Child sleep behaviors and sleep problems from infancy to school-age

Few studies have examined the sleep behaviors associated with a caregiver-reported sleep problem beyond early childhood and across different age groups. This study examined sleep behaviors associated with a caregiver-reported sleep problem from birth to middle childhood.

Participants were 5107 children from the Longitudinal Study of Australian Children-Birth Cohort. Caregiver-reported child sleep problems and sleep behaviors were assessed biennially from ages 0-1 to 10-11 years. Logistic regressions were used to examine associations between three child sleep behaviors (waking overnight, difficulty falling asleep, and difficulty sleeping alone) and the odds of having a caregiver-reported sleep problem at each age.

Caregiver-reported child sleep problems were most prevalent in infancy (17.1%) and decreased through middle childhood (7.7%). All three sleep behaviors were associated with a sleep problem at each age. Whereas waking overnight was the most common sleep behavior and was associated with the highest odds of having a sleep problem from infancy to age 6-7 years (ORs = 5.78-8.29), difficulty falling asleep was the most common sleep behavior and was associated with the highest odds of having a sleep problem at ages 8-9 and 10-11 years (ORs = 10.65 and 17.78, respectively).

Caregivers' endorsement of a child sleep problem was associated with developmentally-relevant sleep behaviors, with night awakenings most relevant during infancy and difficulty falling asleep most relevant in middle childhood. Study findings have implications for targeted and developmentally-focused sleep problem screening questions in child healthcare settings. Future research examining additional indicators of caregiver-defined sleep problems is required.