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Sleep difficulties and related behavioral problems in Korean preschool children
Taeyeop Lee1, Jichul Kim1, Kee Jeong Park1
1Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Insights
Preschoolers with developmental disabilities (DD) who have sleep difficulties exhibit more externalizing behaviors like aggression. Sleep issues in these children are linked to behavioral problems, not cognitive development.
Area of Science:
- Child Psychology
- Developmental Pediatrics
- Sleep Medicine
Background:
- Sleep difficulties are common in preschoolers and linked to behavioral and cognitive issues.
- The association between sleep problems and developmental disabilities (DD) requires further investigation in young children.
Purpose of the Study:
- To compare behavioral and cognitive characteristics of poor and good sleepers among preschoolers with and without DD.
- To identify specific behavioral and cognitive differences associated with sleep difficulties in this population.
Main Methods:
- Recruited 196 preschoolers (34-77 months) from various community centers.
- Classified children into four groups: poor sleepers with DD, poor sleepers without DD, good sleepers with DD, and good sleepers without DD.
- Defined poor sleepers using the Children's Sleep Habits Questionnaire Total Sleep Disturbance Score (CSHQ TSDS) cutoff of >52.
Main Results:
- Poor sleepers with DD showed significantly higher attention problems and aggressive behaviors compared to good sleepers with DD.
- Caregivers of poor sleepers with DD reported increased depressive symptoms and stress.
- Poor sleepers without DD exhibited higher anxiety/depression scores, but cognitive development and adaptive functioning were similar across all groups.
Conclusions:
- Sleep difficulties in preschoolers with DD are primarily associated with externalizing behaviors, such as aggression.
- Cognitive development and adaptive functioning are not significantly impacted by sleep patterns in this age group.
- Sleep onset delay is a key factor correlating with behavioral issues and caregiver distress.
Objectives:
Sleep difficulties are associated with various behavioral problems and cognitive development, but the association has not been thoroughly evaluated in preschoolers with and without developmental disability (DD). The aim of this study was to compare the behavioral and cognitive characteristics of poor and good sleepers with and without DD in a community-based sample of preschool children.
Methods:
We recruited 196 children aged 34-77 months from community-based daycare centers, kindergartens, and special education centers. Children were classified as poor sleepers with DD (n = 23), poor sleepers without DD (n = 23), good sleepers with DD (n = 64), and good sleepers without DD (n = 94). Poor sleepers were defined based on Children's Sleep Habits Questionnaire Total Sleep Disturbance Score (CSHQ TSDS) cutoff of >52.
Results:
When compared to good sleepers with DD, poor sleepers with DD scored significantly higher on the Attention Problems (p = 0.005) and Aggressive Behaviors (p = 0.001) subscales of the CBCL, indicating greater difficulty. Caregivers of the poor sleepers with DD reported more depressive symptoms (p = 0.028) and more stress related to the child (p = 0.002) and the parent (p = 0.045) than caregivers of the good sleepers with DD. On the other hand, when compared to good sleepers without DD, poor sleepers without DD scored significantly higher only on the Anxious/Depressed subscale (p = 0.045) of the CBCL. Cognitive development and adaptive functioning were not significantly different between poor and good sleepers with and without DD. Among the subscales of the CSHQ, the Sleep Onset Delay showed strongest correlation with behavioral measures of the children and distress of the caregivers.
Conclusion:
Externalizing problems such as aggressive behaviors, rather than cognitive development, are associated with sleep difficulties in preschool children with DD.
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