Sleep Problems in Early Childhood: Continuities, Predictive Factors, and Behavioral Correlates
1 From the Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Boston City Hospital, Boston University School of Medicine, Boston, the Department of Psychology, University of Surrey, Guilford, England, and the Department of Child and Adolescent Psychiatry, West Middlesex University Hospital, London
A longitudinal study, based on interviews with 308 middle-class, preponderantly white mothers, provided an opportunity to evaluate the continuity, predictive factors, and behavioral correlates of sleep problems in young children. When their children were 8 months old, 10% of the mothers reported that their babies woke three or more times per night, 8% reported that the babies took an hour or more to settle after waking, 5% complained that their own sleep was severely disrupted by the child, and 18% reported at least one of these problems. At 3 years of age, 29% of the children had difficulty getting to bed and/or falling asleep or staying asleep. Of children with a sleep problem at 8 months of age, 41% still had a problem at 3 years of age, whereas only 26% of children without a problem at 8 months of age had a problem at 3 years of age (P < .001). Among children with sleep problems at 8 months of age, mothers' depressed feelings were the only measured demographic or psychosocial factor associated with persistent sleep problems (P = .02). A separate analysis indicated that these depressed feelings did not appear to be a consequence of the child's sleep problem. Future studies should evaluate how maternal depression interacts with other factors to result in persistent sleep problems. Children with persistent sleep problems were more likely to have behavior problems, especially tantrums (P < .02) and behavior management problems (P < .01), than were children without persistent sleep problems (P < .02). They were not more likely to have fears, anxiety, or other behavior problems measured by the Behavior Screening Questionnaire.
Key Words: sleep • behavior problem • depression
Submitted on March 17, 1986
Accepted on January 24, 1987
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