Frequent nocturnal awakening in children: prevalence, risk factors, and associations with subjective sleep perception and daytime sleepiness.

Liwen Li,Xinming Jin,Chonghuai Yan,Xiaoming Shen,Jiwei Ren,Lei Shi,Fan Jiang,Shenghui Li

doi:10.1186/1471-244x-14-204

Abstract

BackgroundNocturnal awakening is the most frequent insomnia complaint in the general population. In contrast to a growing knowledge based on adults, little is known about its prevalence, correlated factors, and associations with subjective sleep perception and daytime sleepiness in children. This study was designed to assess the prevalence and the correlate factors of frequent nocturnal awakening (FNA) among Chinese school-aged children. Furthermore, the associations of FNA with subjective sleep perception and daytime sleepiness were examined.MethodsA random sample of 20,505 children aged 5.00 to 11.92 years old (boys: 49.5% vs. girls: 50.5%) participated in a cross-sectional survey, which was conducted in eight cities of China. Parent-administered questionnaires were used to collect information on children’s sleep behaviors, sleep perception, and potential influential factors of FNA from six domains. Univariate and multivariate logistic regression models were performed.ResultsThe prevalence of FNA was 9.8% (10.0% for boys vs. 8.9% for girls) in our sampled children. The prominent FNA-related factors inclued biological health problems, such as overweight/obesity (OR = 1.70), chronic pain during night (OR = 2.47), and chronic respiratory condition (OR = 1.23), poor psychosocial condition, such as poor mental and emotional functioning (OR = 1.34), poor sleep hygiene, such as frequently doing exciting activities before bedtime (OR = 1.24) and bedtime resistance (OR = 1.42), and parents’ history of insomnia (OR = 1.31). FNA was associated with subjective poor sleep quality (OR = 1.24), subjective insufficient sleep (OR = 1.21), and daytime sleepiness (OR = 1.35).ConclusionFNA was associated with poor sleep and daytime sleepiness. Compared to sleep environment and family susceptibility, chronic health problems, poor psychosocial condition, and poor sleep hygiene had greater impact on FNA, indicating childhood FNA could be partly prevented by health promotion, by psychological intervention, and by improving sleep hygiene routine.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-244X-14-204) contains supplementary material, which is available to authorized users.

Highlights

Nocturnal awakening is the most frequent insomnia complaint in the general population
Prevalence of frequent nocturnal awakening (FNA) Our survey showed that the prevalence of FNA in our sampled children was 9.8%
It can be seen that, except for ethnicity, sleep arrangements, and food/drug allergy, all other factors were significantly associated with FNA in the univariate regression models

Summary

Introduction

Nocturnal awakening is the most frequent insomnia complaint in the general population. The exact etiology and pathophysiology of insomnia are still far from clear, a number of risk factors have been identified to be associated with the development of insomnia, such as age, gender, socio-economic status, sleep hygiene, sleep environment, stressful life events, and psychiatric and medical conditions [1,2,6,7,12,13,14]. Studies both in adults and children found that insomnia symptoms had the phenomenon of familial aggregation [15,16,17]. The interactions and co-existing of genetic factors, biological condition, and environments could play a pivotal role in the intrigue of insomnia symptoms [1,18]

Methods

Results

Discussion

Conclusion