The Effect of Sleep Quality of Caregivers on the Risk of Unintentional Injury among Toddlers

Unintentional injury remains the leading cause of death for children. Furthermore, the consequence of injury such as disability and psychological harm of children may result in great impact on the burden of family and society. The association of sleep disturbance of caregivers and the risk of child injury was found in our pilot case-control study. However, the temporal effect of sleep disturbance of caregivers on the risk of child injury is still remained to be clarified for understanding the mechanism of child injury. The main purpose of this study is to determine the effect of sleep quality of caregiver on the risk of child injury using a 3-year multi-stage study design. In stage one, the caregivers of infants aged one month will be recruited to provide information of substance use, health status, sleep quality, supervision, health status and injury of child in baseline. The participants will be divided as sleep deprivation cohort and normal cohort. All participating cohorts will be followed to collect the information regarding substance use, health status, sleep quality, supervision, health status and injury of child by face-to-face interview when the participated cohorts go to pediatric clinic for scheduled inoculation. In the 7th follow up, the sensational seeking scale for young children will be added to collect the risk taking behavior of toddlers. In order to control the effect of health status among caregivers, a nested case-control study will be conducted to link risk factors of cohort and health insurance claim data set in stage two. The participated cohort who ever obtained medical treatment for child injury will be selected as case group. The age and gender matched control groups will be selected from the participated cohorts without child injury using 1:4 ratios. The interactive effect of sleep quality and comorbidity of caregivers will be tested to further understand the mechanism of child injury. The anticipated study results will help to understand the mechanism of child injury and develop tailored preventive strategies for sleep deprivation of caregivers and child injury.