研究背景：嬰幼兒期是神經與免疫系統發展的黃金階段，充足且優質的睡眠對其認知、情緒及生理健康至關重要。儘管國際組織已發布各階段的睡眠時數指引，但調查顯示臺灣嬰幼兒睡眠時數普遍低於標準，且受家庭環境、父母工作及文化習俗等多重因素影響。目前國內研究多側重橫斷面分析，缺乏探討本土幼兒隨年齡增長的動態睡眠軌跡及其與長期認知發展關聯的縱貫性實證。
研究目的：本研究旨在運用縱貫性資料，建立臺灣嬰幼兒自3月齡至36月齡的長期睡眠軌跡模型（涵蓋夜間、白天及總時數），識別不同的睡眠發展分型，並探討影響軌跡歸屬的家庭與個人特徵因素。最終，深入分析不同睡眠軌跡對幼兒後續認知發展的預測作用，以期補足本土資料缺口，提供精準介入之實證依據。
研究方法：本研究採前瞻性世代研究設計，利用「臺灣幼兒發展調查資料庫（KIT）」3月齡與36月齡組之全國代表性數據 。分析方法主要運用潛在類別混合模型（Latent Class Mixed Modeling, LCMM）擬合嬰幼兒睡眠時數與夜間比例之縱貫性發育曲線，藉此動態識別並建立具異質性的潛在睡眠軌跡群組。接續透過多元線性迴歸與順序分層模型，在嚴格控制各項干擾變項後，深入評估睡眠軌跡對幼兒學齡前長期認知發展分數（EAP分數）的獨立預測效果。
研究結果：研究透過潛在類別混合模型成功識別出臺灣嬰幼兒獨特的睡眠軌跡分群。在睡眠時數方面，3月齡組區分為「初期低睡眠時長組」與「初期高睡眠時長組」，至36月齡組則分化為「持續高睡眠組」、「初期低後期追趕組」及「持續低睡眠組」，各群組之分佈特徵顯著受到托育環境、常規固定睡眠型態等臺灣本土照顧背景之影響。
在控制各項干擾共變項後，多元線性迴歸分析顯示，嬰幼兒的睡眠軌跡對其學齡前長期認知發展（EAP分數）具備獨立且穩健的預測效果：長期維持「持續高睡眠軌跡」或能在發育過程中展現「後期追趕軌跡」之幼兒，其後續的認知表現顯著優於「持續低睡眠軌跡」者，其獨立效果量達中適度水準（Cohen's d = 0.11–0.26）。進一步的性別分層分析顯示，睡眠軌跡對認知發展的預測路徑存在異質性，其中男性嬰幼兒在面對不佳或持續偏低的睡眠軌跡時，後續認知分數的劣勢較女性更為顯著，反映出男嬰在早期發育階段對睡眠剝奪具有較高的神經敏感性。
研究結論：嬰幼兒睡眠模式具有高度異質性，早期睡眠軌跡能有效預測後續認知功能。研究建議在嬰兒期應同時關注睡眠時數與規律性，而在學齡前階段則需更重視睡眠總量的穩定性，以預防因睡眠剝奪對發展中大腦造成的累積性負面影響。

Adequate sleep during infancy and early childhood is essential for neurodevelopment, supporting synaptic pruning, memory consolidation, and hormonal regulation. Despite international guidelines recommending 10–17 hours daily depending on age, Taiwanese infants and toddlers consistently fall short, with prevalent problems including irregular bedtimes and non-fixed sleep schedules. Most domestic research is cross-sectional, leaving the developmental dynamics of sleep trajectories and their cognitive consequences poorly characterized.
Using prospective data from the nationally representative "Kids in Taiwan" (KIT) cohort, this study applied Latent Class Mixed Models to identify distinct sleep trajectory groups in a 3-month cohort (N = 6,711; assessed at 3, 6, 12, 18, and 36 months) and a 36-month cohort (N = 1,937; assessed at 36, 48, 60, and 72 months). Associations with cognitive development (EAP scores) were examined via sequential linear regression with stratified analyses by sex, parental education, and daytime care arrangement.
Three total-sleep trajectory groups emerged in the 3-month cohort—Stable-Normal (65%), Early-High (31%), and Early-Low (4%)—and two in the 36-month cohort—Stable (73%) and Decreasing (27%). Both atypically high and low early sleep were associated with lower cognitive scores at follow-up. Stable total sleep through preschool predicted better outcomes than declining sleep (Cohen's d = 0.11–0.26), independently of family socioeconomic status. Nighttime sleep ratio trajectories showed weaker cognitive associations, supporting total duration as the primary clinical indicator. Sleep hygiene education should be promoted universally in early childhood.

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