Preschool attendance and children's sleep patterns: Associations with sleep and behavioral problems

Sleep has long been recognized as a critical factor in early development, with its patterns changing across age and influenced by environmental and social contexts. While school attendance offers benefits for cognitive and socioemotional development, it may also influence children's sleep schedules. This study compared the sleep patterns between preschool-attending and non-attending children and examined their associations with emotional and behavioral problems. Questionnaires were administered to 8,629 (87.52%) parents of children aged 3 to 6 years who attended preschool regularly and 1,231 (12.48%) parents of children who did not attend school. Our finding demonstrated that, compared with children who did not attend preschool, preschool-attending children experienced shorter nighttime sleep on weekdays, greater weekday-weekend differences in sleep duration, and higher levels of social jetlag. Additionally, they exhibited increased daytime sleepiness, more sleep-related breathing difficulties, and reported fewer peer problems. In contrast, children who did not attend preschool showed greater prosocial behavior, whereas no significant group differences were observed in emotional or behavioral difficulties. Furthermore, preschool attendance was found to moderate the associations between social jetlag and both sleep disturbances and daytime sleepiness, whereas no significant moderation effect was observed for SDQ behavioral outcomes. These results highlight the importance of balancing early education with children's sleep health, and underscores the need for psychoeducation to promote healthy sleep habits among preschoolers to facilitate their overall development.