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Sleep and behavior problems in school-aged children.

M A Stein1, J Mendelsohn, W H Obermeyer

  • 1Departments of Pediatrics and Psychiatry, George Washington University School of Medicine and Children's National Medical Center, Washington, DC 20010, USA. mstein@cnmc.org

Pediatrics
|May 23, 2001
PubMed
Summary

Sleep problems are common in school-aged children, with a history of early sleep issues predicting current problems. Parental reports of sleep disturbances may indicate underlying medical or psychological concerns.

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Area of Science:

  • Pediatric Sleep Medicine
  • Child Psychology
  • Public Health

Background:

  • Sleep problems affect a significant portion of school-aged children.
  • Parental perception of sleep issues is a key indicator.

Purpose of the Study:

  • To determine the prevalence of sleep problems in school-aged children.
  • To investigate associations between sleep problems, parental perception, medical history, and psychopathology.

Main Methods:

  • Survey of 472 children (ages 4-12) using sleep, medical history, and Child Behavior Checklist questionnaires.
  • Data collected from parents in urban, rural, and suburban pediatric practices.

Main Results:

  • 10.8% of children experienced sleep problems in the past 6 months; less than half were discussed with pediatricians.

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  • History of sleep problems before age 2 was the strongest predictor of current issues.
  • Common sleep problems (snoring, daytime tiredness, difficulty falling asleep) occurred weekly in over 20% of children.
  • Factor analysis identified five sleep problem categories: parasomnias, enuresis/gags, tiredness, noisy sleep, and insomnia.
  • Specific factors correlated with medical history (falls, pica, allergies, hospitalizations) and psychopathology.
  • Lower socioeconomic status was linked to parasomnias and noisy sleep.
  • Younger children had higher rates of enuresis/gags and longer naps.
  • Boys were more prone to enuresis/gags, associated with trauma and falls.
  • Tiredness was linked to napping, later bedtimes, and hospitalizations.
  • Sharing a bed was associated with tiredness and noisy sleep; sharing a room was not linked to any factor.

    • Conclusions:

    • Parental reports of sleep problems in school-aged children are frequent and may signal underlying issues.
    • Sleep problems can be indicators of psychiatric, social, or medical conditions.
    • Pediatricians should routinely inquire about sleep problems in school-aged children.