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Sleep Duration and Regularity are Associated with Behavioral Problems in 8-year-old Children
Abstract
Background Relatively little is known about the significance of normal variation in objectively assessed sleep duration and its regularity in children's psychological well-being.Purpose We explored the associations between sleep duration and regularity and behavioral and emotional problems in 8-year-old children.Methods A correlational design was applied among an epidemiological sample of children born in 1998. Sleep was registered with an actigraph for seven nights (range 3 to 14) in 2006. Mothers (n = 280) and fathers (n = 190) rated their child's behavioral problems with the Child Behavior Checklist.Results Children with short sleep duration had an increased risk for behavioral problems, thought problems, and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition-based attention-deficit hyperactivity problems according to maternal ratings. Based on paternal ratings, short sleep duration was associated with more rule-breaking and externalizing symptoms. Irregularity in sleep duration from weekdays to weekends was associated with an increased risk for specifically internalizing symptoms in paternal ratings.Conclusions The results highlight the importance of sufficient sleep duration and regular sleep patterns from weekdays to weekends. Short sleep duration was associated specifically with problems related to attentional control and externalizing behaviors, whereas irregularity in sleep duration was, in particular, associated with internalizing problems.
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“The effect of sleep impairment differs greatly from one individual to another, but can be distressing to both the child and the family and may give rise to behavioural and learning difficulties in the daytime [103, 107].”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [107]
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“In typically developing children, several studies have used a definition of short sleep that was based on sleep duration of less than the 10th percentile for reported norms by age (Nixon et al., 2008; Owens, Mehlenbeck, Lee, & King, 2008; Paavonen et al., 2009; Pesonen et al., 2010).”
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“Notably, some studies 25,33 did not control for known confounding variables such as socioeconomic status, 73 maternal mental health, 78 and parenting effects or effects of bedtime routines, 79 which may explain some of the variations in the cognition-related findings.”
Temporal Associations between Daytime Physical Activity and Sleep in Children
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“shows the characteristics of the study sample by gender. Over half of the children came from families with a high level of parental education. As reported previously”
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“While guidelines have been established for children with typical development [21, 22], it is still unclear whether children with ASD require more, less, or similar amounts of sleep compared to typically developing peers.”
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“, comparatively shorter sleep durations, lower sleep efficiency, and erratic sleep schedules) and can lead to problems in cognitive (Buckhalt, El-Sheikh, Keller, & Kelly, 2009), emotional (Chorney, Detweiler, Morris, & Kuhn, 2008), and behavioral adjustment domains (Pesonen et al., 2010).”
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“Regular sleep timing is often recommended by interventions that aim to improve sleep (Bei et al., 2013; Moseley and Gradisar, 2009), and studies on younger children have associated more variable sleep patterns with poorer emotional (Pesonen et al., 2010) and physical (Spruyt et al., 2011) health.”
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“Several recent studies in larger population samples confirmed that short sleep duration is associated with problems related to attentional control and hyperactivity/impulsivity (Paavonen et al., 2009; Pesonen et al., 2010; Touchette et al., 2009).”
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Self-citationChanges in bedtime schedules and behavioral difficulties in 7 year old children
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“…(for a review see Wolfson & Carskadon, 2003), problems with concentrating (Brand, Hatzinger, Beck, & Holsboer-Trachsler, 2009), and contributes to behavioral problems (Bates, Viken, Alexander, Beyers, & Stockton, 2002; Pesonen et al., 2009; for inconsistent findings, see Moore et al., 2009).”
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“, 2011), children (Pesonen et al., 2010), adolescents (Gregory and O’Connor, 2002), and adults (Gregory et al.”
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“Research has also highlighted the association between sleep problems and externalizing problems, including delinquency (Clinkinbeard, Simi, Evans, & Anderson, 2011; Owens, Wang, Lewin, Skora, & Baylor, 2017; Pesonen et al., 2010; Rubens et al., 2014).”
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“In 2006, 413 children and their parents still living close to or in Helsinki were invited to participate in a follow-up study (Pesonen et al., 2009; Räikkönen et al., 2010a, 2009, 2010b; Strandberg et al., 2001) and 321 (77.”
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“This information is crucial in order to understand whether the effect of the individual circadian rhythm on mental health is independent of the actual sleep characteristics, which are often associated with mental wellbeing in previous studies among children and adolescents (Pesonen et al., 2010; Tarokh et al., n. d.;…”
BackgroundSelf-citationSleep patterns and the risk for ADHD: a review
Gruber, R. (2012) · Nature and Science of Sleep · doi:10.2147/nss.s31269 · Cited by 66
“Different studies use different objective actigraphy 58,59 and polysomnography 14,61 or subjective parental report 15–18, 20,”
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Sleep and mental health in children and adolescents
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“Several studies have used a definition of short sleep that was based on sleep durations of less than the 10th percentile for reported norms by age (Nixon et al., 2008; Owens, Mehlenbeck, Lee, & King, 2008; Paavonen et al., 2009; Pesonen et al., 2010).”
MethodInfluentialCalhoun, S. L., Fernández‐Mendoza, J., Vgontzas, A. N., Mayes, S. D., Liao, D., & Bixler, E. O. (2016) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-016-0166-4 · Cited by 54
“This definition of objective short sleep duration is commensurate with that used in our previous study (Fernandez-Mendoza et al. 2014) and other studies using actigraphy data, a more typical representation of habitual sleep duration (Pesonen et al. 2010; Raikkonen et al. 2010).”
InfluentialSleep quality subtypes predict health-related quality of life in children
Magee, C., Robinson, L. D., & Keane, C. A. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2017.04.007 · Cited by 48
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“%) agreed to participate (M = 8.1, SD = 0.3 years, range 7.4—8.9 years) (Pesonen et al., 2009a; Räikkönen et al., 2009, 2010a).”
MethodInfluentialSelf-citationPoor Sleep and Cardiovascular Function in Children
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Self-citationSleep in Children With Disruptive Behavioral Disorders
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“Many earlier studies of epidemiological samples, other normative samples, and of samples from sleep clinics have linked inadequate sleep to difficulties with attention, impulse control, and behavioral regulation (Aronen et al., 2000; Beebe, 2011; Pesonen et al., 2010; Sadeh, Gruber, & Raviv, 2002; Steenari et al., 200…”
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“…typically developing school-aged children to map the relationship between sleep and numerous aspects of daytime functioning including inattention, school performance, conduct problems, and general internalizing symptoms (Gruber et al., 2014; Holley, Hill, & Stevenson, 2011; Pesonen et al., 2010).”
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“Sleep movement [55,56], regularity of sleep [57,58], sleep disturbances [20], and sleep pressure [59] were used in sleep research to evaluate sleep patterns.”
Methodvan Veen, M., Lancel, M., Şener, O., Verkes, R., Bouman, E. J., & Rutters, F. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101661 · Cited by 44
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Study protocol RapMusicTherapy for emotion regulation in a school setting
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“(El-Sheikh & Buckhalt, 2005) and sleep duration and regularity associated with behavioral problems (Pesonen et al., 2010) can be studied.”
BackgroundReynolds, K. C., Patriquin, M. A., Alfano, C. A., Loveland, K. A., & Pearson, D. A. (2017) · Research in Autism · doi:10.1016/j.rasd.2017.04.003 · Cited by 37
“…with impairments in academic or occupational achievement (Dewald, Meijer, Oort, Kerkhof, & Bögels, 2010), emotional and behavioral functioning (Pesonen et al., 2010), family cohesion (Bell & Belsky, 2008; Simard, Nielsen, Tremblay, Boivin, &Montplaisir, 2008), and neuropsychological abilities…”
BackgroundBélanger, M., Bernier, A., Simard, V., Desrosiers, K., & Carrier, J. (2015) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2015.1079782 · Cited by 39
“However, studies with older children have repeatedly shown that sleep duration also plays an important role for emotion regulation and behavioral adjustment (e.g., Paavonen et al., 2009; Pesonen et al., 2010).”
BackgroundA developmental perspective on sleep consistency: Preschool age through emerging adulthood
Nicholson, L. M., Bohnert, A. M., & Crowley, S. J. (2022) · Behavioral Sleep Medicine · doi:10.1080/15402002.2021.2024192 · Cited by 30
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“An emerging body of research also indicates that insufficient sleep and other indices of sleep disturbances are associated with externalizing problems, including aggression, substance use, and delinquency, among children and adolescents (e.g., Aronen, Paavonen, Fjallberg, Soininen, & Torronen, 2000; Gregory & O’Connor…”
BackgroundIncome, ethnicity, and sleep: Coping as a moderator.
El‐Sheikh, M., Kelly, R. J., Sadeh, A., & Buckhalt, J. A. (2014) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/a0036699 · Cited by 27
“Insufficient (Pesonen et al., 2010) and poor sleep continuity (Sadeh, Raviv, & Gruber, 2000) are highly prevalent in children.”
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Muller, D., Paine, S., Wu, L. J., & Signal, T. L. (2019) · Sleep Health · doi:10.1016/j.sleh.2019.05.004 · Cited by 26
Ali, N., Rigney, G., Weiss, S. K., Brown, C. A., Constantin, E., Godbout, R., Hanlon‐Dearman, A., Ipsiroglu, O., Reid, G. J., Shea, S. E., et al. (2018) · Sleep Health · doi:10.1016/j.sleh.2017.12.008 · Cited by 24
“Participants agreed that the intervention should include: (1) modifications for nonverbal children; (2) considerations for children with CP who experience pain at night; (3) information about dealing with anxiety, (4) modifications for communication difficulties; (5) special considerations for children who are enteral…”
BackgroundMethodInfluentialGrowth in Body Mass Index From Childhood Into Adolescence
El‐Sheikh, M., Bagley, E. J., Keiley, M. K., & Erath, S. A. (2014) · The Journal of Early Adolescence · doi:10.1177/0272431613519499 · Cited by 27
“Insufficient (Hart, Larose, Fava, James, & Wing, 2012; Pesonen et al., 2010) and poor quality sleep (Sadeh, Dahl, Shahar, & Rosenblat-Stein, 2009) are highly prevalent in youth, and literature establishing their links with BMI is on the rise.”
BackgroundJust five more minutes please: electronic media use, sleep and behaviour in young children
Séguin, D. G., & Klimek, V. (2015) · Early Child Development and Care · doi:10.1080/03004430.2015.1071528 · Cited by 22
“An epidemiological study of 8-year-old children by Pesonen et al. (2010) revealed a similar negative correlation between sleep duration and problem-solving ability, attention and ADHD-like symptoms.”
BackgroundSleep Disturbances and Behavior Problems in Children With and Without Arthritis
Ward, T. M., Sonney, J., Ringold, S., et al. (2014) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2014.03.022 · Cited by 22
“Previous studies report associations between more disturbed sleep including trouble falling asleep and bedtime resistance, and more anxious/withdrawn behavior (Gregory et al., 2005; Pesonen et al., 2010; Touchette, et al., 2012).”
BackgroundSleep in Infancy Predicts Gender Specific Social-Emotional Problems in Toddlers
Saenz, J., Yaugher, A. C., & Alexander, G. M. (2015) · Frontiers in Pediatrics · doi:10.3389/fped.2015.00042 · Cited by 21
“Moreover, short sleep durations have been associated with more attention and externalizing problems, while irregularity in sleep duration has been associated with more internalizing problems in 8-year-old children (11).”
BackgroundPhysical Activity and Psychiatric Problems in Children
Martikainen, S., Pesonen, A., Lahti, J. M. T., et al. (2012) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2012.03.037 · Cited by 20
Self-citationPesonen, A., Martikainen, S., Kajantie, E., Heinonen, K., Wehkalampi, K., Lahti, J. M. T., Strandberg, T. E., & Räikkönen, K. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.07.005 · Cited by 21
Self-citationSleep and psychiatric symptoms in young child psychiatric outpatients
Huhdanpää, H., Klenberg, L., Westerinen, H., Fontell, T., & Aronen, E. T. (2017) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104517718366 · Cited by 22
“Population-based studies have shown that sleep problems are strongly associated with many types of psychiatric symptoms in preschool- and schoolaged children (Calhoun et al., 2016; Maasalo et al., 2016; Paavonen et al., 2002; Pesonen et al., 2010; Reid et al., 2009; Vélez-Galarraga et al., 2016).”
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“[15] found that short sleep duration and other sleep difficulties in 280 children aged eight years old were associated with higher hyperactivity/impulsivity scores from parent‐reports.”
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“, 2007, 2009) and rule-breaking behaviors (Pesonen et al., 2010), reduced sleep at age two was associated with greater externalizing behavior problems a year later.”
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Metadata
- Authors
- Pesonen, A.-K., Räikkönen, K., Paavonen, E. J., Heinonen, K., Komsi, N., Lahti, J., Kajantie, E., Järvenpää, A.-L., & Strandberg, T.
- Affiliations
- University of Helsinki (FI)
- Finnish Institute for Health and Welfare (FI)
- Oulu University Hospital (FI)
- Corresponding author
- Pesonen, Anu-Katriina
- ORCID
- Venue
- International Journal of Behavioral Medicine
- Published
- 2009-10-21
- Volume
- 17
- Issue
- 4
- Pages
- 298-305
- ISSN
- 1070-5503 (ISSN-L)
- 1532-7558
- OpenAlex
- W2008428610
- Semantic Scholar
- 74dc6cbcb519961a2a78767921efc0f194b4ff45
- Cited by
- 110
- References
- 32
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 4 · 2022: 8 · 2021: 3 · 2020: 3 · 2019: 11 · 2018: 3 · 2017: 12 · 2016: 9 · 2015: 9 · 2014: 14 · 2013: 7 · 2012: 10
- FWCI
- 9.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- sleep duration, sleep regularity, sleep irregularity, behavioral problems, emotional problems, attention deficit hyperactivity disorder, internalizing problems, externalizing problems, rule violations, children, actigraphy, Child Behavior Checklist, parent ratings, attentional control
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Child, Child Behavior Disorders, Fathers, Female, Finland, Humans, Internal-External Control, Male, Mothers, Surveys and Questionnaires, Registries, Risk Factors, Sampling Studies, Sleep, Sleep Wake Disorders, Time Factors
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