Environmental perceptions, self-regulation, and coping with noise mediate the associations between children's physical environment and sleep and mental health problems.

Background: Children face various challenges in their home and extended neighborhood settings. In this study, we examine the impact of the built and social environments on sleep/mental health and the potential mediating role of environmental perceptions, self-regulation, and coping with noise.

Methods: Cross-sectional data for 1251 schoolchildren (8-12 years) were sampled in the Tyrol region of Austria/Italy. Questionnaires provided information on sociodemographic and housing factors, perceived neighborhood quality, coping with noise during home-work, self-regulation, sleep, and mental health problems. A built environment score was based on modeled levels of road and rail traffic noise, nitrogen dioxide, and imperviousness density. Home garden represented availability of accessible greenspace. Associations between predictors and mental health/sleep problems were examined using quantile regressions and structural equation modeling (SEM).

Results: In multivariate regressions, poor neighborhood quality, poor self-regulation, low traffic safety, and higher coping efforts were associated with more mental health and sleep problems. Good family relations acted in the opposite direction. In SEM, the built environment score was associated with lower neighborhood quality and lower traffic safety, which in turn led to higher coping efforts, and then to mental health/sleep problems. Home gardens related to less sleep problems through higher perceived neighborhood quality and lower coping efforts. Good family relations were associated with better mental health/sleep directly and via better self-regulation and lower coping efforts.

Conclusions: Children forced to engage in coping activities when disturbed by noise during homework show poorer mental health. Good family relations, good neighborhood quality, and close-by greenspace may be factors to alleviate built environment stressors. The negative association of required coping with noise during homework suggests that children, in contrast to adults, may be limited in their coping abilities. Our findings call for further inquiries, as children and their environments may vary with respect to coping efficiently.