleep health of children adopted from foster care, including predictors and moderators of sleep quality. The current study included 226 parents who adopted a child from foster care (aged 4 to 11 years) within the past two years and propensity score matched sample of 379 caregivers of children currently in foster care. Both samples completed online questionnaires about their child’s sleep, physical, and mental health. Comparatively, children in foster care experienced more nightmares, night terrors, moved to someone else’s’ bed during the night more often and worse overall sleep quality, whereas adopted children were reported to experience more nighttime awakenings. In the adopted sample, a greater number of adverse childhood experiences (ACEs) predicted better sleep quality, but this relationship was moderated by parent-child interactions around sleep. Specifically, child sleep dependence scores (i.e., difficulty going to sleep without parent) falling at both the highest and lowest levels strengthened the relationship between ACEs and sleep quality. Findings suggest that while some sleep problems might remit after children in foster care achieve permanence, nighttime sleep fragmentation may persist. Further, parent-child interactions surrounding sleep may be pivotal in targeting sleep problems in this population.