Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. 86-93 (doi:10.1542/peds.2006-1757)
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ARTICLE

Adverse Associations of Sleep Problems in Australian Preschoolers: National Population Study

Harriet Hiscock, MDa,b,c, Louise Canterford, GDipSci(Stats)a,b, Obioha C. Ukoumunne, PhDb,c,d and Melissa Wake, MDa,b,c

a Centre for Community Child Health
d Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, Melbourne, Australia
b Murdoch Childrens Research Institute, Melbourne, Australia
c Department of Paediatrics, University of Melbourne, Melbourne, Australia

OBJECTIVE. In contrast to school-aged children, the impact of sleep problems in preschool-aged children is not well documented. We aimed to determine relationships between preschool-aged child sleep problems and child behavior; health-related quality of life; verbal, preliteracy, and early numeracy skills; diagnosis of attention-deficit/hyperactivity disorder; and injury.

PARTICIPANTS AND METHODS. Participants included families (n = 4983) participating in the first wave of the Longitudinal Study of Australian Children, a nationally representative study of Australian children aged 4 to 5 years surveyed from March to November 2004. Measures consisted of a primary caregiver's report of whether their child had a sleep problem (none versus mild versus moderate/severe); specific sleep patterns occurring ≥4 nights per week; health-related quality of life (by using the Pediatric Quality of Life Inventory 4.0); behavior (by using the Strengths and Difficulties Questionnaire) and parent-reported diagnosis of attention-deficit/hyperactivity disorder; and injury requiring medical attention in the past 12 months. Tests of receptive vocabulary and preliteracy/numeracy skills (by using the Who Am I? developmental assessment and the adapted Peabody Picture Vocabulary Test, 3rd Edition) were directly administered to each child.

RESULTS. Sleep problems were common, and compared with children without sleep problems, children with sleep problems had poorer child health-related quality of life, more behavior problems, and higher rates of attention-deficit/hyperactivity disorder. Difficulty going to sleep and morning tiredness had greater adverse associations than snoring or night waking.

CONCLUSIONS. Given that sleep problems are very common, the adverse outcomes shown here could affect the transition to school for a very large number of preschoolers.

Key Words: sleep • preschool-aged children • behavior • health-related quality of life • injury • literacy • receptive language

Abbreviations: HRQoL—health-related quality of life • LSAC—Longitudinal Study of Australian Children • SDQ—Strengths and Difficulties Questionnaire • ADD—attention-deficit disorder • ADHD—attention-deficit/hyperactivity disorder • PedsQL—Pediatric Quality of Life Inventory 4.0 • PPVT-III—Peabody Picture Vocabulary Test, 3rd Edition • WAI—Who Am I? • CI—confidence interval

Accepted Aug 31, 2006.




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