Sleep disutbances and emotional/behavioral problems among Chinese school-aged children: prevalence and association

Abstract

Introduction Sleep disturbances and emotional/behavioral problems are highly prevalent in childhood across all societies, and they frequently present with other co-morbidities. However, little is known about these issues among Chinese school-aged children. Therefore, the objectives were to investigate the prevalence of sleep disturbances and emotional/behavioral problems, and their associations. Materials and methods The sample comprises 886 children (6–12 years old) recruited from normal elementary schools in Shenzhen, China, with a cluster stratified sampling procedure. Their parents completed the Children Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ), and some socio-demographic questions to assess the domains involved. Results Based on clinical cut-offs, 69.5% of parents perceived their children had global sleep disturbances, the prevalence of specific sleep disturbances ranged from 5.2% (night waking) to 23.1% (bedtime resistance); 11.5% of parents perceive their children had global emotional/behavioral problems, the prevalence of specific emotional/behavioral problems ranged from 8.5% (emotional symptoms) to 26.6% (peer problems). The correlations between most sleep disturbances and emotional/behavioral problems domains were statistically significant (∣r∣ = 0.01 ∼ 0.39, p 0.05 or 0.01). After controlling the effects of age, gender, parental education level, housing income, and co- sleeping, emotional symptoms ( ∣ Â = 0.26, p 0.01), conduct problems ( ∣ Â = 0.09, p 0.05) and hyperactivity ( ∣ Â = 0.17, p 0.01) account for 16% variance in sleep disturbances. Conclusion As in other societies, both sleep disturbances and emotional/behavioral problems among school-aged children frequently occurred in China, and sleep disturbances are associated with emotional/behavioral problems, especially emotional symptoms, conduct problems and hyperactivity. Our study suggests a need to prevent, detect, and invent sleep disturbances and emotional/behavioral problems among Chinese children, and provides reference data to researchers and professionals. Acknowledgements The authors thank the lovely children and their parents and teachers. We acknowledge Rui Ma (Nanshan Xuefu Primary School) for her help with data collection. We also appreciate the efforts of Lin Lin and her three classmates (Shenzhen University, China) in data entry.