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Reliability and validity of the Children's Sleep Habits Questionnaire-toddler in Chinese preschoolers
Yi Tang1,2, Huijuan Peng1, Songsong Huang3
1Shanghai Key Laboratory of Maternal Fetal Medicine, Department of Women's and Children's Health Care, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
Objective:
This study aims to evaluate the psychometric properties of the CSHQ-T and establish an empirically supported factor structure for assessing sleep habits among Chinese children aged 3 to 4 years based on a large population-based study.
Methods:
Caregivers of 37,556 children from multiple regions in China completed the online Chinese CSHQ-T. Reliability was assessed using internal consistency (Cronbach's α), split-half reliability, and test-retest reliability (intraclass correlation coefficients, ICCs). Factor structure was examined through exploratory and confirmatory factor analyses (EFA, CFA). Concurrent validity was tested by correlating CSHQ-T scores with the Sleep Problems subscale of the Child Behavior Checklist for Ages 1½-5 (CBCL/1.5-5).
Results:
The total scale showed acceptable internal consistency (α = 0.769) and split-half reliability (Guttman coefficient = 0.857), with moderate test-retest reliability (ICCs = 0.66-0.78). EFA supported a four-factor structure-Sleep Distress, Sleep Duration, Sleep Initiation, and Sleep Transition-explaining 50.18% of the variance. CFA confirmed good model fit after excluding two items with factor loadings below 0.25 (GFI = 0.911, RMR = 0.026, RMSEA = 0.070). The CSHQ-T total score correlated moderately with the CBCL sleep subscale (r = 0.50, p < 0.01), supporting concurrent validity.
Conclusion:
The Chinese CSHQ-T demonstrates acceptable reliability and validity for assessing sleep habits in preschool children aged 3-4 years. The revised factor structure may be influenced by cultural practices, particularly the prevalence of co-sleeping in China. The instrument shows promise as a screening tool for pediatric sleep health in this population.
