This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Stein, M. A.
Right arrow Articles by Benca, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Stein, M. A.
Right arrow Articles by Benca, R.
Related Collections
Right arrow Neurology & Psychiatry

PEDIATRICS Vol. 107 No. 4 April 2001, p. e60

ELECTRONIC ARTICLE:
Sleep and Behavior Problems in School-Aged Children

Received Jun 15, 2000; accepted Nov 22, 2000.

Mark A. Stein*, Janis MendelsohnDagger , William H. Obermeyer§, Julie AmrominDagger , and Ruth Benca

From the * Departments of Pediatrics and Psychiatry, George Washington University School of Medicine and Children's National Medical Center, Washington, DC; Dagger  Department of Pediatrics, University of Chicago, Chicago, Illinois; and § Department of Psychiatry, University of Wisconsin, Madison, Wisconsin.

Objectives.  The primary purposes of the present study were to survey the prevalence of sleep problems in school-aged children and to examine these associations with parental perception of sleep problems, medical history, and childhood psychopathology.

Methods.  Sleep and medical history questionnaires and the Child Behavior Checklist were administered to the parents of 472 children between ages 4 and 12 years receiving routine pediatric care from urban, rural, and suburban pediatric practices.

Results.  Although sleep problems were reported for 10.8% of the sample during the past 6 months, less than one half of the parents who identified sleep problems reported that they had discussed sleep with their child's pediatrician. The best predictor of current sleep problems was a history of sleep problems before age 2 years. Sleep problems such as snoring, tiredness during the day, and taking excessive time to fall asleep were very common, occurring at least 1 night per week in over 20% of the total sample. Factor analysis of the sleep problems questionnaire resulted in 5 sleep problem factors that accounted for 58.7% of the variance. Specific sleep problem factors include: parasomnias, enuresis/gags, tiredness, noisy sleep, and insomnia. Sleep problem factor scores were differentially associated with medical history variables and measures of childhood psychopathology. Children rated highly on parasomnias were more likely to have frequent falls and to display pica. Parasomnias and noisy sleep were inversely associated with socioeconomic status (SES). Children from lower SES families were rated higher on these factors than children from higher SES families. Enuresis/gags was the only sleep problem factor associated with age. Younger children scored higher on this factor. Duration of naps was highly correlated with age and with bed times during the week and weekends. As expected, younger children were more likely to nap for longer periods and to have earlier bed times. In addition, higher tiredness factor scores were associated with napping and with later bed times during the week and weekend. Boys were much more likely than were girls to have higher scores on enuresis/gags, and higher enuresis/gags scores were associated with an increased prevalence of trauma and falls. Bed times were not associated with any other sleep problem factor score. Children rated highly on tiredness were more likely to have a history of hospitalizations. Tiredness factor scores were strongly associated with the sleep practice of sharing a bed but not with sharing a room. Sharing a room was not associated with any sleep problem factor score. High scores on noisy sleep were associated with allergies, falls frequently, and with sharing a bed. Children with high scores on the insomnias were also more likely to display an increased prevalence of allergies.

Conclusions.  Parental perception of global sleep problems was surprisingly common in school-aged children receiving routine pediatric care. Parental reports of their children's sleep problems may be a red flag for specific sleep problems and psychiatric, social, or medical problems. Sleep problems should be queried about during pediatric visits for school-aged children.  Key words:  sleep problems, insomnia, behavioral problems.




This article has been cited by other articles:


Home page
 Proc Am Thorac SocHome page
O. S. Capdevila, L. Kheirandish-Gozal, E. Dayyat, and D. Gozal
Pediatric Obstructive Sleep Apnea: Complications, Management, and Long-term Outcomes
Proceedings of the ATS, February 15, 2008; 5(2): 274 - 282.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
L. S. Nield and D. Kamat
Enuresis: How to Evaluate and Treat
Clinical Pediatrics, June 1, 2004; 43(5): 409 - 415.
[PDF]

Home page
 CLIN PEDIATRHome page
A. Ivanenko, V. M. Crabtree, R. Tauman, and D. Gozal
Melatonin in Children and Adolescents with Insomnia: A Retrospective Study
Clinical Pediatrics, January 1, 2003; 42(1): 51 - 58.
[Abstract] [PDF]