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 11/2005; 9(4):210-214. DOI: 10.1111/j.1439-054X.2005.00073.x


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.

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    • "Children in the age range of our sample are often asked to report their sleep behavior (e.g., Meijer, 2008; Spilsbury et al., 2005). They tend to identify more sleep problems than their parents, especially problems with falling asleep and restless sleep (Owens et al., 2000; Wiater et al., 2005). Our items were pretested in a study with 75 elementary school children (five occasions) and had to be brief and easy for children. "
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    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; 56(2). DOI:10.1111/jcpp.12296 · 6.46 Impact Factor
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    • "For example, children with behavior problems have more sleep disturbances [30] [31]. Sleep onset delays, sleep problems through the night, and daytime sleepiness are associated with an increased risk of behavioral problems [2]. Bedtime resistance is related to either hyperactivity or conduct problems, and longer sleep duration occurs more frequently in children with both hyperactive and emotional problems [32]. "
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    ABSTRACT: Objective: The study aimed to (1) characterize sleep patterns and sleep disturbances among Chinese school-aged children, (2) determine the prevalence of their short sleep duration and sleep disturbances based on clinical cutoffs, and (3) examine possible factors (socio-demographic factors and emotional/behavioral problems) that are associated with sleep disturbances. Methods: A large representative sample of 912 children aged 6-14years was recruited from Shenzhen, China. Their parents completed the Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ). Results: The mean bedtime was 9:45pm (SD=1h 11min), mean wake-up time was 7:03am (SD=31min), mean sleep duration was 9h 14min (SD=46min), and 23.8% of the children had sleep duration <9h. Overall, 69.3% of the children suffered from global sleep disturbances (CSHQ total score >41). Bedtime resistance (22.9%), sleep anxiety (22.1%), sleep duration (21%) and daytime sleepiness (20%) were the most prevalent sleep disturbances; followed by sleep disordered breathing (12.1%), parasomnias (9.4%), sleep onset delay (6.9%), and night waking (5.2%). The prevalence of specific sleep disturbances ranged from 3.2% (falling asleep while watching television) to 81.9% (awakening by others in the morning). Correlations between most domains of sleep disturbances and emotional/behavioral problems were statistically significant (p<0.05 or p<0.01). Hierarchical multiple regression analysis revealed that gender (β=0.10, p<0.01), school grade (β=-0.09, p<0.05), co-sleeping (β=0.25, p<0.01), emotional symptoms (β=0.24, p<0.01), conduct problems (β=0.09, p<0.05), and hyperactivity (β=0.17, p<0.01) accounted for significant variance in CSHQ total score. Conclusions: Short sleep duration and sleep disturbances are prevalent among Chinese school-aged children. Sleep disturbances are associated with gender, school grade, co-sleeping, emotional symptoms, conduct problems, and hyperactivity.
    Sleep Medicine 12/2012; 14(1). DOI:10.1016/j.sleep.2012.09.022 · 3.15 Impact Factor
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    • "Among recent findings, a cross-sectional, questionnairebased study of data from 4531 children aged 8 to 11 years concluded that sleep disorders were common among 8-to 11-year-old children, and that sleep onset delays, problems of sleeping through the night, and daytime sleepiness were associated with increased risk of behavioral problems. It is important to note that these behavioral problems included emotional problems, hyperactivity, conduct problems, peer problems, and social difficulties (Wiater et al., 2005). "
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    ABSTRACT: The aim of this study was twofold: to assess psychological functioning, interactional competencies, and sleep patterns in children and adolescents with cleft lip and palate (CLP), and to compare these results with those from age- and gender-matched controls. It was hypothesized that participants with CLP would exhibit greater difficulties in psychological functioning, more interactional difficulties, and poorer sleep patterns than those without CLP. Thirty-two children and adolescents with CLP and 34 controls were recruited. Ages ranged from 6 to 16 years. For psychosocial assessment, the Strength and Difficulties Questionnaire (SDQ) and a questionnaire on interactional competencies (PIELCQ) were completed; for sleep assessment, a sleep log was completed for seven consecutive nights. Results: Participants with and without CLP did not differ with respect to emotional problems, conduct problems, or hyperactivity. With respect to interactional competencies, participants with CLP were six times more likely to report difficulties. Unfavorable sleep patterns were associated with psychosocial strain but not with the presence of CLP. Results indicate that children and adolescents with CLP may report that they have sleep irregularities as often as those without CLP. In adolescence, the presence of CLP may be associated with increased difficulties. Consequently, skill training to improve context-related social competencies may be appropriate.
    The Cleft Palate-Craniofacial Journal 04/2009; 46(2):124-35. DOI:10.1597/07-165.1 · 1.20 Impact Factor
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