Sleep patterns and sleep disturbances among Chinese school-aged children: Prevalence and associated factors

ObjectiveThe study aimed to (1) characterize sleep patterns and sleep disturbances among Chinese school-aged children, (2) determine the prevalence of their short sleep duration and sleep disturbances based on clinical cutoffs, and (3) examine possible factors (socio-demographic factors and emotional/behavioral problems) that are associated with sleep disturbances.MethodsA large representative sample of 912 children aged 6–14 years was recruited from Shenzhen, China. Their parents completed the Children’s Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ).ResultsThe mean bedtime was 9:45 pm (SD = 1 h 11 min), mean wake-up time was 7:03 am (SD = 31 min), mean sleep duration was 9 h 14 min (SD = 46 min), and 23.8% of the children had sleep duration <9 h. Overall, 69.3% of the children suffered from global sleep disturbances (CSHQ total score >41). Bedtime resistance (22.9%), sleep anxiety (22.1%), sleep duration (21%) and daytime sleepiness (20%) were the most prevalent sleep disturbances; followed by sleep disordered breathing (12.1%), parasomnias (9.4%), sleep onset delay (6.9%), and night waking (5.2%). The prevalence of specific sleep disturbances ranged from 3.2% (falling asleep while watching television) to 81.9% (awakening by others in the morning). Correlations between most domains of sleep disturbances and emotional/behavioral problems were statistically significant (p < 0.05 or p < 0.01). Hierarchical multiple regression analysis revealed that gender (β = 0.10, p < 0.01), school grade (β = −0.09, p < 0.05), co-sleeping (β = 0.25, p < 0.01), emotional symptoms (β = 0.24, p < 0.01), conduct problems (β = 0.09, p < 0.05), and hyperactivity (β = 0.17, p < 0.01) accounted for significant variance in CSHQ total score.ConclusionsShort sleep duration and sleep disturbances are prevalent among Chinese school-aged children. Sleep disturbances are associated with gender, school grade, co-sleeping, emotional symptoms, conduct problems, and hyperactivity.