Sleep disorders and behavioural problems among 8- to 11-year-old children

Kinderklinik, Krankenhaus Porz/Rhein Postfach 900680 51116 Köln Germany
Somnologie - Schlafforschung und Schlafmedizin 01/2005; 9(4):210-214. DOI: 10.1111/j.1439-054X.2005.00073.x

ABSTRACT Question of the studyTo assess the prevalence of sleep disorders in 8- to 11-year-old children and their relation to behavioural problems.

Study designA population based, cross-sectional survey was carried out among fourth-grade elementary school children in Cologne, Germany.
A total of 8599 children were enrolled. Parent-completed and children-completed questionnaires were used to ascertain sleep
disorders and behavioural problems.

ResultsIn all, 4531 questionnaires were completed. Parent-reported sleep onset delays were frequent with 6% of the children, problems
to sleep through the night with 3%, daytime sleepiness with 1%. Children-reported sleep onset delays were frequent with 10%,
problems to sleep through the night with 6%, and daytime sleepiness with 3%. Children with these sleep disorders and daytime
sleepiness had an increased risk of emotional problems, hyperactivity, conduct problems, peer problems, and social difficulties
compared with children without sleep disorders or daytime sleepiness.

ConclusionsSleep disorders are common among 8- to 11-year-old children. To assess the prelalence of sleep disorders among school children,
parent-completed and children-completed questionnaires are necessary. Sleep onset delays, problems to sleep through the night,
and daytime sleepiness among children are associated with an increased risk of behavioural problems.

FragestellungUntersuchung der Prävalenz von Schlafstörungen bei 8–11 Jahre alten Kindern und deren Auswirkung auf Verhaltensprobleme.

StudiendesignEs wurde eine populations-bezogene Querschnittsuntersuchung bei allen Kinder der 4. Grundschulklasse in Köln durchgeführt.
8599 Kinder waren einbezogen. Eltern- und Kinderfragebögen wurden eingesetzt, um Schlafstörungen und Verhaltensprobleme zu

Ergebnisse4531 Fragebögen wurden vollständig ausgefüllt. Von den Eltern berichtete Einschlafstörungen waren häufig bei 6% der Kinder.
Durchschlafstörungen bei 3%, Tagesmüdigkeit bei 1%. Nach Kinderangaben waren Einschlafstörungen häufig bei 10%, Durchschlafstörungen
bei 6% und Tagesmüdigkeit bei 3%. Kinder mit Ein- und Durchschlafstörungen und Tagesmüdigkeit hatten ein erhöhtes Risiko für
emotionale Probleme, Hyperaktivität, Verhaltensprobleme, Probleme mit Gleichaltrigen und fehlendes prosoziales Verhalten im
Vergleich mit Kindern ohne Schlafstörungen und Tagesmüdigkeit.

SchlussfolgerungSchlafstörungen sind häufig bei 8–11 Jahre alten Kindern. Um die Prävalenz der Schlafstörungen bei Schulkindern zu erfassen,
sind sowohl Eltern- als auch Kinderbefragungen notwendig. Einschlafstörungen, Durchschlafstörungen und Tagesmüdigkeit bei
Kindern gehen einher mit einem erhöhten Risiko für Verhaltensprobleme.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Sleep problems may affect daytime performance. Thus, the prevalence of sleep problems and their associations with poor academic performance in a cross-sectional study performed in 27 primary schools in Hannover, Germany, were investigated. Methods Sleep problems (e.g., sleep onset delays, night awakenings, sleepwalking, nightmares, and bedwetting) were examined by parental and children’s questionnaires. Poor academic performance, defined as grade 4 or more on a 6-point scale, or requirement for additional lessons in mathematics, science, reading, spelling, or handwriting was assessed using grades from the last term’s school report forms. Results Of 1,144 children enrolled (mean age 9.6 years, 51% males), 760 (66.4%) had sleep problems reported by their parents, with sleep onset delays having the highest prevalence (prevalence 49.1%, 95% confidence interval (CI) 46.1–51.9). Children reported sleep problems more frequently than their parents. Significant associations with academic performance were found for night awakenings and nightmares; however, clear dose–response relationships were only found for nightmares. Children who “often” had nightmares (n = 24) were more likely to have poor academic performance in mathematics (odds ratio 5.2, 95% CI 1.6–17.1), science (6.8, 95% CI 1.4–32.1), and spelling (7.5, 95% CI 2.3–24.9). Conclusion Sleep problems are common in primary school children. Among these, nightmares may have a negative impact on academic performance.
    Somnologie - Schlafforschung und Schlafmedizin 12/2011; 15(4).
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Being a parent is often associated with less sleep and sleep problems. In addition, young children often suffer from sleep problems. Hence, children’s sleep problems can evoke sleep problems in their parents. However, little is known about sleep of family members. Method A total of 54 parents with their children between 4 and 12 years of age (mean 7.04 years) participated in this study prior to a universal parent-training. Sleep problems were assessed by the Child Behavior Checklist (CBCL) and the Symptom Checklist 90-R (SCL-90-R). Psychological problems of the children and parental burden were further evaluated with the Eyberg Child Behavior Inventory (ECBI). In addition, parental behavior was assessed with the short form of the Parenting Scale of Arnold (“Erziehungsfragebogen für Eltern”, EFB-K). Results In sum, 13 % of the children showed shorter overall sleep duration than other children, whereas 5.6 % slept more. None of the parents reported daytime sleepiness in their children, but 3.9 % reported that their children do often have nightmares and also 3.9 % often talk during sleep. Altogether 15.4 % of the parents thought that their child suffered from sleep problems. Problems falling asleep were reported by 19.6 % of mothers and 10.5 % of fathers and disturbed sleep was reported by 33.3 % of mothers and 12.6 % of fathers, whereas 15.8 % of mothers and 8.4 % of fathers were suffering from waking up too early in the morning. Children with sleep disturbances did not differ significantly from children without sleep problems regarding their psychological disturbances. However, parents differed with regard to parental burden, depression, anxieties, and sleep problems. The main limitations are the small sample size and the lack of a healthy control group. Conclusion In contrast to their parents, children with or without sleep problems did not differ concerning psychological disturbances. Consequently, even if the child is not affected by sleep problems these issues need to be considered for parents participating in a universal parent-training. Furthermore, fathers also need to be integrated into diagnostics, not only mothers, because sleep problems and other psychological problems are often experienced by both parents.
    Somnologie - Schlafforschung und Schlafmedizin 09/2013;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Recent studies have suggested substantial fluctuations of cognitive performance in adults both across and within days, but very little is known about such fluctuations in children. Children's sleep behavior might have an important influence on their daily cognitive resources, but so far this has not been investigated in terms of naturally occurring within-person variations in children's everyday lives. Methods In an ambulatory assessment study, 110 elementary school children (8–11 years old) completed sleep items and working memory tasks on smartphones several times per day in school and at home for 4 weeks. Parents provided general information about the children and their sleep habits. Results We identified substantial fluctuations in the children's daily cognitive performance, self-reported nightly sleep quality, time in bed, and daytime tiredness. All three facets were predictive of performance fluctuations in children's school and daily life. Sleep quality and time in bed were predictive of performance in the morning, and afternoon performance was related to current tiredness. The children with a lower average performance level showed a higher within-person coupling between morning performance and sleep quality. Conclusions Our findings contribute important insights regarding a potential source of performance fluctuations in children. The effect of varying cognitive resources should be investigated further because it might impact children's daily social, emotional, and learning-related functioning. Theories about children's cognitive and educational development should consider fluctuations on micro-longitudinal scales (e.g., day-to-day) to identify possible mechanisms behind long-term changes.
    Journal of Child Psychology and Psychiatry 07/2014; · 5.42 Impact Factor