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Sleep Problems in Early Childhood: Continuities, Predictive Factors, and Behavioral Correlates
Abstract
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.
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“Moreover, the occurrence of sleep problems in childhood does not appear to be transitory: developmental continuity in sleep problems has been documented from infancy to childhood, such that 41 % of infants identified as having sleep problems at 8 months experienced continuing difficulties at 3 years (Zuckerman et al. 1987).”
From Sleep Problems Across Development: A Pathway to Adolescent Risk Taking Through Working Memory (2015) · cites this paper as Zuckerman et al. 1987
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What affects the age of first sleeping through the night?
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Night-waking trajectories and associated factors in French preschoolers from the EDEN birth-cohort
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“However, studies establishing a link between maternal depression and child night-waking [1,7,37], measured depression in postpartum (between 8 and 24 months), simultaneously with night-waking measurements, whereas depressive symptoms were assessed in our study during pregnancy, which might explain the discrepancy.”
InfluentialThe influence of home-rearing environment on children's behavioral problems 3 years’ later
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“Zuckerman et al. (1987) and Tiesler and Heinrich (2014) also demonstrated that persistent sleep problems and prenatal nicotine exposure are tied to behavioral problems in children.”
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BackgroundChildhood sleep: assessments, risk factors, and potential mechanisms
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“Among the most common disturbances are frequent nighttime waking and bedtime difficulties such as inability to fall asleep [2, 12, 13, 21, 25].”
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Feeding and sleeping problems in infancy - a follow-up at early school age
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“Many other studies have found the same kind of relations (e.g. Zuckerman et al. 1987; Lavigne et al. 1999; Stein et al. 2001; Wolke et al. 2002; Paavonen et al. 2009).”
Reducing postnatal depression, anxiety and stress using an infant sleep intervention
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Nighttime Nurturing: An Evolutionary Perspective on Breastfeeding and Sleep
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“Second, a diagnosis of sleeping problems is not usually made before 6 months of age (Zuckerman et al., 1987); hence our assessments at 3 months reflect early symptoms of sleeping problems rather than a sleeping problem diagnosis.”
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Huang, X., Wang, H., Zhang, L.-J., & Liu, X. (2010) · Biological Rhythm Research · doi:10.1080/09291011003687940 · Cited by 24
“…of breast-feeding in spite of the fact that infants who are breastfed wake more frequently during the night than those who are bottle-fed (Zuckerman et al. 1987; Wright et al. 1983) and this increases the frequency with which breastfeeding mothers have to wake to feed their infants, a…”
BackgroundNight-waking and behavior in preschoolers: a developmental trajectory approach
Reynaud, È., Forhan, A., Heude, B., Charles, M.-A. A., Plancoulaine, S., Annesi‐Maesano, I., Bernard, J. Y., Botton, J., Charles, M.-A. A., Dargent‐Molina, P., et al. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2017.10.008 · Cited by 25
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Toward a practical definition of pediatric insomnia
Glaze, D. G., ROSEN, C. L., & Owens, J. A. (2002) · Current Therapeutic Research · doi:10.1016/s0011-393x(02)80100-x · Cited by 23
Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sul, Brazil
Reimão, R., Souza, J. C., Medeiros, M. M., et al. (1998) · Arquivos de Neuro-Psiquiatria · doi:10.1590/s0004-282x1998000500001 · Cited by 23
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“Nonetheless, despite the socio-cultural changes mentioned earlier, the associations between sleep disturbances and emotional/behavioural problems appear to have remained stable for more than three decades [60–62].”
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Pinato, L., Ribeiro, E. M., Leite, R. F. P., Lopes, T. E. C. F., Pessoa, A. L. S., Campos, L. M. G., Arantes, G. E. P. S., de Souza, A. L. D. M., & Giacheti, C. M. (2018) · SLEEP · doi:10.1093/sleep/zsy009 · Cited by 22
“problems should also be studied, since if not treated, these night-waking problems are persistent [41, 42] and lead to conse-”
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Schrei-, Schlaf- und Fütterstörung
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Survey of sleep in infants and young children in northern Taiwan
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Growth of Cognitive Skills in Preschoolers: Impact of Sleep Habits and Learning-Related Behaviors
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“For example, Zuckerman, Stevenson, and Bailey (1987) reported that sleep problems identified at 8 months of age were still seen in 41% of children at 3 years of age compared to 26% of children with no sleep problems at 8 months who also evidenced sleep problems at 3 years of age.”
BackgroundDevelopmental Changes in Ultradian Sleep Cycles across Early Childhood
Lopp, S., Navidi, W. C., Achermann, P., LeBourgeois, M. K., & Behn, C. D. (2017) · Journal of Biological Rhythms · doi:10.1177/0748730416685451 · Cited by 20
“…in sleep behavior, including a decline in total sleep duration, the elimination of daytime naps, and the emergence of behavioral sleep problems (Beltramini and Hertzig, 1983; Zuckerman et al., 1987; Iglowstein et al., 2003; Acebo et al., 2005; Crosby et al., 2005; Honaker and Meltzer, 2014).”
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Are children just small adults? The differences between paediatric and adult sleep medicine
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Children's ability to copy triangular figures is affected by their sleep-wakefulness rhythms
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Correlates of diurnal sleep patterns in infants of adolescent and adult single mothers
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Handling Parents' Concerns Regarding the Behavioural Treatment of Infant Sleep Disturbance
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Sleep and body mass index in infancy and early childhood (6‐36 mo): a longitudinal study
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“…sleep problems are not transient in nature and are typically sustained for months or even years if not treated (Jenni, Fuhrer, Iglowstein, Molinari, & Largo, 2005; Kataria et al., 1987; Richman, Stevenson, & Graham, 1975; Rich-man, Stevenson, & Graham, 1982; Zuckerman, Stevenson, & Bailey, 1987).”
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“Infant sleep duration in the last week was acquired by asking mothers question like: “What is the average total time slept during the day and at night of your baby in a 24-h period?” Infant sleep problems was defined as waking up three times or even more per night, or parents reporting “severe” disturbance proposed by…”
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“In addition, insufficient sleep and sleep problems have been associated with later obesity [11] and behavioral issues such as tantrums and other behavioral management problems [12].”
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“The last two categories were grouped into ‘ >2 nights/week ’ (Zuckerman, Stevenson, & Bailey, 1987).”
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“In a longitudinal study, Zuckerman, Stevenson, and Bailey (1987) found that 41% of children who had a night-awakening problem at 8 months still had a sleep problem at 3 years.”
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Dahl, R. E. (1996) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/s1056-4993(18)30347-x · Cited by 14
Blackham, A. L., McDaniel, J. R., Chauvin, I., Nelson, K. L., & Buboltz, W. C. (2019) · doi:10.36959/532/321 · Cited by 14
A Qualitative Study of How Preschoolers’ Problematic Sleep Impacts Mothers
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Volling, B. L. (2017) · Monographs of the Society for Research in Child Development · doi:10.1111/mono.12307 · Cited by 16
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The factor structure of the GHQ-30 for mothers with young children
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Self-citationBar, M., Efron, M., Gothelf, D., & Kushnir, J. (2015) · Sleep Medicine · doi:10.1016/j.sleep.2015.11.015 · Cited by 13
Boone, K. M., Rausch, J. R., Pelak, G., Li, R., Turner, A. N., Klebanoff, M. A., & Keim, S. A. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7902 · Cited by 12
Metadata
- Authors
- Zuckerman, B., Stevenson, J., & Bailey, V.
- Affiliations
- Boston University (US)
- ORCID
- Zuckerman, Barry
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 1987-11-01
- Volume
- 80
- Issue
- 5
- Pages
- 664-671
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2126897373
- Cited by
- 472
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 26 · 2023: 5 · 2022: 5 · 2021: 6 · 2020: 8 · 2019: 16 · 2018: 7 · 2017: 28 · 2016: 15 · 2015: 9 · 2014: 15 · 2013: 15 · 2012: 17
- FWCI
- 4.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- 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 › Pediatrics, Perinatology and Child Health › Infant Health and Development
- Keywords
- infant sleep problems, nocturnal awakenings, bedtime resistance, maternal depression, behavioral problems, tantrums, early childhood, longitudinal development, mother-child relationship
- MeSH terms
- Adult, Age Factors, Breast Feeding, Child Behavior, Child, Preschool, Depression, England, Ethnicity, Female, Humans, Infant, Longitudinal Studies, Sleep Wake Disorders, Socioeconomic Factors, Time Factors
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