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Cited by 558Sleep and related disordersChild and Adolescent Psychosocial and Emotional DevelopmentObstructive Sleep Apnea Research

Sleep and Behavior Problems in School-Aged Children

Stein, Mark A., Mendelsohn, Janis, Obermeyer, William H., Amromin, Julie, Benca, Ruth·2001·Pediatrics
DOI 10.1542/peds.107.4.e60
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Abstract

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.

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Authors
Stein, M. A., Mendelsohn, J., Obermeyer, W. H., Amromin, J., & Benca, R.
Affiliations
  • Children's National (US)
  • University of Chicago (US)
  • University of Wisconsin–Madison (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2001-04-01
Volume
107
Issue
4
Pages
e60-e60
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.107.4.e60
OpenAlex
W2098591565
Cited by
558
References
31
Citations by year
2026: 8 · 2025: 9 · 2024: 8 · 2023: 13 · 2022: 12 · 2021: 15 · 2020: 23 · 2019: 29 · 2018: 19 · 2017: 22 · 2016: 25 · 2015: 34 · 2014: 34 · 2013: 34 · 2012: 36
FWCI
15.12
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Institute of Mental Health (K24MH001823, MH01823-02)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Keywords
child sleep problems, parasomnias, enuresis, daytime fatigue, insomnia, snoring, bed-sharing, nap duration, childhood psychopathology, socioeconomic status, parental attitudes, Child Behavior Checklist, pica, allergy, school-aged children, prevalence of sleep problems
MeSH terms
Age Factors, Attitude to Health, Mental Disorders, Child, Child Behavior Disorders, Child, Preschool, Circadian Rhythm, Factor Analysis, Statistical, Family Health, Female, Health Status, Humans, Male, Parents, Pediatrics, Perception, Surveys and Questionnaires, Sleep, Sleep Wake Disorders, Socioeconomic Factors, Wakefulness, Comorbidity, Prevalence, Multivariate Analysis

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