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Sleep problems of elementary school children. A community survey
J C Blader1, H S Koplewicz, H Abikoff
1Division of Child and Adolescent Psychiatry, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
Insights
Bedtime resistance is the most common sleep issue in elementary children, but a subgroup experiences insomnia and anxiety. Addressing sleep onset and wake times is crucial for managing these problems.
Area of Science:
- Pediatric Sleep Medicine
- Child Psychology
Background:
- Sleep problems are prevalent in elementary school children.
- Understanding the co-occurrence and correlates of these issues is vital for effective intervention.
Purpose of the Study:
- To examine the prevalence, co-occurrence, and correlates of sleep problems in elementary school children.
- To identify specific sleep issues and their associated factors.
Main Methods:
- Anonymous survey completed by parents of 987 children aged 5-12 years.
- Survey assessed background characteristics, sleep environment, habits, interventions, history, and specific sleep problems.
Main Results:
- Bedtime resistance was the most common problem (27%), followed by morning wake-up issues and fatigue (17%).
- Sleep-onset delays (11.3%) and night waking (6.5%) were also reported.
- Sleep-onset problems correlated with fears, medical/psychiatric conditions, and a history of sleep issues.
Conclusions:
- Bedtime resistance is a primary parental complaint, but a subset of children exhibit insomnia and anxiety-related sleep issues.
- Sleep-phase delays may contribute to persistent sleep problems, highlighting the need for consistent bedtime and wake times.
- Distinct evaluation of sleep onset, maintenance, waking, and emotional adjustment is essential for comprehensive care.
Objective:
To examine the prevalence, co-occurrence, and correlates of sleep problems among elementary school children.
Design:
Survey.
Setting:
General community.
Participants:
The parents of 987 children aged 5 to 12 years completed an anonymous survey distributed in their children's schools.
Main Outcome Measures:
The survey form asked about background characteristics, children's sleep environment, sleep habits, adult interventions, sleep history, and specific sleep problems.
Results:
Bedtime resistance was the most prevalent sleep problem (27%). Sleep-onset delays (11.3%), night waking (6.5%), morning wake-up problems (17%), and fatigue complaints (17%) were also common. Among children with sleep-onset problems, 80% displayed bedtime resistance, while 34% of bedtime resisters had onset problems. Onset problems correlated with more fears, night waking, psychiatric and medical conditions, the need for reassurance and caregiver proximity, and history of sleep problems. Bedtime resistance was associated with an inconsistent bedtime and falling asleep away from bed. Those who display delayed sleep onset and bedtime resistance also wake later, suggesting that sleep-phase delays may maintain these problems.
Conclusions:
The results confirm bedtime resistance as parents principal sleep-related complaint for this age group but reveal a subgroup more prone to insomnia, night waking, and anxiety-related features. Phase delay findings suggest the importance of limits around wake-up time as well as bedtime. The results highlight the importance of distinctly evaluating bedtime resistance, sleep onset, sleep maintenance, waking, and emotional adjustment.