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Sleep problems of school-aged children: a complementary view
E J Paavonen1, E T Aronen, I Moilanen
1Department of Child Psychiatry, University of Helsinki, Finland.
Insights
Many children experience sleep problems, with nearly a third of cases missed if only parents report. Including child reports improves detection of disturbed sleep in children.
Area of Science:
- Pediatric Sleep Medicine
- Child Psychology
- Epidemiology
Background:
- Sleep problems are common in children and can impact health.
- Previous studies often rely solely on parental reports, potentially underestimating prevalence.
Purpose of the Study:
- To determine the prevalence of sleep problems in 8-9-year-old Finnish children.
- To compare sleep problem reporting between children and parents.
- To assess the impact of using single vs. dual informants on detection rates.
Main Methods:
- Population-based multicentre study involving 5813 Finnish children (8-9 years old).
- Data collected through questionnaires completed by both children and their parents.
- Analysis of sleep problem prevalence, types (dyssomnias), and informant agreement.
Main Results:
- 21.7% of parents and 17.8% of children reported disturbed sleep.
- Dyssomnias included difficulties with sleep onset (11.1%), night waking (7.1%), and early waking (2.3%).
- Poor agreement (kappa = 0.224) between child and parent reports; using only parents missed one-third of cases.
Conclusions:
- Childhood sleep problems are prevalent and varied, including dyssomnias.
- Dual reporting (child and parent) significantly increases the sensitivity of screening for sleep problems.
- Clinical and epidemiological assessments should incorporate both child and parent perspectives for accurate diagnosis.
Abstract:
The aim of this population-based multicentre study was to evaluate the prevalence rates of sleep problems among 8-9-y-old children. The sample consisted of 5813 Finnish children, making up 10% of the age cohort. Both parents and children provided information. Disturbed sleep was reported by 21.7% of parents. Most of the problems were mild; only 0.3% were serious. Dyssomnias were frequent: 11.1% had difficulties with sleep onset, 7.1% with night waking and 2.3% with waking too early. Multiple sleep problems were present in 9.1% of the children. 17.8% of children reported disturbed sleep, 12.7% had problems many nights and 5.1% every night. In 32.0% of cases, either the parent or the child reported disturbed sleep; 7.4% of these reports came from both the parent and the child, 14.1% from the parent only and 10.3% from the child only. The correspondence between informants was poor (kappa = 0.224). Sleeping problems were associated with somatic and psychiatric problems. It is concluded that by restricting questioning to parents only, one-third of all potential cases of sleep problems may go unnoticed. In order to increase the sensitivity of screening children's sleep problems, both parents and children should provide information in epidemiological settings as well as in clinical work.